Rehabilitation Through Hippotherapy for the Management of Women After Primary Treatment of Breast Cancer
Condition: Breast Cancer Female; Side Effects; Psychological Distress; Physical Disability
MeSH terms: Breast Neoplasms
Study type: Interventional

Summary: 
      Breast cancer is the most common women's cancer and the third leading cause of death.
      Advances in prevention, detection and primary treatment have improved overall survival
      leading to its growing acceptance as a long-term disease. Following the announcement of
      breast cancer, but also after primary treatment, some symptoms appear directly compromising
      psychic and physical spheres. Hippotherapy is an emerging specialized rehabilitation approach
      performed through specially trained horses by accredited health professionals. The proposed
      hippotherapy program offers key elements for physical, psychic and social reinforcement,
      complementing conventional care. The aim is to provide patients with tools to consolidate
      their self-awareness and thus strengthen their ability to cope with the disease.
    

Detailed description: 
      Following the announcement and evolution of breast cancer, but also in response to primary
      treatment, some symptoms appear to directly compromise the psychic and/or physical sphere of
      the individual. Current rehabilitation programs are not sufficiently oriented to solve most
      of these symptoms. Hippotherapy is an emerging specialized rehabilitation approach, performed
      on a specially trained horse by accredited health professionals (e.g. medical doctors,
      physical therapists, occupational therapists, psychomotricians, speech-language pathologists,
      clinical psychologists). The horse is an excellent collaborator in situations of physical and
      psychic disability, whether temporary or consolidated. It provides human support for
      impairments (anatomical or physiological), activity limitations, and participation
      restrictions as defined by WHO. Hippotherapy has a direct action on the sensorimotor
      capacities of the individual but also on his cognitive abilities, i.e. attention, memory,
      psychomotricity, emotion, perception, sequencing of complex movements, self-experience,
      psychic temporality. Overall, the strong solicitation of the sensory and motor spheres
      promotes and interacts with the mechanisms related to the execution of tasks in the cognitive
      domain through the interactions of several neural networks. A randomized simple-blinded
      controlled trial on hippotherapy versus conventional care will be carried out. After giving
      their informed consent, patients will be enrolled in the trial. The 6-months program includes
      1-week daily sessions of hippotherapy by the end of the initial cancer treatment followed by
      three short 2-days sessions with an interval of 2 months between each. The study will focus
      on 86 patients. Recruitment will be done over a 48-months' period. A battery of
      self-administered questionnaires will allow to study both the functional and psychological
      outcome. The primary end point will be quality of life, whereas body image, fatigue, anxiety,
      depression and cognitive performances will be the secondary end points.
    

Intervention name(s): Hippotherapy; Conventional therapy
Intervention type(s): Other; Other
Intervention description(s): The horse is an excellent collaborator in situations of physical and mental disability, whether temporary or consolidated. It provides support to humans towards an impairment (anatomical or physiological), a disability, or a restriction of participation as defined by the WHO in 2001. Hippotherapy has a direct action on the sensorimotor capacities of the individual but also on their cognitive capacities, such as attention, memory, psychomotricity, emotions, perceptions, the sequencing of complex movements, or the experience of oneself and the functions of time. Overall, the strong demand from the sensitive, sensory and motor spheres promotes and interacts with the mechanisms linked to the execution of tasks in the cognitive domain (memory, attention, executive functions, speed of information processing, etc.) through the interactions of several neural networks.; Personalized care pathway after/during the cancer treatment takes into consideration all aspects of the disease, allowing to coordinate the intervention of the professionals that the patient might need in order to better preserve her quality of life while answering questions about cancer, prevention, treatments, or life after illness. The MIS mobilizes a chain of skills and support by providing patients: radiologists, pathologists, surgeons, oncologists, and radiation therapists, nuclear doctors, physiotherapists, cardiologists, psychologists, psychiatrists, nurses, social workers, nutritionists, dieticians, onco-geneticists, osteopaths, homeopaths, acupuncturists, sexologists, addictologists, algologists, and vascular physicians.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: A randomized simple-blind controlled trial on efficacy of the hippotherapy treatment against conventional one will be conducted. Patients selected will be randomly divided into 2 groups: hippotherapy treated group versus control group. To ensure that patients in the 2 groups are similar in all respects, except for the planned intervention, the randomization will be stratified by age representing respectively two stages: 1) Pre-menopause; 2) Post-menopause; and by type of treatment: A) Single treatment: surgery or chemotherapy or hormone therapy or radiotherapy; B) Two or more treatments.
Masking: Single (Investigator)
Primary purpose: Supportive Care
Keywords: Breast cancer; Hippotherapy; Global rehabilitation; Quality of life; Body image; Cognitive impairment; Fatigue; Anxiety and depression; Physical impairment; Psychological reinforcement; Social reintegration