Author(s): ROSINY, F., BRAUNSMANN, L., PÖHLAU, D., ABEL, T., KNAEPEN, K., STOLZ, I., Institution: GERMAN SPORT UNIVERSITY COLOGNE, Country: GERMANY, Abstract-ID: 2191

INTRODUCTION:
Multiple sclerosis (MS), a chronic disease of the central nervous system, is characterized by a range of symptoms and impairments that affect performance in everyday activities and social participation. Targeted promotion of activities and participation can be achieved through exercise-based interventions, while the implementation of Patient-Reported Outcomes provide valuable insights into treatment effects at the individual level. This study investigates the effectiveness of hippotherapy on the components activities and participation of the International Classification of Functioning, Disability and Health (ICF) developed by the World Health Organization (WHO) in individuals with multiple sclerosis.
METHODS:
This investigation is part of the MS-HIPPO II study, a prospective, multicenter, randomised controlled trial. A total of 103 participants with MS (age: 55.7±9.79 years; 91 women, 12 men; Expanded Disability Status Scale (EDSS) between 4.0 and 6.0; mean EDSS: 5.36 ±0.71) were included. Participants were randomly assigned to either the intervention group (IG: 12 weeks of hippotherapy (DKThR)®, additional to treatment as usual; n = 55) or the control group (CG: treatment as usual; n = 48). Global functioning was assessed with the ICF-based World Health Organization Disability Assessment Schedule (WHODAS) 2.0 at baseline, post-intervention, and at 6-week follow-up.
RESULTS:
Repeated-measures ANOVA revealed significant time x group interaction effects, indicating significant improvements in the IG across all six WHODAS 2.0 domains (cognition, mobility, self-care, getting along, life activities (household and work), participation), as well as the 32-item summary score. Holm-adjusted post-hoc tests revealed significantly higher functioning in the IG compared to the CG at post-test for mobility (MDiff = -14.872, d = -0.818, pholm < 0.001) and for self-care (MDiff = -12.125, d = -0.575, pholm = 0.036). At follow-up, significant differences in favour of the IG were observed for mobility (MDiff = -15.426, d = -0.849, pholm < 0.001), self-care (MDiff = -13.481, d = -0.639, pholm = 0.028), and life activities (household) (MDiff = -16.803, d = -0.668, pholm = 0.021). For the 32-item WHODAS summary score, the IG showed significantly higher global functioning than the CG at both post-test (MDiff = -10.198, d = -0.638, pholm = 0.018) and the follow-up (MDiff = -10.789, d = -0.674, pholm = 0.017).
CONCLUSION:
Global functioning improved and WHODAS 2.0 disability score decreased following hippotherapy across ICF domains activities and participation, with effects maintained at follow-up. The findings support hippotherapy as an effective adjunct to rehabilitation for individuals with MS to maintain mobility in everyday life and underline the value of ICF-based outcome measures for evaluating equine-assisted interventions within a rehabilitative context using a standardized and internationally comparable framework.