Centre for Education and Rehabilitation for Children and Adolescents with Special Needs (CIRIUS), Kamnik, Slovenia.
Dev Med Child Neurol. 2011 Aug;53(8):684-91. doi: 10.1111/j.1469-8749.2011.03951.x. Epub 2011 Mar 24.
This research review and meta-analysis presents an overview of the effects of hippotherapy and therapeutic horseback riding (THR) on postural control or balance in children with cerebral palsy (CP).
To synthesize previous research findings, a systematic review and meta-analysis were undertaken. Relevant studies were identified by systematic searches of multiple online databases from the inception of the database through to May 2010. Studies were included if they fulfilled the following criteria: (1) quantitative study design, (2) investigation of the effect of hippotherapy or THR on postural control or balance, and (3) the study group comprised children and adults with CP. The selected articles were rated for methodological quality. The treatment effect was coded as a dichotomous outcome (positive effect or no effect) and quantified by odds ratio (OR). The pooled treatment effect was calculated using a random-effects model. Meta-regression of the effect size was performed against study covariates, including study size, publication date, and methodological quality score.
From 77 identified studies, 10 met the inclusion criteria. Two were excluded because they did not include a comparison group. Therapy was found to be effective in 76 out of 84 children with CP included in the intervention groups. The comparison groups comprised 89 children: 50 non-disabled and 39 with CP. A positive effect was shown in 21 of the children with CP in the comparison group regardless of the activity undertaken (i.e. physiotherapy, occupational therapy, sitting on a barrel or in an artificial saddle). The pooled effect size estimate was positive (OR 25.41, 95% CI 4.35, 148.53), demonstrating a statistically significant effectiveness of hippotherapy or THR in children with CP (p<0.001). Meta-regression of study characteristics revealed no study-specific factors.
The eight studies found that postural control and balance were improved during hippotherapy and THR. Although the generalization of our findings may be restricted by the relatively small sample size, the results clearly demonstrate that riding therapy is indicated to improve postural control and balance in children with CP.
本研究综述和荟萃分析概述了马术疗法和治疗性骑马（THR）对脑瘫（CP）儿童姿势控制或平衡的影响。
为了综合以前的研究结果，我们进行了系统评价和荟萃分析。通过对多个在线数据库进行系统搜索，从数据库建立到 2010 年 5 月，确定了相关研究。如果研究符合以下标准，则将其纳入：（1）定量研究设计，（2）调查马术疗法或 THR 对姿势控制或平衡的影响，（3）研究组由脑瘫儿童和成人组成。对选定的文章进行了方法学质量评分。将治疗效果编码为二项结果（有效或无效），并用比值比（OR）量化。使用随机效应模型计算汇总治疗效果。对效应大小进行了荟萃回归分析，以对抗研究协变量，包括研究规模、发表日期和方法学质量评分。
从 77 项已确定的研究中，有 10 项符合纳入标准。有 2 项因未包括对照组而被排除。在纳入干预组的 84 名 CP 儿童中，有 76 名儿童的治疗效果明显。对照组包括 89 名儿童：50 名非残疾儿童和 39 名 CP 儿童。无论进行何种活动（即物理治疗、职业治疗、坐在桶上或人工鞍座上），对照组中有 21 名 CP 儿童的治疗效果均为阳性。汇总效应大小估计值为阳性（OR 25.41，95%CI 4.35，148.53），表明马术疗法或 THR 对 CP 儿童具有统计学上显著的有效性（p<0.001）。对研究特征的荟萃回归分析未发现特定于研究的因素。
这八项研究表明，马术疗法和 THR 可改善姿势控制和平衡。尽管我们的发现的推广可能受到样本量相对较小的限制，但结果清楚地表明，骑马疗法可改善 CP 儿童的姿势控制和平衡。
