Multicenter, Randomized Trial to Determine the Effect of Therapeutic Riding, on a Group of People With Arthritis
Condition: Arthritis
MeSH terms: Arthritis
Study type: Interventional

Summary: 
      The aim of this job is to evaluate the possible changes in the state of health of 10
      indi-viduals diagnosed with arthritis who follow a standardised Therapeutic Riding treatment,
      as an experimental group, versus 10 patients who follow a standardised physical exercise
      programme.

      The intervention guidelines for both groups are established in a programme of 12 ses-sions in
      total, 6 weeks in duration, twice a week and a duration of 45 minutes each ses-sion.

      The effectiveness of the intervention program will be evaluated in terms of pain, joint
      mobility, static and dynamic balance, gait, capacity for effort and quality of sleep.
    

Detailed description: 
      Arthritis is inflammation of the joints, causing pain, stiffness and limitations in
      activities of daily living, with decreased quality of life.

      To improve musculoskeletal and functional health, the World Health Organization recommends
      physical activity, including aerobic physical activity, to improve strength, flexibility and
      balance. Non-pharmacological recommendations include physical conditioning, which can be
      provided through Therapeutic Riding. Advances and research in the area of Equine Assisted
      Interventions (Hippotherapy and Therapeutic Riding) have led to a progressive move away from
      empirical observation to scientific evidence. This is why it is necessary to develop
      scientific studies that contribute to scientific evidence. This has motivated an
      international group of experts to design and develop an international clinical trial to
      collect data on therapeutic horse riding in a group of adults with arthritis. Starting with a
      pilot project, which is the one presented here.

      The established hypothesis is that people diagnosed with arthritis who follow a standardised
      Therapeutic Riding treatment, as an experimental group, improve their state of health in
      relation to those who follow a protocolised physical exercise table.

      Main objectives: To evaluate the possible changes in the state of health of individuals
      diagnosed with arthritis who follow a standardised Therapeutic Riding treatment, as an
      experimental group, versus patients who follow a standardised physical exercise programme and
      to analyse the effectiveness of the Therapeutic Riding treatment in patients diagnosed with
      arthritis in terms of pain, joint mobility, static and dynamic balance, gait, capacity for
      effort and quality of sleep. Furthermore, the aim is to monitor and establish the
      methodology, protocols and phases in the Therapeutic Riding treatment of patients with a
      diagnosis of arthritis, as well as to contribute to assessment protocols.

      Methodology: In order to achieve the objectives, a double-blind randomised pilot project is
      proposed in a sample of 10 subjects participating in a therapeutic horse riding programme and
      10 subjects participating as a control group in a physical exercise programme. The
      intervention guidelines for both groups are established in a programme of 12 sessions in
      total, 6 weeks in duration, twice a week and a duration of 45 minutes each session. All
      interventions will be carried out by specialist professionals. Pain will be assessed using
      the EVA scale and questionnaires; joint range in the back, hips, knees and shoulders using
      goniometry; postural stability using the Romberg test on pressure platforms; gait analysis
      using inertial sensors during the 10-metre test; capacity for effort using the 2-minute walk
      test and the use of a smartwatch; and sleep quality using the PittsBurg sleep quality test
      and MOVOI's TicSleep tool. All assessments are non-invasive.

      The project is coordinated by AINISE (International Alliance for Healthy Equine Interaction)
      and involves an international scientific group led by Dr Íñigo Hernández. It is made up of
      volunteer expert researchers from 8 countries. Germany, Argentina, Spain, France, Malta,
      Mexico, Portugal, USA, in which the research group Physioh of the University of Extremadura
      participates. The project is based on the published trial of Dr. Sharon White Lewis
      University of Missouri-Kansas City. "A Randomized controlled trial comparing equine-assisted
      therapy and exercise education for adults and older adults with arthritis". And it is
      currently supported to start the pilot programme by the Norwegian Ann Kern-Godal Foundation.
    

Intervention name(s): Horse-assisted therapy; Physical exercise
Intervention type(s): Procedure; Procedure
Intervention description(s): 12 horse-assisted therapy sessions (45 mins each) for 6 weeks.
Each session will comprise the next stages:
Groundwork, Approachment and preparation of the horse, Warm up exercises
Development of the main part (riding):
Introduction - beginning: Breathing control and body awareness, maintain sitting (riding position) while walking on the horse, perceiving the movement Exercises for the postural and balance control: Variations in the walking of the horse, realize different figures in the arena (circles, serpentines, change direction…), Stopping and Walking, Arms situation combined with the movement of the horse All exercises are determined in the track design protocol Exercises for the acquisition of motion skills: Finished the riding with relaxation activities. Final part: Dismount the horse, Unsaddled and unbridle, feedback and goodbye procedure.; 12 physical exercise sessions (45 mins each) for 6 weeks. Each session Each session Lessons will be held by physical activity professionals. The proposed exercises are focussed on improving the articular movements, aerobic resistance and the proprioception, always on the premises of No Pain.
Lessons will be divided in three parts :
1. Warmup - 2. Main part - 3. Return to calm
Lessons will be hold online
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Two groups of participants: i) experimental group, ii) active control group
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Therapeutic riding; Horse-assisted therapy; Arthritis treatments; Therapeutic exercise; Inertial Measurement Unit; Gait analysis; Sleep analysis; Pain analysis; Joints analysis