Equine-facilitated therapy has been shown to improve functioning in patients with low back pain

Patients with chronic low back pain may benefit from equine-facilitated therapy (EFT), according to a new study from the University of Eastern Finland. During a 12-week intervention, perceived pain levels decreased and daily functioning improved among EFT participants. The findings have been published in Frontiers in veterinary medicine.

The study was designed to evaluate the impact of EFT on perceived physical performance, pain level, pain acceptance, depression and anxiety, and quality of life. The study was conducted in Finland and involved a total of 22 men and women suffering from low back pain.

The 12-week intervention showed that EFT can be used to improve people’s daily functioning. A statistically significant improvement was observed in sleep, reaching and bending forward, and prolonged standing.

By gradually increasing the exercise load, it was also possible to reduce the amount of pain experienced by patients, increase their participation in social activities and improve their psychological well-being. During a six-month follow-up, only two of the chronic pain patients returned to the clinic because of pain.

In the follow-up interviews, patients highlighted the perceived physical, psychological, and social effects of EFT, demonstrating that the intervention had a comprehensive impact on their rehabilitation.

A statistically significant quantitative improvement was observed for mental health: during the intervention, the patients’ social functioning improved and their depression decreased – something that was also reflected in the interviews: “The group effect created was a positive experience.”

“Chronic back pain is a multidimensional experience that involves not only physical pain, but also learned thought patterns and emotional responses. Physical therapy has traditionally been recommended for the rehabilitation of patients with chronic pain, as exercise has been shown to be the most effective way to treat back pain. Hippocrates already recommended the use of horse movements as a form of physical and psychological rehabilitation for humans, but the exact reason behind the rehabilitation effect has remained unknown until now,” says doctoral researcher Sanna Mattila-Rautiainen from the University of Eastern Finland .

A horse’s gait encourages the right kind of lumbar movement

Equine-facilitated therapy brought relief to patients with chronic pain who had been incapacitated for several years.

“Patients with chronic pain tend to avoid the pain sensation that comes from moving the affected part of their body. However, if someone with low back pain is on a moving horse, they will eventually move to the gait of the horse, which encourages the right kind of lumbar movement,” says Mattila-Rautiainen.

In the intervention, sitting on a horse up to 100 walking-like movements per minute was found to be beneficial:

“The movement felt good – the horse moved me correctly.”

“There’s no other way to practice like this.”

Improper movements perpetuate a vicious cycle of pain and affect people’s physical, psychological and social well-being. The patient’s compatibility with the horse’s movements, along with an appropriate exercise load, played a key role in the intervention. The exercise load was gradually increased, within the limits of the pain. Patients’ opinions on the choice of their horse and equipment were also listened to.

In Finland, equine-facilitated therapy is a form of medical rehabilitation that has been subsidized by the country’s social insurance institution since 2019. However, equine-facilitated therapy is less well established in the rehabilitation of musculoskeletal disorders. Mattila-Rautiainen has more than 20 years of experience using EFT in the rehabilitation of patients with back pain, working closely with regional social welfare and health authorities in the Kainuu region, Finland.