In an area of Rome that once hosted horse races, four horses and two ponies move at a much slower pace to help neurological patients restore their movements and confidence.

With handles on the side of their saddles, the animals at the San Giovanni Battista Hospital allow some people to take their first halting steps after trauma, strokes, degenerative diseases, as well as long COVID.

"It's a beautiful feeling, to be able to stay in equilibrium, to be able to walk. It's difficult but with the horse I can do it," said former shooting champion Matteo Santopadre, who relies on a wheelchair after a months-long coma following a car accident.

The hospital on the outskirts of Rome, where the city's hippodrome was once located, is the only one in Italy to use hippotherapy - which allows movements that would be harder to carry out in a gym to improve muscle strength, balance and coordination.

It also fosters connections between the animals and patients, who develop trust and affection for them in a gradual and sensory approach with huge psychological benefits.

The hospital's program, which operates alongside traditional rehabilitation, has been running for a few years. In 2023 it involved more than 600 patients.

Physiotherapist Giorgia De Santis says it helps that a horse "does not judge, is not prejudiced".

"With its calm, quiet breathing and slow heartbeats (the horse) engages the patients, and leads them to relax, let their guard down, let go. It makes everything easier for them, more welcoming," she said.

Giuliana Geatti and Paola Conto, both affected by Parkinson's disease, say the hippotherapy gives them self-assurance and a new feeling of freedom.

"The contact with the animal is exceptional. Because it feels what you feel, you know?" Geatti said, who leaned forward to embrace the animal's neck as she sat on its back.