Lindroth Jodi L, Sullivan Jessica L, Silkwood-Sherer Debbie
a Menominee Tribal Clinic , Keshena , WI , USA .
b MidMichigan Medical Center, Harrison , MI , USA , and.
Physiother Theory Pract. 2015;31(8):575-81. doi: 10.3109/09593985.2015.1067266. Epub 2015 Oct 14.
This case-series study aimed to determine if there were observable changes in sensory processing for postural control in individuals with multiple sclerosis (MS) following physical therapy using hippotherapy (HPOT), or changes in balance and functional gait.
This pre-test non-randomized design study, with follow-up assessment at 6 weeks, included two females and one male (age range 37-60 years) with diagnoses of relapse-remitting or progressive MS. The intervention consisted of twelve 40-min physical therapy sessions which included HPOT twice a week for 6 weeks. Sensory organization and balance were assessed by the Sensory Organization Test (SOT) and Berg Balance Scale (BBS). Gait was assessed using the Functional Gait Assessment (FGA).
Following the intervention period, all three participants showed improvements in SOT (range 1-8 points), BBS (range 2-6 points), and FGA (average 4 points) scores. These improvements were maintained or continued to improve at follow-up assessment. Two of the three participants no longer over-relied on vision and/or somatosensory information as the primary sensory input for postural control, suggesting improved use of sensory information for balance.
The results indicate that HPOT may be a beneficial physical therapy treatment strategy to improve balance, functional gait, and enhance how some individuals with MS process sensory cues for postural control. Randomized clinical trials will be necessary to validate results of this study.
本病例系列研究旨在确定,对于患有多发性硬化症(MS)的个体,在采用马术疗法(HPOT)进行物理治疗后,其姿势控制的感觉处理是否有可观察到的变化,以及平衡和功能性步态是否有变化。
本预测试非随机设计研究,在6周时进行随访评估,纳入了两名女性和一名男性(年龄范围37 - 60岁),他们被诊断为复发缓解型或进展型MS。干预包括十二次40分钟的物理治疗课程,其中包括每周两次HPOT,持续6周。通过感觉组织测试(SOT)和伯格平衡量表(BBS)评估感觉组织和平衡。使用功能性步态评估(FGA)评估步态。
在干预期后,所有三名参与者在SOT(范围1 - 8分)、BBS(范围2 - 6分)和FGA(平均4分)评分上均有改善。这些改善在随访评估中得以维持或持续改善。三名参与者中有两名不再过度依赖视觉和/或体感信息作为姿势控制的主要感觉输入,这表明在平衡中对感觉信息的利用有所改善。
结果表明,HPOT可能是一种有益的物理治疗策略,可改善平衡、功能性步态,并增强一些MS患者处理姿势控制感觉线索的方式。需要进行随机临床试验来验证本研究的结果。