第十四屆 馬術治療於發展遲緩兒童坐姿平衡表現之立即成效-個案報告

Effects of Hippotherapy on Sitting Postural Stability in Child with Developmental Delay - A Single-Subject Report

張茹茵¹、張永祥¹、劉金枝²、吳汀原³、徐敏⁴、黃國裕⁵、吳美慧⁶、莊璧菁⁷

Ju-Ying Chang¹, Yung-Hsiang Chang¹, Chin-Chih Liu², Ting-Yuan Wu³ , Min Xu⁴, Guo-Yu Huang⁵, Mei-hui Wu⁶, Bi-Jing Zhuang⁷

¹國立屏東教育大學特殊教育系、²樹人醫護管理專科學校物理治療科、³高雄市立高雄啟智學校、⁴屏東基督教醫院、⁵南區身心障礙者職業輔導評量資源中心、⁶社團法人高雄市物理治療師公會、⁷財團法人八卦寮文教基金會

¹Department of Special Education, National Pingtung University of Education, ²Department of Physical Therapy, Shu-Zen College of Medicine and Management, ³Kaohsiung Municipal Kaohsiung School for Students with Disabilities, ⁴Pingtung Christian Hospital, ⁵The Vocational Evaluation Resources Center for Individuals with Disabilities in Southern Taiwan, ⁶Kaohsiung Physiotherapist Association Corp, ⁷Ba-Gua-Liao Foundation

Background and Purpose: Hippotherpay is a form of therapeutic strategy that utilized equine movement as part of an integrated intervention program to offer well-modulated sensory input to vestibular, proprioceptive, tactile and visual channels, and to improve neurological function and sensory processing. Equine movement provides a dynamic base of support, making it an appropriate tool for increasing trunk strength and control, balance, enhancing postural strength and endurance, and addressing motor planning. The purpose of this study was to examine the effectiveness of hippotherapy as an intervention for the treatment of sitting postural stability in child with developmental delay. Methods: One 5 years old girl, who was diagnosed as developmental delay and participated in the 12-week equine-movement therapy program conducted by Ba-Gua-Liao Foundation, was enrolled in the study through convenience sampling. The dynamic sitting postural stability was assessed by the PROKIN system (PK214, TecnoBody S.r.l., Italy) before and after each training course. Stability index, the dispersion around the expected value, was analyzed to represent as an index of dynamic sitting postural stability. Results: Gradually decreased both in anterior-posterior stability index (from 3.32 to 1.71) and medial-lateral stability index (from 7.94 to 1.42) were shown during the intervention period. It was suggested that equine-movement therapy program had effects on immediate promoting the participant’s postural stability. Conclusion: The effects of equine movement on postural control, sensory systems, and motor planning can be used to facilitate dynamic postural stability anteroposteriorly and mediolaterally. Stability index might be used as an essential component in assessing the efficacy of interventions for improving balance, and be reflected in a clinically meaningful score.

Keywords: hippotherapy, developmental delay, postural stability