Experimental Design
This study was a two-group, pilot, randomized, controlled,
clinical trial. All patients underwent a series of baseline assessments
over 7 days, including functional assessment (i.e.,
VO2max, bioelectrical impedance test, maximal strength of
principal muscular groups) and psychological measurements
(Functional Assessment of Chronic Illness Therapy-Fatigue
[FACIT-F]). After completion of all baseline assessments,
patients were randomly divided into two groups: the intervention
group (n = 10) and the control group (n = 10).
Patients randomly assigned to the control group were
instructed not to begin any new formal physical exercise
program. After the 16-week intervention period, all patients
underwent the same series of assessments completed at
baseline. Relevant patients’ medical information included
height, body mass, body–mass index (BMI), and cancer
treatment history are reported in Table 1.
EAT protocol
The EAT was held at the Therapeutic Riding Centre of
Italian Equestrian Federation ‘‘Il Giardino di Filippo’’ (Viterbo,
Italy). The therapeutic riding setting included the
patient, the horse, and a therapist specialized in equestrian
rehabilitation.
All the intervention group patients received two 1-hour
therapeutic riding treatments for week, for 16 weeks. Each
riding session consists of three phases: (1) warm up, horse
caring, and grooming; (2) riding; and (3) unsaddling and
grooming activity.
Sessions 1–3 were required to establish the human–horse
relationship and ethologic and metacognitive comprehension
of the horse (grooming, information and nomenclature
of saddlery tools, horse behavioral codes, management of
the horse, hand walk). Sessions 4–8 provided patients with
riding basic elements: mounting and dismounting; position
and control on the horse with exercises that help participants
to create balance and correct postural lines necessary for
mounted work. Sessions 9–20 allowed patients to consolidate
the acquired position ability and horse control at walk
(walk-stop-walk, rising walk on stirrups). Sessions 21–32
were structured to improve the ability of autonomous horse
management (diagonals and transversals, sitting trot, trekking
outside the court/ring).
Patients’ heart rates were recorded during all the riding
sessions with recorder belts (Team System recorder belt;
Polar, Kempele, Finland), and data were downloaded onto a
portable computer using the specific software (Polar Precision
software, version 4; Polar).