Division of Cardiology, Department of Internal Medicine, Samsung Medical Center, Seoul, Republic of Korea.
Samsung Equestrian Team, Gunpo, Republic of Korea.
J Altern Complement Med. 2021 Jan;27(1):96-102. doi: 10.1089/acm.2020.0346. Epub 2020 Nov 27.
Children with cerebral palsy (CP) have an impaired cardiac autonomic function. Attenuated heart rate recovery (HRR), which is a valuable prognostic parameter for autonomic nervous system, is known to be associated with an increased risk of cardiovascular events and all-cause mortality. However, only few studies have observed the effects of exercise on the cardiac autonomic function in children with CP. The purpose of this pilot study was to examine the effects of equine-assisted activity (EAA) program on cardiac autonomic function in children with CP. A single-blinded, parallel, two-arm pilot trial with 1:1 randomization to the EAA or control group. A tertiary university hospital and a local arena. Twenty-six children with CP (Gross Motor Function Classification System Levels I-II). Each lesson of the EAA program for the EAA group was conducted for 40 min twice a week, and the whole program duration was 16 weeks (a total of 32 sessions). A graded exercise test was performed to measure the resting heart rate (RHR), HRR, and peak oxygen uptake (VO) on both groups before and after the 16-week period. The autonomic nervous function measured by the response of HRR improved at 1 min ( < 0.009), 3 min ( < 0.001), and 5 min ( < 0.004) only in the EAA group. RHR significantly improved in the EAA group ( < 0.013), whereas the VO did not significantly differ between the two groups. The HRR and RHR of the children with CP improved after completing the 16-week EAA program. The results demonstrated that the program had a positive effect on the improvement of cardiac autonomic function in these patients. Clinical Trial Registration Number: NCT03870893.
患有脑瘫(CP)的儿童存在心脏自主功能障碍。心率恢复(HRR)减弱,这是自主神经系统的一个有价值的预后参数,已知与心血管事件和全因死亡率增加相关。然而,只有少数研究观察了运动对 CP 儿童心脏自主功能的影响。本研究旨在探讨马术辅助活动(EAA)方案对 CP 儿童心脏自主功能的影响。这是一项单盲、平行、双臂的先导试验,采用 1:1 随机分组到 EAA 或对照组。试验地点为一家三级大学医院和当地的一个竞技场。研究对象为 26 名 CP 儿童(粗大运动功能分级系统 I-II 级)。EAA 组的每个课程都进行 40 分钟,每周两次,整个课程持续 16 周(共 32 次)。对两组进行分级运动试验,以测量 16 周前后的静息心率(RHR)、HRR 和峰值摄氧量(VO)。仅在 EAA 组中,HRR 对心率的反应所测量的自主神经功能在 1 分钟( < 0.009)、3 分钟( < 0.001)和 5 分钟( < 0.004)时得到改善。EAA 组的 RHR 显著改善( < 0.013),而 VO 两组间无显著差异。完成 16 周 EAA 方案后,CP 儿童的 HRR 和 RHR 均有所改善。结果表明,该方案对改善这些患者的心脏自主功能有积极作用。临床试验注册号:NCT03870893。