遊憩治療在台灣－馬術活動發展與應用之觀點

Recreational Therapy in Taiwan-Viewpoint of Development and Application of Equestrian Activities

10.6130/JORS.2011.24(1)4

楊明青(Ming-Ching Yang)；陳俊湰(Jun-Long Chen)

遊憩治療 ； 馬術治療 ； recreational therapy ； hippotherapy

戶外遊憩研究

24卷1期（2011 / 03 / 01）

83 - 114

繁體中文

隨著醫療的進步與生活的富裕，身心障礙的人口也逐年提升。據內政部統計資料顯示，截至2010年6月底前，全國領有身心障礙手冊者計1,064,339人，佔總人口數4.6%，其中以肢體障礙佔36.5%爲多數，而自閉症相較於2009年又以11.1%的比例增加爲最高。政府每年花在社會福利的補助約有105.6億多元，其中又以生活補助佔絕大多數約75.8%。然這些障礙者所呈現之生理、心理等問題在接受健康保險所提供的醫療外，有越來越多人選擇另類療法，其一爲遊憩治療，馬術治療也是如此。馬術治療針對以肢體動作爲主要處理對象，其療效常見於各大醫學及復健期刊，在美國、英國、德國等實施馬術治療的國家均有一套完善的訓練計畫、執行課程、資格認證等。 相較於國內實施馬術治療的場地、教練資格、課程與對象等標準與成效參差不齊。本研究即在瞭解國內馬場除提供馬術活動、休閒體驗外是否有爲相關身心障礙者提供馬術治療之活動？其教練資格、場地規劃、課程設計的現況爲何？接受馬術治療者對馬術治療的看法等。研究對象爲台灣44間馬場及3位家長，研究採深度訪談方式進行，對象爲馬術治療師與接受馬術治療個案家長。結果發現台灣馬場多數(84%)僅提供馬術活動之休閒體驗、教學、運動，其中僅7間提供馬術治療，此7間中有2間專爲馬術治療而成立。在馬術治療師資格上，僅3位取得國外之馬術治療專業證照，實施方式偏向治療性馬背騎乘，對象以腦性麻痺居多，家長和馬術治療實施者均認爲馬術治療對接受馬術治療之個案在降低肌肉張力、關節角度正常化、及姿勢控制上有顯著進步。本研究爲對台灣遊憩治療中有關馬術活動之現況調查先驅研究，研究結果可作爲提昇國內馬場的功能性、多元化經營之參考。

As medical progress and affluence of life, the population with disabilities is also increasing year by year. According to MOI statistics, as of 2010, the end of June, the National Disabled Handbook obtained by 1,064,339 people, 4.6% of the total population, of which, 36.5% physical disability are for the majority, while the autistic are relatively more than 11.1% increase in 2010. Government's annual budget on social welfare benefits are about more than 10.56 billion NT dollars, among which the majority are for living allowance, of about 75.8%. However, these obstacles are presented to the physical and psychological problems in receiving medical care provided by health insurance, in addition, there are more and more people are choosing alternative therapies. The first choice is recreational therapy; equestrian therapy shall be one of recreational therapy. Equestrian therapy is dealing with body movements as the main object; its efficacy is common in all major medical and rehabilitation journals in the United States, Britain, Germany and other countries. The implementation of equestrian therapy does have a sophisticated training program, the implementation of curriculum, accreditation, etc. In comparison, the treatment of implementation of the equestrian venues, coaching qualifications, curriculum and other standards with the object and effect is pretty uneven in Taiwan. This study, in addition to providing understanding of the domestic horse farm equestrian activities, also investigates whether there is provision of equestrian-related disabilities treatment activities outside of leisure experiences? The coaching qualification, site planning, and curriculum design status, views of receiving treatments of equestrian therapy are also explored by the researchers. Study involved in-depth interviews on 44 horse field and three parents of the subject receiving the equestrian therapy. The results showed that the majority of Taiwan's horse fields (84%) provide equestrian activities only on leisure experience, teaching, sports, of which only 7 horse fields to provide equestrian therapy, in the 7 horse fields; only 2 of them are set up for the purpose of equestrian therapy. Only three qualified therapists obtain professional certification of equestrian therapy overseas. The implementation of equestrian therapy is biased to therapeutic horseback riding; the majority of subjects are people with cerebral palsy. Parents and people implement equestrian therapy agreed that receiving equestrian therapy treatment can reduce muscle tension, improve joint angle normalization, and make significant progress on postural control. This study is the first pilot study of the current status and the treatment of recreational equestrian activities in Taiwan. The results could be used to enhance the functionality of the domestic horse fields, and serve as their diversification of the management reference.

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