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基于国际功能、残疾和健康分类儿童和青年版(ICF-CY)评估的马疗对脑瘫儿童身体功能、活动及参与的影响

Effects of hippotherapy on body functions, activities and participation in children with cerebral palsy based on ICF-CY assessments.

作者信息

Hsieh Yueh-Ling, Yang Chen-Chia, Sun Shih-Heng, Chan Shu-Ya, Wang Tze-Hsuan, Luo Hong-Ji

机构信息

a Department of Physical Therapy , Graduate Institute of Rehabilitation Science, China Medical University , Taichung , Taiwan.

b Kao-an Rehabilitation and Pain Clinic , Taichung , Taiwan.

出版信息

Disabil Rehabil. 2017 Aug;39(17):1703-1713. doi: 10.1080/09638288.2016.1207108. Epub 2016 Jul 20.

Abstract

PURPOSE

To evaluate the effects of hippotherapy on body functions, activities, and participation in children with CP of various functional levels by using the International Classification of Functioning, Disability and Health-Children and Youth (ICF-CY) checklist.

METHODS

Fourteen children with cerebral palsy (CP) (3-8 years of age) were recruited for a 36-week study composed of baseline, intervention, and withdrawal phases (12 weeks for each phase, ABA design). Hippotherapy was implemented for 30 min once weekly for 12 consecutive weeks during the intervention phase. Body Functions (b) and Activities and Participation (d) components of the ICF-CY checklist were used as outcome measures at the initial interview and at the end of each phase.

RESULTS

Over the 12 weeks of hippotherapy, significant improvements in ICF-CY qualifiers were found in neuromusculoskeletal and movement-related functions (b7), mobility (d4) and major life areas (d8) and, in particular, mobility of joint functions (b710), muscle tone functions (b735), involuntary movement reaction functions (b755), involuntary movement functions (b765), and play (d811) (all p < 0.05) when compared with baseline.

CONCLUSION

This study demonstrated the beneficial effects of hippotherapy on body functions, activities, and participation in children with CP. Implications for Rehabilitation ICF-CY provides a comprehensive overview of functioning and disability and constitutes a universal language for identifying the benefits of hippotherapy in areas of functioning and disability in children with CP. In children with CP, hippotherapy encourages a more complementary approach that extends beyond their impairments and limitations in body functions, activities, and participation. The effect of hippotherapy was distinct from GMFCS levels and the majority of improvements were present in children with GMFCS levels I-III.

摘要

目的

通过使用《国际功能、残疾和健康分类-儿童与青少年版》(ICF-CY)检查表,评估马疗对不同功能水平的脑瘫儿童的身体功能、活动及参与度的影响。

方法

招募了14名3至8岁的脑瘫儿童参与一项为期36周的研究,该研究包括基线期、干预期和撤药期(每个阶段12周,ABA设计)。在干预期,连续12周每周进行一次30分钟的马疗。在初次访谈时以及每个阶段结束时,使用ICF-CY检查表中的身体功能(b)和活动与参与(d)部分作为结果指标。

结果

在12周的马疗过程中,与基线相比,发现ICF-CY限定值在神经肌肉骨骼和运动相关功能(b7)、移动性(d4)和主要生活领域(d8)有显著改善,特别是关节功能移动性(b710)、肌张力功能(b735)、不自主运动反应功能(b755)、不自主运动功能(b765)和游戏(d811)(所有p<0.05)。

结论

本研究证明了马疗对脑瘫儿童的身体功能、活动及参与度有有益影响。康复启示ICF-CY提供了功能和残疾的全面概述,并构成了一种通用语言,用于确定马疗在脑瘫儿童功能和残疾领域的益处。对于脑瘫儿童,马疗鼓励一种更具互补性的方法,超越其在身体功能、活动和参与方面的损伤和限制。马疗的效果与粗大运动功能分类系统(GMFCS)水平无关,大多数改善出现在GMFCS水平为I-III的儿童中。

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