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Changes in Activities of Daily Living of Children with Spastic Cerebral Palsy According to Gross Motor Function Classification System After One Year of Physical and Occupational Therapy

물리 및 작업치료 1년 후 대동작 기능분류체계에 따른 경직성 뇌성마비 아동의 일상생활동작 변화

  • Lee, Kwon-Woo (Department of Physical Therapy, Daegu Haany University) ;
  • Kim, Won-Ho (Department of Physical Therapy, Ulsan College)
  • 이관우 (대구한의대학교 물리치료학과) ;
  • 김원호 (울산과학대학교 물리치료학과)
  • Received : 2019.05.27
  • Accepted : 2019.08.02
  • Published : 2019.08.31
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Abstract

This study was conducted to investigate changes in activities of daily living (ADLs) according to the Gross Motor Function Classification System (GMFCS) after one year of physical and occupational therapy and to compare the responsiveness of ADL tools. A total of 48 children with spastic cerebral palsy participated in the study. The GMFCS, Functional Independence Measure for Children (WeeFIM), and Pediatric Evaluation of Disability Inventory (PEDI) were measured. The results showed that the GMFCS was significantly correlated with the PEDI (p<0.05), while there was a significant difference in the change of ADLs measured by the PEDI, but not the WeeFIM. There was a significant difference in the changes in ADLs according to the GMFCS, and the change in ADLs in the high functional level group was significantly higher than in the low functional level group (p<0.05). After physical and occupational therapy, the degree of improvement of ADLs varied according to the GMFCS, but seemed to be improved in a clinically meaningfully way. The PEDI is sensitive to changes in ADLs, so it may be used widely in clinical practice.

이 연구는 경직성 뇌성마비 아동을 대상으로 1년간 물리 및 작업치료 후 대동작 기능분류체계에 따라 일상생활동작 변화정도가 차이가 있는지 그리고 소아장애척도지수와 아동용 일상생활 기능독립 측정 중 어떤 평가도구가 일상생활 동작의 변화에 민감하게 반응하는지를 알아보기 위해 시행되었다. 48명의 경직성 뇌성마비 아동이 참여하였고, 대동작 기능분류체계, 아동용 일상생활 기능독립 측정, 그리고 소아장애척도지수를 측정하였다. 연구결과, 대동작 기능분류체계는 소아장애척도지수와 유의한 상관을 보였지만(p<0.05) 아동용 일상생활 기능독립 측정과 유의한 상관을 보이지 않았다. 또한 중재 전과 후 일상생활동작의 변화는 아동용 일상생활 독립측정인 경우 유의한 차이를 보이지 않았지만, 소아장애척도지수인 경우 유의한 차이를 보였다(p<0.05). 대동작 기능분류체계에 따라 일상생활동작의 변화는 유의하게 차이가 있었으며, 기능수준이 높은 경우 일상생활동작이 변화가 유의하게 컸었다(p<0.05). 물리 및 작업치료 후 대동작 기능 분류체계에 따라 일상생활동작의 향상정도는 다르지만 임상적으로 의미 있게 향상되는 것으로 보이며, 소아장애척도지수는 일상생활동작의 변화에 민감하게 반응하므로 임상에서 폭 넓게 활용하는 것이 필요한 것으로 여겨진다.

Keywords

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