This information is integrated by the central nervous system that will send an adequate neuromuscular response to the musculoskeletal system to perform the required movements.
Therefore, the sensory system (vestibular, visual, and somatosensory systems) provides the information necessary to maintain an upright posture. These balance reactions are carried out through a complex process involving the sensory system, the central nervous system, and the skeletal muscle system. In that way, the body will make different adjustments known as balance reactions. The maintenance of balance encompasses the acts of maintaining, reaching, or restoring the center of body mass in relation to the base of sustenance within the limits of stability. Balance is achieved through the integration and coordination of multiple body systems (vestibular, visual, auditory, motor, and higher-level premotor systems). The ability to maintain posture is an important factor in carrying out activities of daily living and in achieving independent individual development. Postural control could be defined as the ability to maintain posture in space and has an intimate relationship with the sense of balance. However, due to the limited number of articles and their low methodological quality, no solid conclusions can be drawn about the effectiveness of this therapy. Most studies have shown beneficial effects on postural balance compared with conventional physical therapy. Not conclusive results were found in sitting postural balance, measured using the Gross Motor Function Measure-66 (GMFM-66) Sitting Dimension, in patients with cerebral palsy. Statistical analysis showed favorable results for balance in stroke patients, measured by the Berg Balance Scale (standardized mean difference (SMD) = 3.24 95% confidence interval (CI): 1.66–4.83). A total of seven articles were included in this systematic review, of which four contributed information to the meta-analysis. The methodological quality of the studies was evaluated through the PEDro scale. The search was conducted during January–March 2019 in PubMed, Physiotherapy Evidence Database (PEDro), Cochrane, Web of Science, CINAHL, and Scopus. The main objective of this study is to analyze the effectiveness of mechanical horse-riding simulators to improve postural balance in subjects with neurological disorders. Mechanical horse-riding simulators consist of a device that mimics the movement of a real horse, generating between 50 and 100 three-dimensional physical movements (forward and back, left and right, up and down).
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