Vall d’Hebron studies the benefits of horse-assisted rehabilitation in recovery of children after cancer treatment

Children who survive cancer can have medium and long-term sequelae derived from the disease itself and the oncological therapy they have to face. For this reason, it is important to monitor them, not only to anticipate relapse or the appearance of another tumor, but also to analyze these sequelae. With the aim of improving the quality of life of these children, new research will analyze the benefits of horse-assisted rehabilitation. This is a study promoted and financed by Fundación Real Club de Polo de Barcelona, that is carried out by the Vall d'Hebron University Hospital together with Escuelas Universitarias Gimbernat in collaboration with Fundación Federica Cerdá and the Spanish Association Against Cancer (AECC).

Hippotherapy or horse-assisted therapy is a discipline that uses the relationship between the person and the horse to improve both physical parameters (such as motor function, position, balance, walking...) and psychological parameters. This therapy has already shown benefits in previous studies in people with cerebral palsy, autism spectrum disorders, or in adults after cancer therapy. Now, this new study called “Riding Life” wants to analyze whether horse-assisted rehabilitation reduces the medium and long-term impact of oncological therapy in children and adolescents who have suffered from cancer affecting the central nervous system.

The clinical trial, which is already underway in Vall d’Hebron, has included 15 participants between the ages of 4 and 18 so far, between 6 months and a year after being discharged from cancer therapy. Half of them follow horse-assisted therapy, in addition to the treatment and follow-up guidelines indicated for their disease, while the other half only continue with the usual treatment and follow-up.

Rehabilitation consists of 24 individual sessions, one per week. With the help of a hippotherapy-specialized rehabilitator, children do various activities with the horse to stimulate memory and motor skills as well as improve their mood. In the sessions, children go to the stable, do basic hygiene of the horse, brush it, put the saddle on it, feed it, ride it, and do games and rehabilitation activities on top of the animal. "During the study, we analyzed physical variables such as balance and coordination, and other psychic variables such as general health, anxiety, depression, mood, sociability, etc., to see if their quality of life improves", highlights Dr. Anna Llort, associate of the Pediatric Oncology Service at the Vall d'Hebron University Hospital and researcher at the Translational Research on Cancer in Childhood and in Child and Adolescent Cancer group at the Vall d’Hebron Research Institute (VHIR). “So far we are verifying that both the experience of riding a horse and the interaction with it as well as the movement on the animal make these aspects improve. At the same time, we hope that therapy provides emotional benefits improving self-esteem and favoring patient’s mood", says Anna Saló, psychologist at the Pediatric Oncology Service of the Vall d'Hebron University Hospital and the Translational Research on Cancer in Childhood and in Child and Adolescent Cancer group at the VHIR.

“During riding, the horse transfers its three-dimensional movement to the rider, which allows joint and muscular work from the pelvis through the sitting bones to the first cervical vertebra, respecting the physiology of the human trunk. This causes proprioceptive and exteroceptive functions to be requested and used at the same time. These children become aware of their situation and adapt until they reach normal movement thanks to the cadence of the horse’s coordinated gait”, explains Teresa Xipell, physiotherapist and director of hippotherapy at the Federica Cerdá Foundation. “In addition, the horse and the natural environment make these activities highly motivating for them”, she adds.

The “Riding Life” project, subsidized by Fundación Real Club de Polo de Barcelona, has as a relevant purpose the dissemination of the benefits of the symbiosis between the horse and the human being throughout history. “In a meeting with Fundación Federica Cerdá, we decided to undertake this project that connects with a long relationship between medicine and the horse. It began with Hippocrates whose name, not in vain, means “Horse Dominator” and continued with a long tradition of illustrious practitioners of medical science who pondered the benefits of horse riding for the human body. Today, the qualities of this discipline are already evident all over the world”, explains Emilio Zegrí, president of Fundación Real Club de Polo de Barcelona, who acknowledges that “we cannot think of a more beautiful project so that people know what our friends, the horses, can give to us”.

The clinical trial began at the end of 2019 and had to be stopped at the beginning of the pandemic. "The families really wanted to come back to therapy because they observed a benefit in the evolution both in the physical state of their children and in their self-confidence", explains Dr. Llort, who appreciates the effort on the part of the families as the sessions require a high availability and flexibility to attend the equestrian where the rehabilitation is done. Now, the sessions have been resumed and the objective is to increase the sample so that more children can benefit and researchers can analyze what is the impact that horse-assisted therapy can have.