PDF(Pubmed)
Abstract：
BACKGROUND: Equine-assisted services (EAS) involves the use of horses within therapy, learning or horsemanship sessions and has been used with military veterans suffering from post-traumatic stress disorder (PTSD). This study systematically reviewed existing research on the use of EAS in the treatment of PTSD in military veterans and evaluated its effectiveness.
METHODS: A systematic review was performed, in May 2023, with searches and data extraction carried out from three separate databases (PubMed, JSTOR and Science Direct) related to testing the effect of EAS on PTSD outcomes in veterans. A risk of bias assessment of included studies was conducted and meta-analysis of outcomes performed when two or more studies reported the same outcomes. Other effects of EAS on veterans\' health were also discussed.
RESULTS: A total of 13 studies were identified based on our inclusion and exclusion criteria with 11 originating from the US and the remaining two from Australia and Israel. There were 344 participants amongst all of the studies with a mean age of 47 years and a male:female ratio of 19:6. Eight out of the 13 studies reported PTSD scores, as measured by either PTSD Checklist for DSM-5 (PCL-5) or PCL-Veteran/-Military versions (PCL-V/-M), and results suggested a reduction in PTSD score after EAS treatment of 22.6%. A meta-analysis confirmed that EAS favored a significantly lower PTSD score after treatment, with a mean difference of 12.46, 95% CI [9.03,15.88], p < 0.00001. However, only one study had low risk of bias whilst all the rest of the studies had some concerns to high risk of bias.
CONCLUSIONS: EAS appeared to have a positive influence on PTSD symptoms in military veterans, significantly reducing PTSD severity scores. Other benefits of EAS may be peer support, social integration, learning new skills and bonding. However, the results of this systematic review must be interpreted with caution as almost all of the studies were of low quality. Therefore, further rigorous research is required with larger participants to be able to draw conclusions about the benefits of EAS on PTSD severity.
METHODS: A systematic review was performed, in May 2023, with searches and data extraction carried out from three separate databases (PubMed, JSTOR and Science Direct) related to testing the effect of EAS on PTSD outcomes in veterans. A risk of bias assessment of included studies was conducted and meta-analysis of outcomes performed when two or more studies reported the same outcomes. Other effects of EAS on veterans\' health were also discussed.
RESULTS: A total of 13 studies were identified based on our inclusion and exclusion criteria with 11 originating from the US and the remaining two from Australia and Israel. There were 344 participants amongst all of the studies with a mean age of 47 years and a male:female ratio of 19:6. Eight out of the 13 studies reported PTSD scores, as measured by either PTSD Checklist for DSM-5 (PCL-5) or PCL-Veteran/-Military versions (PCL-V/-M), and results suggested a reduction in PTSD score after EAS treatment of 22.6%. A meta-analysis confirmed that EAS favored a significantly lower PTSD score after treatment, with a mean difference of 12.46, 95% CI [9.03,15.88], p < 0.00001. However, only one study had low risk of bias whilst all the rest of the studies had some concerns to high risk of bias.
CONCLUSIONS: EAS appeared to have a positive influence on PTSD symptoms in military veterans, significantly reducing PTSD severity scores. Other benefits of EAS may be peer support, social integration, learning new skills and bonding. However, the results of this systematic review must be interpreted with caution as almost all of the studies were of low quality. Therefore, further rigorous research is required with larger participants to be able to draw conclusions about the benefits of EAS on PTSD severity.
摘要：
背景：马辅助服务（EAS）涉及在治疗中使用马，学习或马术课程，并已用于患有创伤后应激障碍（PTSD）的退伍军人。本研究系统回顾了EAS在退伍军人创伤后应激障碍治疗中的现有研究，并评估了其有效性。
方法：进行了系统评价，2023年5月，从三个独立的数据库进行搜索和数据提取(PubMed，JSTOR和ScienceDirect）与测试EAS对退伍军人PTSD结果的影响有关。对纳入的研究进行偏倚风险评估，并在两项或多项研究报告相同结果时对结果进行荟萃分析。还讨论了EAS对退伍军人健康的其他影响。
结果：根据我们的纳入和排除标准，共确定了13项研究，其中11项来自美国，其余2项来自澳大利亚和以色列。所有研究中有344名参与者，平均年龄为47岁，男女比例为19:6。13项研究中有8项报告了创伤后应激障碍评分，根据DSM-5（PCL-5）或PCL-Veteran/-军用版本（PCL-V/-M）的PTSD清单测量，结果表明，EAS治疗后PTSD评分降低了22.6%。一项荟萃分析证实，EAS有利于治疗后PTSD评分明显降低，平均差为12.46，95%CI[9.03，15.88]，p<0.00001。然而,只有一项研究的偏倚风险较低,而其余所有研究的偏倚风险较高.
结论：EAS似乎对退伍军人的PTSD症状有积极影响，显著降低PTSD严重程度评分。EAS的其他好处可能是对等支持，社会融合,学习新的技能和结合。然而,本系统综述的结果必须谨慎解释,因为几乎所有的研究都是低质量的.因此,需要对更大的参与者进行进一步的严格研究,以便能够得出关于EAS对PTSD严重程度的益处的结论.
方法：进行了系统评价，2023年5月，从三个独立的数据库进行搜索和数据提取(PubMed，JSTOR和ScienceDirect）与测试EAS对退伍军人PTSD结果的影响有关。对纳入的研究进行偏倚风险评估，并在两项或多项研究报告相同结果时对结果进行荟萃分析。还讨论了EAS对退伍军人健康的其他影响。
结果：根据我们的纳入和排除标准，共确定了13项研究，其中11项来自美国，其余2项来自澳大利亚和以色列。所有研究中有344名参与者，平均年龄为47岁，男女比例为19:6。13项研究中有8项报告了创伤后应激障碍评分，根据DSM-5（PCL-5）或PCL-Veteran/-军用版本（PCL-V/-M）的PTSD清单测量，结果表明，EAS治疗后PTSD评分降低了22.6%。一项荟萃分析证实，EAS有利于治疗后PTSD评分明显降低，平均差为12.46，95%CI[9.03，15.88]，p<0.00001。然而,只有一项研究的偏倚风险较低,而其余所有研究的偏倚风险较高.
结论：EAS似乎对退伍军人的PTSD症状有积极影响，显著降低PTSD严重程度评分。EAS的其他好处可能是对等支持，社会融合,学习新的技能和结合。然而,本系统综述的结果必须谨慎解释,因为几乎所有的研究都是低质量的.因此,需要对更大的参与者进行进一步的严格研究,以便能够得出关于EAS对PTSD严重程度的益处的结论.
