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Open AccessSystematic Review
Effects of Hippotherapy and Mechanical Horse Riding Simulators in People with Stroke: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
by
Estefania Villar-Paredes
Estefania Villar-Paredes
Amaranta De Miguel-Rubio
Amaranta De Miguel-Rubio 
,
Alvaro Alba-Rueda
Alvaro Alba-Rueda
David Lucena-Anton
David Lucena-Anton
1
Department of Nursing and Physiotherapy, University of Cadiz, 11009 Cadiz, Spain
2
Department of Nursing, Pharmacology and Physiotherapy, University of Cordoba, 14004 Cordoba, Spain
3
Biomedical Research and Innovation Institute of Cadiz (INiBICA), 11009 Cadiz, Spain
*
Author to whom correspondence should be addressed.
Appl. Sci. 2026, 16(12), 6023; https://doi.org/10.3390/app16126023 (registering DOI)
Submission received: 23 April 2026
/
Revised: 3 June 2026
/
Accepted: 12 June 2026
/
Published: 14 June 2026
Abstract
Stroke is a neurological disease caused by a sudden, localized vascular lesion in the central nervous system. The objective of this systematic review (SR) was to analyze the effects of complementary interventions such as hippotherapy (HPT) and mechanical horse riding simulators (MHRSs) compared to conventional physiotherapy, no treatment, or other therapies in individuals with this condition. A literature search was conducted in six databases from January to November 2025. The PICOS research strategy was used to establish the study eligibility criteria. The Cochrane RoB 2 tool was used to assess the risk of bias, and the PEDro scale was used to evaluate the methodological quality of the studies. Meta-analyses, including calculating mean differences (MDs) and 95% confidence intervals (CIs), were performed using Cochrane Review Manager (RevMan). Ten articles were included in the SR, and seven in the meta-analysis. Meta-analyses revealed significant differences in dynamic balance with the Berg Balance Scale in HPT (MD = 1.62; 95% CI = 0.72–2.51; p < 0.01) and MHRSs (MD = 1.21; 95% CI = 0.06–2.36; p = 0.04). In conclusion, HPT and MHRSs may provide potential benefits for functional mobility in people with stroke. However, the limited number of studies makes it difficult to draw definitive conclusions.
Share and Cite
MDPI and ACS Style
Villar-Paredes, E.; De Miguel-Rubio, A.; Alba-Rueda, A.; Lucena-Anton, D.
Effects of Hippotherapy and Mechanical Horse Riding Simulators in People with Stroke: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Appl. Sci. 2026, 16, 6023.
https://doi.org/10.3390/app16126023
AMA Style
Villar-Paredes E, De Miguel-Rubio A, Alba-Rueda A, Lucena-Anton D.
Effects of Hippotherapy and Mechanical Horse Riding Simulators in People with Stroke: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Applied Sciences. 2026; 16(12):6023.
https://doi.org/10.3390/app16126023
Chicago/Turabian Style
Villar-Paredes, Estefania, Amaranta De Miguel-Rubio, Alvaro Alba-Rueda, and David Lucena-Anton.
2026. "Effects of Hippotherapy and Mechanical Horse Riding Simulators in People with Stroke: A Systematic Review and Meta-Analysis of Randomized Controlled Trials" Applied Sciences 16, no. 12: 6023.
https://doi.org/10.3390/app16126023
APA Style
Villar-Paredes, E., De Miguel-Rubio, A., Alba-Rueda, A., & Lucena-Anton, D.
(2026). Effects of Hippotherapy and Mechanical Horse Riding Simulators in People with Stroke: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Applied Sciences, 16(12), 6023.
https://doi.org/10.3390/app16126023
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