Effects of hippotherapy simulation exercise vs. conventional home exercises on muscle strength and balance in people with multiple sclerosis: A randomized controlled trial

•Horse-riding simulation exercises indicate a positive effect on health conditions, balance, mobility skills, and muscle strength in people with multiple sclerosis.•For people with multiple sclerosis, horse-riding simulation is a safe workout for the whole body, which is performed using core muscles and many joints.•Horse-riding simulation approach can be offered as a practical and cost-effective exercise program.•We suggest that future research should focus on how effective horse-riding simulation exercises are in the high disability multiple sclerosis group.