Table 2 Characteristics of the studies included in this systematic review

Borges de Araujo et al. (2018) [26]

Brazil

Equine-Assisted Therapy with docile horses exclusively used for equine therapy

People diagnosed with mild to moderate Alzheimer’s Disease (n = 9, 78.6, 33%)

Quasi-experimental, uncontrolled pre-post

20 sessions of Equine-Assisted Therapy, twice a week for 10 weeks with each session lasting 30 min

1.Balance (force plate)

2.Functional capacity (Timed Up & Go test & 30-sec chair stand test)

3.Cognition (Verbal fluency & Mini-Mental State Examination)

Improvement pre & post intervention for outcomes 1 & 2. No deterioration in cognitive function.

Dabelko-Schoeny et al. (2014) [27]

USA

Equine-Assisted Therapy with 4 therapy horses

People diagnosed with early to moderate stage Alzheimer’s Disease or related dementia (n = 16, 78.1, 56%)

Randomised pre-post crossover

Weekly sessions, once a week for 4 weeks with 3 × 15-minute activities per session. Activities included: grooming, observation or interaction, painting

1.Behaviour & affect (Philadelphia Geriatric Center Affect Rating Scale)

2.Stress (Salivary cortisol concentrations)

3.Disruptive Behaviours (Nursing Home Behaviour Problem Scale)

Participants showed positive engagement with the activities. There was a reduction in behavioural problems post-intervention compared to the comparison group.

Fields et al. (2018) [28]

USA

Equine-Assisted Activities Program with 3 trained horses and 1 pony at an accredited therapeutic riding centre

Residents in a long-term care facility with mild to moderate dementia (n = 6, 83.3, 67%)

Quantitative component of a mixed methods case study, comparing Equine-Assisted Activities Program to long-term care facility activities.

Weekly one-hour session of Equine-Assisted Activities Program for 8 weeks of riding, grooming, petting or observing horses. Long-term care facility activities included downtime, TV, meals & snacks, physical therapy, games, joke & riddle time

Quality of Life (QoL) indicators related to:

1.Time use (gaze, position & movement, conversation, participation)

2.Emotional wellbeing (apparent affect & agitation)

The QoL subdomains of conversation and apparent affect (pleasure) were more frequently observed during the Equine-Assisted Activities Program than long-term care facility activities. There was no difference between Equine-Assisted Activities Program and long-term care facility activities for gaze, position & movement, and agitation.

Fields et al. (2019) [29]

USA

Equine-Assisted Activities Program, with 3 trained horses and 1 pony at an accredited therapeutic riding centre

Providers of the Equine-Assisted Activities Program (n = 5)

Qualitative component of a mixed methods case study from the providers perspective

Same as in Fields et al., 2018

Providers perceptions of Equine-Assisted Activities Program that relate to:

1.safety

2.QoL outcomes

3.acceptiblilty

Equine-Assisted Activities Program was found to be safe and acceptable by providers and contributed to positive QoL outcomes for participants.

Lassell et al. (2021) [31]

USA

1.Adaptive Riding with 3 horses and 1 donkey at an accredited therapeutic riding centre

2.Adaptive Gardening

People diagnosed with dementia (n = 8, 74, 75%)

Descriptive case study

Two interventions of Adaptive Riding (n = 4) and Adaptive Gardening (n = 4), with a weekly one-hour session for 8 weeks

QoL indicators of:

1.Participation (gaze, communication, and active participation)

2.Emotional wellbeing (apparent affect & agitation)

Positive outcomes for QoL indicators for Adaptive Riding and Adaptive Gardening. Adaptive Riding participants engaged in more complex active participation compared to Adaptive Gardening participants.

Lassell et al. (2022) [30]

USA

Adaptive Riding: Riding in the Moment, with Horses and donkeys at an accredited therapeutic riding center

People diagnosed with dementia (n = 5, 70, 80%) and dementia care partners (n = 5, 58, 70%)

Qualitative case study design

Weekly one-hour sessions of Riding in the Moment for 8 weeks with opportunity to groom, observe, pet and ride a horse or donkey

1.Well-being

2.Meaning through social

connections

3.Function in daily life.

The program was deemed appropriate for people living with dementia and care partners. Care partners reported improved well-being and function in daily life for people living with dementia. Meaning through social connections improved for people living with dementia and carers.