Autism Spectrum Disorder (ASD) is an intricate and complex disorder that continues to grow in its prevalence year after year. The disorder is based on decreased social communication with prevalent stereotypical behaviors and problems in sensory processing. Due to the disorder diagnosis based on a spectrum, each child is different in their severity, and thus requires individualized forms of therapies and treatments. The cause of ASD is unknown, which makes the treatment difficult to standardize. Desperate to find a regimen that benefits their child’s ability to function more successfully, more and more parents are utilizing complementary alternative medicine (CAM). The problem with CAM is lack of evidence that supports using CAM practice. One example of CAM is hippotherapy, which is a type of intervention used by physical, occupational and speech therapists which uses the movements of a horse to address a patient’s impairments physically, emotionally and neurologically. Hippotherapy has been used since the 1960s for a number of disorders. This systematic literature review examines the effects of hippotherapy for children with ASD in regards to increasing social communication and decreasing stereotypical behaviors. The conclusion of the review resulted in conflicting evidence regarding the efficacy of hippotherapy for children with ASD. This inconclusive lack of evidence is generally due to the lack of standardized measurement scales or treatment plans used during each session and small sample sizes.

Background: Evidence-based complementary treatment options for multiple sclerosis (MS) are limited. Objective: To investigate the effect of hippotherapy plus standard care versus standard care alone in MS patients. Methods: A total of 70 adults with MS were recruited in five German centers and randomly allocated to the intervention group (12 weeks of hippotherapy) or the control group. Primary outcome was the change in the Berg Balance Scale (BBS) after 12 weeks, and further outcome measures included fatigue, pain, quality of life, and spasticity. Results: Covariance analysis of the primary endpoint resulted in a mean difference in BBS change of 2.33 (95% confidence interval (CI): 0.03–4.63, p = 0.047) between intervention (n = 32) and control (n = 38) groups. Benefit on BBS was largest for the subgroup with an Expanded Disability Status Scale (EDSS) ⩾ 5 (5.1, p = 0.001). Fatigue (−6.8, p = 0.02) and spasticity (−0.9, p = 0.03) improved in the intervention group. The mean difference in change between groups was 12.0 (p < 0.001) in physical health score and 14.4 (p < 0.001) in mental health score of Multiple Sclerosis Quality of Life-54 (MSQoL-54). Conclusion: Hippotherapy plus standard care, while below the threshold of a minimal clinically important difference, significantly improved balance and also fatigue, spasticity, and quality of life in MS patients.