Mutoh Tomoko, Mutoh Tatsushi, Tsubone Hirokazu, Takada Makoto, Doumura Misato, Ihara Masayo, Shimomura Hideo, Taki Yasuyuki, Ihara Masahiro
Department of Nuclear Medicine and Radiology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.
Division of Clinical Psychology, Graduate School of Human Sciences, Kobe Shoin Women's University, Kobe, Japan.
Front Neurol. 2019 Aug 13;10:834. doi: 10.3389/fneur.2019.00834. eCollection 2019.
Cerebral palsy (CP) is a permanent motor disorder that occurs at birth or during early infancy. Despite advances in fetal and maternal medicine, the incidence of CP remains high. Hippotherapy has gradually been recognized as an excellent rehabilitation tool for children with CP. However, a scientific basis for how it achieves long-term functional improvements or provides additional benefits to patients' caregivers remains unknown. We performed a prospective trial to determine how hippotherapy affects the gross motor and gait functions in children with CP and how it may also impact the quality of life (QOL) of patients' caregivers. In total, 24 children with CP (11 boys, 13 girls; age: 4-14 years; Gross Motor Function Classification System [GMFCS] II-III) underwent a program (30 min/day, once a week) of hippotherapy or day-care recreation (control) over a 1-year intervention and a 3-month follow-up period. Assessment measures used for the children were gait parameters for a 5-m walk test, Gross Motor Function Measure (GMFM)-66, and GMFM dimension-E (GMFM-E). The QOL of the caregivers was estimated using a brief version of the World Health Organization Quality Of Life (WHOQOL-BREF) self-assessment questionnaire. In addition to better GMFM-66 and GMFM-E scores, hippotherapy was associated with increased cadence, step length, and mean acceleration; stabilized horizontal/vertical displacement of patients; and better relationship between the psychological status and QOL of the caregivers than those seen in the control group ( < 0.05). Additionally, the initially improved children's step length and their caregivers' psychological QOL domain (particularly in the "positive feeling" facet) tended to be preserved up to the 3-month follow-up. These data suggest that compared with common day-care recreational activities, a 1-year program of once-weekly hippotherapy can improve not only the walking ability of children with CP but also the psychological health and QOL of their caregivers. : www.umin.ac.jp/ctr/, identifier: UMIN000022986.
脑瘫（CP）是一种在出生时或婴儿早期发生的永久性运动障碍。尽管胎儿和母体医学取得了进展，但脑瘫的发病率仍然很高。马术疗法已逐渐被公认为是治疗脑瘫儿童的一种出色的康复工具。然而，关于它如何实现长期功能改善或为患者照顾者带来额外益处的科学依据仍然未知。我们进行了一项前瞻性试验，以确定马术疗法如何影响脑瘫儿童的粗大运动和步态功能，以及它如何影响患者照顾者的生活质量（QOL）。共有24名脑瘫儿童（11名男孩，13名女孩；年龄：4 - 14岁；粗大运动功能分类系统[GMFCS] II - III级）在为期1年的干预和3个月的随访期内接受了马术疗法或日托娱乐（对照）项目（每天30分钟，每周一次）。用于评估儿童的指标包括5米步行测试的步态参数、粗大运动功能测量（GMFM）- 66以及GMFM维度 - E（GMFM - E）。使用世界卫生组织生活质量简表（WHOQOL - BREF）自我评估问卷来评估照顾者的生活质量。除了GMFM - 66和GMFM - E得分更高外，马术疗法还与步频增加、步长增加和平均加速度增加相关；患者的水平/垂直位移稳定；与对照组相比，照顾者的心理状态与生活质量之间的关系更好（<0.05）。此外，最初改善的儿童步长及其照顾者的心理生活质量领域（特别是在“积极感受”方面）在3个月的随访期内往往得以保持。这些数据表明，与普通的日托娱乐活动相比，为期1年、每周一次的马术疗法项目不仅可以改善脑瘫儿童的行走能力，还可以改善其照顾者的心理健康和生活质量。：www.umin.ac.jp/ctr/，标识符：UMIN000022986
