Impact of Long-Term Hippotherapy on the Walking Ability of Children With Cerebral Palsy and Quality of Life of Their Caregivers
Impact of Long-Term Hippotherapy on the Walking Ability of Children With Cerebral Palsy and Quality of Life of Their Caregivers
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DOI：
10.3389/fneur.2019.00834
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发表时间：
2019-08-13
影响因子：
3.4
通讯作者：
Ihara, Masahiro
中科院分区：
文献类型：
--
作者：
Mutoh, Tomoko;Mutoh, Tatsushi;Ihara, Masahiro
背景：脑性瘫痪（CP）是一种发生于出生时或婴儿早期的永久性运动障碍。尽管胎儿和母体医学的进步，CP的发病率仍然很高。海马疗法已逐渐被公认为是一种很好的康复工具，为儿童CP。然而，它如何实现长期功能改善或为患者的照顾者提供额外益处的科学依据仍然未知。目的：我们进行了一项前瞻性试验，以确定康复治疗如何影响CP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）。方法：共有24名CP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）接受了为期1年的干预和3个月的随访期间的康复治疗或日托娱乐（对照）计划（30分钟/天，每周一次）。用于儿童的评估措施是5米步行试验的步态参数、粗大运动功能测量（GMFM）-66和GMFM维度-E（GMFM-E）。使用世界卫生组织生活质量的简要版本估计照顾者的生活质量结果：除了更好的GMFM-66和GMFM-E评分外，运动疗法还与增加的节奏、步长和平均加速度、稳定的患者水平/垂直位移、增加的运动量、增加的运动量和增加的运动量有关。照顾者心理状况与生活质量的相关性优于对照组（p < 0.05）。此外，初始改善儿童的步长和他们的照顾者的心理QOL领域（特别是在“积极感觉”方面）倾向于保留到3个月的随访。这些数据表明，与普通的日托娱乐活动相比，一年一次的计划-每周一次的康复治疗不仅可以改善脑瘫患儿的步行能力，而且可以改善其照顾者的心理健康和生活质量。
Background: 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.Objectives: 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.Methods: 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.Results: 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 (p < 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.Conclusion: 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.