模拟马术训练对脑卒中后共济失调的效果

doi:10.3969/j.issn.1006-9771.2022.11.015

Abstract

Abstract:

Objective To explore the effects of horse-riding simulator exercise on posture control, balance, walking and activities of daily living (ADL) in patients with ataxia after posterior circulation stroke.

Methods From September, 2018 to August, 2021, 49 stroke inpatients in Beijing Bo'ai Hospital were randomly divided into control group (n = 27) and exercise group (n = 22). Both groups accepted routine medicine and rehabilitation, while the exercise group accepted horse-riding exercise in addition, for four weeks. They were assessed with International Cooperative Ataxia Rating Scale (ICARS), Fugl-Meyer Assessment-Balance (FMA-B), Berg Balance Scale (BBS), Postural Assessment Scale for Stroke Patients (PASS), Timed 'Up and Go' Test (TUGT) and modified Barthel Index (MBI) before and after treatment.

Results All the indexes improved after treatment in both groups (|t| > 6.019, P < 0.001), while the scores of BBS and PASS, and timed of TUGT were better in the exercise group than in the control group (|t| > 2.212, P < 0.05).

Conclusion Horse-riding simulator exercise can further improve the postural control, balance and walking abilities for patients with ataxia after stroke.

Key words: stroke, ataxia, horse-riding exercise

CLC Number:

R743.3

CHI Qianqian,ZHANG Yue,ZHANG Xiaonian. Effects of horse-riding simulator exercise on post-stroke ataxia[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(11): 1349-1354.

Figures/Tables 7

References 54

[1]	SHINOMIYA Y. Development and muscle strength training evaluation for horseback riding therapeutic equipment[J]. J Robotics Mechatronics, 2002, 14(6): 597-603. doi: 10.20965/jrm.2002.p0597
[2]	BENDA W, MCGIBBON N H, GRANT K L. Improvements in muscle symmetry in children with cerebral palsy after equine-assisted therapy (hippotherapy)[J]. J Altern Conplement Med, 2003, 9(6): 817-825.
[3]	CHERNG R J, HWANG A, LIAO H F, et al. The effectiveness of therapeutic horseback riding in children with spastic cerebral palsy[J]. Adapt Phys Act Q, 2004, 32(2): 103-121.
[4]	MCGIBBON N H, BENDA W, DUNCAN B R, et al. Immediate and long-term effects of hippotherapy on symmetry of adductor muscle activity and functional ability in children with spastic cerebral palsy[J]. Arch Phys Med Rehabil, 2009, 90(6): 966-974. doi: 10.1016/j.apmr.2009.01.011
[5]	STERBA J A, ROGERS B T, FRANCE A P, et al. Horseback riding in children with cerebral palsy: effect on gross motor function[J]. Dev Med Child Neurol, 2002, 44(5): 301-308. doi: 10.1017/s0012162201002122 pmid: 12033715
[6]	ZHAI X, ZHANG X, YIN Q, et al. Application of DFA in research on the effect of horseback riding therapy on postural control complexity of hemiplegic patients[J]. Panminerva Med, 2020. DOI: 10.23736/S0031-0808.20.03870-7. doi: 10.23736/S0031-0808.20.03870-7
[7]	ANDERSON K, BEHM D G. Trunk muscle activity increases with unstable squat movements[J]. Can J Appl Physiol, 2005, 30(1): 33-45. pmid: 15855681
[8]	LEE N G, YOU J S H, YI C H, et al. Best core stabilization for anticipatory postural adjustment and falls in hemiparetic stroke[J]. Arch Phys Med Rehabil, 2018, 99(11): 2168-2174. doi: 10.1016/j.apmr.2018.01.027
[9]	RICHARD A, VAN HAMME A, DREVELLE X, et al. Contribution of the supplementary motor area and the cerebellum to the anticipatory postural adjustments and execution phases of human gait initiation[J]. Neuroscience, 2017, 358: 181-189. doi: S0306-4522(17)30452-9 pmid: 28673716
[10]	GRAMIGNA V, PELLEGRINO G, CERASA A, et al. Near-infrared spectroscopy in gait disorders: Is it time to begin?[J]. Neurorehabil Neural Repair, 2017, 31(5): 402-412. doi: 10.1177/1545968317693304 pmid: 28196453
[11]	TASSEEL-PONCHE S, YELNIK A P, BONAN I V. Motor strategies of postural control after hemispheric stroke[J]. Neurophysiol Clin, 2015, 45(4-5): 327-333. doi: 10.1016/j.neucli.2015.09.003
[12]	温子星, 徐欣, 潘景文, 等. 预测性姿势调节对人体站立受扰后姿势响应影响的研究[J]. 中国康复医学杂志, 2016, 31(10): 1104-1110.
	WEN Z X, XU X, PAN J W, et al. Influence of anticipatory postural adjustment on postural response to standing postural perturbations[J]. Chin J Rehabil Med, 2016, 31(10): 1104-1110.
[13]	SOUSA A S, SILVA A, TAVARES J M. Biomechanical and neurophysiological mechanisms related to postural control and efficiency of movement: a review[J]. Somatosens Mot Res, 2012, 29(4): 131-143. doi: 10.3109/08990220.2012.725680 pmid: 23094940
[14]	CLAUDINO R, DOS SANTOS E C, SANTOS M J. Compensatory but not anticipatory adjustments are altered in older adults during lateral postural perturbations[J]. Clin Neurophysiol, 2013, 124(8): 1628-1637. doi: 10.1016/j.clinph.2013.02.111 pmid: 23601702
[15]	渡部和彦, 王芸. 老年人的身体平衡能力与"外部干扰适应理论"[J]. 体育科学, 2014, 34(2): 54-59.
	WATANABE K, WANG Y. The characteristic of upright balance in elderly and methodology of the coaching: background of "Disturbance and Adaptation Theory"[J]. Chin Sport Sci, 2014, 34(2): 54-59.
[16]	MARTINEZ K M, MILLE M L, ZHANG Y, et al. Stepping in persons poststroke: comparison of voluntary and perturbation-induced responses[J]. Arch Phys Med Rehabi, 2013, 94(12): 2425-2432. doi: 10.1016/j.apmr.2013.06.030
[17]	CHANG W H, TANG P F, WANG Y H, et al. Role of the premotor cortex in leg selection and anticipatory postural adjustments associated with a rapid stepping task in patients with stroke[J]. Gait Posture, 2010, 32(4): 487-493. doi: 10.1016/j.gaitpost.2010.07.007
[18]	MIHARA M, MIYAI I, HATTORI N, et al. Cortical control of postural balance in patients with hemiplegic stroke[J]. NeuroReport, 2012, 23(5): 314-319. doi: 10.1097/WNR.0b013e328351757b pmid: 22357394
[19]	FUJIMOTO H, MIHARA M, HATTORI N, et al. Cortical changes underlying balance recovery in patients with hemiplegic stroke[J]. NeuroImage, 2014, 85(Pt 1): 547-554. doi: 10.1016/j.neuroimage.2013.05.014
[20]	PEREIRA S, SILVA C C, FERREIRA S, et al. Anticipatory postural adjustments during sitting reach movement in post-stroke subjects[J]. J Electromyogr Kinesiol, 2014, 24(1): 165-171. doi: 10.1016/j.jelekin.2013.10.001
[21]	MCCOMBE WALLER S, YANG C L, MAGDER L, et al. Impaired motor preparation and execution during standing reach in people with chronic stroke[J]. Neurosci Lett, 2016, 630: 38-44. doi: S0304-3940(16)30496-7 pmid: 27436481
[22]	POLLOCK C L, CARPENTER M G, HUNT M A, et al. Physiological arousal accompanying postural responses to external perturbations after stroke[J]. Clin Neurophysiol, 2017, 128(6): 935-944. doi: S1388-2457(17)30096-2 pmid: 28407522
[23]	SOUSA A S, SILVA A, SANTOS R. Ankle anticipatory postural adjustments during gait initiation in healthy and post-stroke subjects[J]. Clin Biomech (Bristol, Avon), 2015, 30(9): 960-965. doi: 10.1016/j.clinbiomech.2015.07.002
[24]	ANDERSON K G, BEHM D G. Maintenance of EMG activity and loss of force output with instability[J]. J Strength Cond Res, 2004, 18(3): 637-640. pmid: 15320684
[25]	LU C, AMUNDSEN HUFFMASTER S L, HARVEY J C, et al. Anticipatory postural adjustment patterns during gait initiation across the adult lifespan[J]. Gait Posture, 2017, 57: 182-187. doi: S0966-6362(17)30233-3 pmid: 28651215
[26]	AJACHANDRAKUMAR R, FRASER J E, SCHINKEL-IVY A, et al. Atypical anticipatory postural adjustments during gait initiation among individuals with sub-acute stroke[J]. Gait Posture, 2017, 52(1): 325-331. doi: 10.1016/j.gaitpost.2016.12.020
[27]	YIOU E, CADERBY T, HUSSEIN T. Adaptability of anticipatory postural adjustments associated with voluntary movement[J]. World J Orthop, 2012, 3(6): 75-86. doi: 10.5312/wjo.v3.i6.75 pmid: 22720267
[28]	李欣, 桑德春, 朴春花, 等. 骑马治疗改善脑卒中偏瘫患者平衡功能的研究[J]. 中国康复理论与实践, 2009, 15(11): 1051-1053.
	LI X, SANG D C, PIAO C H, et al. Effects of mechanical horseback riding on balance ability in stroke patients[J]. Chin J Rehabil Theory Pract, 2009, 15(11): 1051-1053.
[29]	郭紫琦, 袁淑娟. 脑卒中患者平衡评定量表的研究进展[J]. 临床与病理杂志, 2021, 41(10): 2481-2486.
	GUO Z Q, YUAN S J. Research advance of balance assessment scale in stroke patients[J]. J Clin Pathol Res, 2021, 41(10): 2481-2486.
[30]	瓮长水, 田哲, 李敏, 等. 起立行走计时测试在评定脑卒中患者功能性移动能力中的价值[J]. 中国康复理论与实践, 2004, 10(12): 733-735.
	WENG C S, TIAN Z, LI M, et al. The value of the Timed "Up & Go" Test at the evaluation of functional mobility in stroke patients[J]. Chin J Rehabil Theory Pract, 2004, 10(12): 733-735.
[31]	陈琳, 郗海涛, 黄红云. 世界神经病联合会国际合作共济失调量表介绍[J]. 中国组织工程研究与临床康复, 2007, 39(11): 8005-8007.
	CHEN L, XI H T, HUANG H Y. Introduction of the World Federation of Neurology's International Cooperative Ataxia Rating Scale[J]. J Clin Rehabil Tissue Eng Res, 2007, 39(11): 8005-8007.
[32]	ARIENTI C, LAZZARINI S G, POLLOCK A, et al. Rehabilitation interventions for improving balance following stroke: an overview of systematic reviews[J]. PLoS One, 2019, 14(7): e0219781. doi: 10.1371/journal.pone.0219781
[33]	SUNG Y H, KIM C J, YU B K, et al. A hippotherapy simulator is effective to shift weight bearing toward the affected side during gait in patients with stroke[J]. NeuroRehabilitation, 2013, 33(3): 407-412. doi: 10.3233/NRE-130971
[34]	RUGGERI A, DANCEL A, JOHNSON R, et al. The effect of motor and physical activity intervention on motor outcomes of children with autism spectrum disorder: a systematic review[J]. Autism, 2020, 24(3): 544-568. doi: 10.1177/1362361319885215 pmid: 31782658
[35]	HEMACHITHRA C, MEENA N, RAMANATHAN R, et al. Immediate effect of horse riding simulator on adductor spasticity in children with cerebral palsy: a randomized controlled trial[J]. Physiother Res Int, 2020, 25(1): e1809.
[36]	PAN C Y, CHANG Y K, TSAI C L, et al. Effects of physical activity intervention on motor proficiency and physical fitness in children with ADHD: an exploratory study[J]. J Atten Disord, 2017, 21(9): 783-795. doi: 10.1177/1087054714533192
[37]	BAILLET H, LEROY D, VÉRIN E, et al. Effect of mechanical horse practice as new postural training in patients with neurological disorders: a pilot study[J]. Front Psychol, 2019, 10: 1035. doi: 10.3389/fpsyg.2019.01035 pmid: 31133944
[38]	KIM S K, HWANGBO G. The effects of horse-riding simulator exercise on balance in elderly with knee osteoarthritis[J]. J Phys Ther Sci, 2017, 29(3): 387-389. doi: 10.1589/jpts.29.387
[39]	KIM S K, KIM S G, HWANGBO G. The effect of horse-riding simulator exercise on the gait, muscle strength and muscle activation in elderly people with knee osteoarthritis[J]. J Phys Ther Sci, 2017, 29(4): 693-696. doi: 10.1589/jpts.29.693
[40]	NOH H J, KIM C M, PARK J W. A study on muscle activity based on the ankle posture for effective exercise with indoor horse riding machine[J]. J Phys Ther Sci, 2019, 31(2): 170-174. doi: 10.1589/jpts.31.170
[41]	COLLADO-MATEO D, LAVÍN-PÉREZ A M, FUENTES GARCÍA J P, et al. Effects of equine-assisted therapies or horse-riding simulators on chronic pain: a systematic review and meta-analysis[J]. Medicina (Kaunas), 2020, 56(9): 444.
[42]	D'CUNHA N M, ISBEL S, MCKUNE A J, et al. Activities outside of the care setting for people with dementia: a systematic review[J]. BMJ Open, 2020, 10(10): e040753. doi: 10.1136/bmjopen-2020-040753
[43]	HILLIERE C, COLLADO-MATEO D, VILLAFAINA S, et al. Benefits of hippotherapy and horse riding simulation exercise on healthy older adults: a systematic review[J]. PM R, 2018, 10(10): 1062-1072. doi: 10.1016/j.pmrj.2018.03.019
[44]	BORGES M B S, WERNECK M J D S, DA SILVA M D L, et al. Therapeutic effects of a horse riding simulator in children with cerebral palsy[J]. Arq Neuropsiquiatr, 2011, 69(5): 799-804. doi: 10.1590/S0004-282X2011000600014
[45]	PARK J, LEE S, LEE J, et al. The effects of horseback riding simulator exercise on postural balance of chronic stroke patients[J]. J Phys Ther Sci, 2013, 25(9): 1169-1172. doi: 10.1589/jpts.25.1169 pmid: 24259938
[46]	GRANACHER U, LACROIX A, MUEHLBAUER T, et al. Effects of core instability strength training on trunk muscle strength, spinal mobility, dynamic balance and functional mobility in older adults[J]. Gerontology, 2013, 59(2): 105-113. doi: 10.1159/000343152 pmid: 23108436
[47]	VERHEYDEN G, NIEUWBOER A, DE WIT L, et al. Trunk performance after stroke: an eye catching predictor of functional outcome[J]. J Neurol Neurosurg Psychiatry, 2007, 78(7): 694-698. pmid: 17178824
[48]	MCGEE M C, REESE N B. Immediate effects of a hippotherapy session on gait parameters in children with spastic cerebral palsy[J]. Pediatr Phys Ther, 2009, 21(2): 212-218. doi: 10.1097/PEP.0b013e3181a39532 pmid: 19440132
[49]	BERTOTI D B. Effect of therapeutic horseback riding on posture in children with cerebral palsy[J]. Phys Ther, 1988, 68(10): 1505-1512. pmid: 3174832
[50]	KIM Y N, LEE D K. Effects of horse-riding exercise on balance, gait, and activities of daily living in stroke patients[J]. J Phys Ther Sci, 2015, 27(3): 607-609. doi: 10.1589/jpts.27.607
[51]	ALGHADIR A H, AL-EISA E S, ANWER S, et al. Reliability, validity, and responsiveness of three scales for measuring balance in patients with chronic stroke[J]. BMC Neurol, 2018, 18(1): 141. doi: 10.1186/s12883-018-1146-9 pmid: 30213258
[52]	LI J, ZHONG D, YE J, et al. Rehabilitation for balance impairment in patients after stroke: a protocol of a systematic review and network meta-analysis[J]. BMJ Open, 2019, 9(7): e026844. doi: 10.1136/bmjopen-2018-026844
[53]	HARUYAMA K, KAWAKAMI M, OTSUKA T. Effect of core stability training on trunk function, standing balance, and mobility in stroke patients[J]. Neurorehabil Neural Repair, 2017, 31(3): 240-249. doi: 10.1177/1545968316675431 pmid: 27821673
[54]	VAN CRIEKINGE T, TRUIJEN S, SCHRÖDER J, et al. The effectiveness of trunk training on trunk control, sitting and standing balance and mobility post-stroke: a systematic review and meta-analysis[J]. Clin Rehabil, 2019, 33(6): 992-1002. doi: 10.1177/0269215519830159 pmid: 30791703

项目	对照组 (n = 27)	治疗组 (n = 22)	χ²/t值	P值
性别(男/女)/n	25/2	20/2	0.000	1.000
年龄/岁	58.81±11.17	54.45±11.66	1.333	0.189
病程/d	90.15±93.89	88.73±85.82	0.055	0.957
性质(梗死/出血)/n	22/5	17/5	0.000	0.994

组别	n	治疗前	治疗后	t值	P值
对照组	27	34.59±9.13	24.04±8.35	17.845	< 0.001
治疗组	22	35.86±12.34	21.59±11.27	13.553	< 0.001
t值		0.414	-0.873
P值		0.681	0.387

组别	n	治疗前	治疗后	t值	P值
对照组	27	9.09±1.72	10.50±1.57	-6.019	< 0.001
治疗组	22	8.48±2.06	10.07±1.71	-9.465	< 0.001
t值		1.107	0.901
P值		0.274	0.372

组别	n	治疗前	治疗后	t值	P值
对照组	27	24.09±12.21	41.73±9.11	-13.906	< 0.001
治疗组	22	20.26±10.02	32.52±10.06	-21.011	< 0.001
t值		1.207	3.323
P值		0.234	0.002

组别	n	治疗前	治疗后	t值	P值
对照组	27	24.14±4.59	29.73±2.66	-10.487	< 0.001
治疗组	22	22.70±4.57	27.74±3.12	-15.406	< 0.001
t值		1.089	2.366
P值		0.282	0.022

Effects of horse-riding simulator exercise on post-stroke ataxia

RichHTML

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 7

References 54

Related Articles 15

Metrics

Comments

Recommended 0

组别	n	治疗前	治疗后	t值	P值
对照组	27	50.13±6.25	38.14±8.79	10.555	< 0.001
治疗组	22	51.34±5.06	42.66±5.87	23.826	< 0.001
t值		-0.749	-2.212
P值		0.457	0.031

组别	n	治疗前	治疗后	t值	P值
对照组	27	57.73±16.81	76.36±13.47	-7.847	< 0.001
治疗组	22	59.07±11.35	73.33±13.80	-15.046	< 0.001
t值		-0.334	0.773
P值		0.740	0.443

[1]	ZHU Lili, ZHAO Jiaxin, CHENG Xue, WANG Huijuan, CHEN Xiaoxia. Experiences and needs of stroke patients during rehabilitation: a qualitative meta-synthesis [J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(3): 286-293.
[2]	LIU Ping, ZHOU Nan, XUE Xiaojie, SHAO Weibo. Application of rehabilitation therapy techniques for post-stroke dysphagia: a bibliometric analysis [J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(3): 294-303.
[3]	YANG Ling, WANG Qinglei, WANG Jie, XU Wenjie, WANG Tong, GUO Chuan, QIAN Xue. Activation patterns and mechanism in the prefrontal cortex of post-stroke anxiety patients: a study using functional near-infrared spectroscopy [J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(3): 329-336.
[4]	YUE Yuan, ZHANG Tong, LIU Yuanmin, WANG Ya'nan. Effect of lower extremity exoskeleton robots on balance and walking function of patients with post-stroke cerebellar ataxia [J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(1): 23-29.
[5]	WU Cheng, ZHANG Yunfeng, WANG Weining, YU Kewei, ZHANG Yanzheng, SHEN Jiarong, WU Yi. Effect of elbow-wrist functional orthosis on plantar pressure and balance function in stroke patients with hemiplegia [J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(1): 30-39.
[6]	ZHANG Junfeng, CHEN Hao, DU Yuzheng, LI Chen, YU Tao, YANG Yuanqing. Non-pharmacological management for post-stroke spasticity from 2004 to 2024: a bibliometric analysis [J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(1): 45-58.
[7]	GAO Kaixiang, LU Haitao. Research in neurorehabilitation from 2015 to 2024: a bibliometric analysis [J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(1): 59-68.
[8]	WEI Jingyi, WANG Xiaojing, WANG Ran, WEI Chen, MA Sai, LIU Xihua. Effect of acupuncture synchronized speech training on post-stroke motor aphasia [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(9): 1000-1008.
[9]	WANG Xiaojing, WEI Jingyi, WEI Chen, WANG Ran, MA Sai, LIU Xihua. Effect of synchronous acupuncture and articulation training on spastic dysarthria after stroke [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(9): 1009-1016.
[10]	ZHOU Xinyue, YE Ruixue, MA Yaqi, XU Ying, CAO Longyao, WANG Yulong. Researches on central post-stroke pain: a bibliometric analysis [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(9): 1038-1049.
[11]	GAO Yunhan, HOU Shanshan, WANG Xinyu, ZHU Chongtian. Effect of brain-computer interface on upper limb motor dysfunction in stroke patients based on functional near-infrared spectroscopy [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(9): 1066-1073.
[12]	GAO Fei, LIU Lixu, HU Xueyan, WU Xiaoli, YANG Lingyu, YANG Yuqi, YE Changqing, DU Xiaoxia. Effect of unilateral or bilateral transcranial direct current stimulation on post-stroke dysphagia [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(9): 993-999.
[13]	ZHANG Ziang, CHEN Jing, SHEN Mengru, GENG Zongxiao, HAN Xue, ZHAO Xu, XU Lei. Comparison of effect of different types of exercise on gait and balance for stroke patients [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(8): 896-905.
[14]	WANG Xiaofeng, HU Mengqiao, WANG Yan, WEI Kun, XU Wenzhu, REN Dan, MA Ye. Effect of exoskeleton robot-assisted gait training on lower limb function after stroke and spinal cord injury: a systematic review [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(8): 914-921.
[15]	ZHANG Zihan, GUAN Jinzhi, HUANG Xing, ZHOU Li, ZHANG Yaxuan, ZHANG Mengyuan, CHANG Jingling. Characteristics of time-domain and time-frequency of Chinese word-picture matching task-related electroencephalogram in patients with post-stroke aphasia [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(8): 947-957.