The Journal of Korean Academy of Sensory Integration
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v.13
no.2
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pp.21-29
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2015
Objective : This study compares sensory processing ability of children with and without spastic diplegia. In addition, it investigates characteristics of sensory processing differentiated by developmental phase such as pre-school age versus school age. Methods : Participants in this study are ordinal children without specific condition and children with spastic diplegia who are aged 3 to 10 years olds. Using Short Sensory Profile (SSP), sensory processing function of the participants was measured. The survey was distributed to caregivers of the children from November, 2013 to February, 2014, and it was suggested that the caregivers to record the questionnaire directly after approval from a rehabilitation hospital, a university hospital, welfare center, day care center, preschool and elementary school to participate in our study. Results : Group of children with spastic diplegia showed lower score than group of children with no special condition in the total score and the each score of all items of Short Sensory Profile. There was significant difference between the two groups in terms of the total score of sensory processing and the 5 factors except tactile sensitiveness and taste/smell sensitiveness among the 7 factors of test. In the comparison of different age groups, pre-school age group showed lower total score than school age group. Conclusion : This study provides a foundational evidence that can be used when therapist evaluate sensory processing function of children with spastic diplegia. There is need for more study about sensory processing functions of various types of children with cerebral palsy.
The Journal of Korean Academy of Sensory Integration
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v.15
no.2
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pp.46-65
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2017
Objective : The purpose of this research is to find clinical effects of application of weighted vest during task-oriented training focused on gross motor performance and balance abilities of children with spastic diplegia. Methods : 34 subjects were divided by simple random sampling into two groups; experimental group (male : 9, female : 8, average age : 8.12) and placebo group (male : 9, female : 9, average age : 7.53). Both two groups underwent to 40 minute intervention, twice a week for 12 weeks. The intervention was task-oriented training focused on facilitating closed kinematic chain and multi-joint functional movement pattern. During the training, the experimental group received loaded-resistance weighted vest and placebo group also received weighted vest but without loaded-resistance. Participants in both groups underwent 8 to 10 reps of the task-oriented training and there were 3 minutes break time between tasks. There were pre-test of gross motor performance and balance abilities, and two times of post-tests were performed upon 6 weeks and 12 weeks after the intervention completed. And in final, an additional follow-up test was performed 12 weeks after the evaluation was finished in order to find any difference between the two groups over time. Results : There was significant difference in Gross Motor Performance Measure (GMPM) between two groups. It is found that average score of the experimental group increased more than the placebo group after 6 weeks and 12 weeks intervention (p<.05). There was significant difference in Pediatric Berg's Balance Scale (PBS) between two groups. It is found that average score of the experimental group increased more than the placebo group after 6 weeks and 12 weeks intervention (p<.05). Conclusion : Based on the results in this study, it is proposed that application of weighted vest into task-oriented training to facilitating closed kinematic chain and multi-joint movement can improve gross motor performance and balance abilities of children with cerebral palsy.
The Journal of Korean Academy of Sensory Integration
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v.14
no.2
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pp.46-57
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2016
Objective : The purpose of this study is to prove the effects of exercise intervention on postural control of children with cerebral palsy in Korea by systematic review. Methods : Total 18 studies were selected through Korean research database engine such as DBpia, KISS and RISS for the systematic review in this study. Key words used were 'cerebral palsy', 'postural control' and 'balance' and publication time period was limited only after October 2006 in the research selection. All the selected studies were reviewed in terms of quality level of evidence and methodological quality level, and then the results were analyzed with Patient, Intervention, Comparison, Outcome (PICO). Results : For the level of evidence, it is found that 8 studies show Grade I, 5 studies show Grade III, and 2 studies show Grade V. In terms of Methodological quality, majority of the studies showed 'Fare' level. Majority of target population of the studies was children with spastic diplegia. Most research design of the studies were randomized controlled trials. The results in several suited showed that the postural control exercise used in Korea has positive impact on improvement of motor and balance ability. Conclusion : Impact of the exercise intervention used in Korea for postural control of children with cerebral palsy has been evidenced in this study. It is proposed that further research need to be done considering several types of cerebral palsy.
Constraint-Induced Movement Therapy(CIMT) is considered as one of the most interesting upper extremity rehabilitation in the field of neurorehabilitation. CIMT is an intensive training provided in the affected upper limb for 6 hours a day, 5 days a week for 2 weeks, while unaffected arm is restrained for 90% of waking hours. Recently, instead of CIMT, modified Constraint-Induced Movement Therapy(mCIMT) has been applied because of the clinical limitations of CIMT. CIMT or mCIMT studies have used various outcome instruments to measure different aspects of upper limb function after intervention. There are various kinds of evaluation tools to measure different aspects of upper limb function after CIMT intervention. It has been proven that Pediatric Motor Activity Log(PMAL), Quality of Upper Extremities Skills Test(QUEST), Melbourne Assessment of Unilateral Upper Limb Function(MAULF), Assisting Hand Assessment (AHA) are effective. The purpose of this study was to investigate the cortical change in children with hemiplegic cerebral palsy after CIMT. As a result, use-dependent cortical reorganization was revealed. Also, increased activity of the contralateral motor cortex and decreased activity of the ipsilateral cortex were found. It supports the mechanism of cortical reorganization, the principles of neural plasticity and specifically activation of the contralateral cortex, for improving upper limb function after CIMT.
The Journal of Korean Academy of Sensory Integration
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v.4
no.1
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pp.47-55
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2006
Objective : The purpose of this study was to evaluate the correlation between visual perception ability and activities of daily living(ADL) in the children with spastic diplegia who were treated at developmental disabilities children salutary institute. Method : The subject were consisted of 8 children with spastic diplegia(mean age, 10). The visual perception ability was measured by the Developmental Test of Visual Perception(DTVP) and by the Functional Independence Measure for Children(WeeFIM) to evaluate activities of daily living. Collected data analysis were completed by using correlation analysis. Results : Visual perception ability of children with spastic diplegia is the highest in Position in Space(PS) score, and is the lowest in Visual-Motor coordination(VM) score. Average visual perception performance of children with spastic diplegia is the highest in SR(Spatial relationship) score, and is the lowest in VM score. In activities of daily living, eating component were significantly correlated with Visual-Motor coordination. Conclusions : Therefore, accurate evaluation of visual perception ability and visual perception training for children with spastic diplegia will be important to improve patient's activities of daily living skill.
Journal of the Korean Society of Physical Medicine
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v.7
no.2
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pp.213-221
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2012
Purpose : The purpose of this study was to investigate the effect of Vojta therapy on Gross Motor Function Measurement(GMFM) and Selective Voluntary Motor Control (SVMC) in children with Spastic diplegia. Methods : During this experiment, the subject of four children diagnosed with spastic diplegia was tested using ABA design for Single-subject Experimental Research Design. The procedure consisted of baseline, intervention and follow-up phase which was held thirty minutes each for three times a week for a total of 24 times. Gross motor function was measured using GMFM and selective voluntary motor control was measured using SCALE. Results : According to this study, the gross motor function and selective voluntary motor control of all subjects were improved from their intervention phase to their baseline phase. During the follow phase which the intervention was removed, the ability that was enhanced during the prior phases was still either maintained or only reduced slightly. Conclusion : The Vojta therapy used on children diagnosed with spastic diplegia was effective on both GMFM and SVMC. In other words, the therapy was effective on coordination. However, this study is difficult to be generalized due to the insufficient number of subject. In further studies, it will be necessary to increase the number of trials with a control group in order to generalize the effectiveness of Vojta therapy.
Purpose: This study investigated the correlation between physical function and forward head posture in spastic diplegia. Methods: The subjects of this study were 10 spastic diplegia patients. We took pictures of the subjects' craniovertebral angle with a digital camera to determine the degree of forward head posture and then analyzed them using the NIH image J program. The physical function test used the TCMS, the BBT, and a spirometer. The data in this study were measured using SPSS version 23.0, and the statistical significance level α was 0.05. A Pearson correlation coefficient analysis was performed to identify the correlation between the degree of the subject's head forward position and physical function. Results: When we performed the BBT and spirometer tests, the subjects' forward head postures were not correlated (p < 0.05). However, with the TCMS, there was a strong correlation between the forward position of the head and balance, with balance decreasing as the head position increased (p < 0.05). Conclusion: Spastic diplegia patients with severe forward head posture showed problems with static balance, dynamic balance, and equilibrium reaction when sitting. Intervention on the right posture and preventive activities will be needed to improve the health of spastic diplegia patients and prevent future problems with physical function.
Journal of the Korean Society of Physical Medicine
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v.8
no.4
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pp.637-645
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2013
PURPOSE: The purpose of this study was to examine the effect of using a suspension device for arm reaching activity on trunk stability and gross motor function of children with spastic diplegia cerebral palsy. METHODS: The subject in this study consisted of 11, GMFCS(Gross Motor Function Classification System) III~IV children with spastic diplegia cerebral palsy, all of whom agreed to participate in the study. All subjects were divided into two groups: the experimental group using a suspension device, and the control group using no suspension device. For each group, a thirty-minute intervention was done twice per week during 8 weeks. Before and after intervention, each test was measured using TIS(Trunk Impairment Scale), GMFM (Gross Motor Function Measure) and PRT(Pediatric Reaching Test) to change trunk stability, gross motor function and arm reaching activity. The data were analyzed with the Wilcoxon signed rank test. RESULT: All two groups had a meaningful increase in GMFM-Sit data measured before and after intervention. The experimental group had a significant increase from an average of 78.83 to an average of 84.83 in GMFM-Crawling. For both groups, there was a substantial increase in the change in sitting position and arm reaching. CONCLUSION: According to the results of this study, the arm reaching activity using suspension device had an effect on trunk stability and gross motor function and it changed arm reaching activity.
Purpose: The aim of this study was to determine the change of static and dynamic foot pressure on trunk stabilization exercise in children with spastic diplegic cerebral palsy. Methods: This study examined five male children participants ages 10~14 years old with spastic diplegic cerebral palsy. All subjects participated in a 6-week sling exercise program for trunk stabilization; the exercise was performed three times per week and each session lasted 50 minutes. The subjects were measured for static and dynamic foot pressure and bilateral symmetry of both feet before and after the trunk stabilization exercise. Results: The static foot pressure increased significantly before and after the trunk stabilization exercise (left foot: before $0.41{\pm}0.02%BW/cm^2$ after $0.79{\pm}0.02%BW/cm^2$, right foot: before $0.14{\pm}0.03%BW/cm^2$, after $0.43{\pm}0.44%BW/cm^2$) (p<0.05) and bilateral symmetry of both feet increased (before $0.27{\pm}0.18%BW/cm^2$, after $0.37{\pm}0.05%BW/cm^2$) with more weight shift on left foot than right foot, but was not statistically significant (p>0.05). The dynamic foot pressure increased (left foot: before $2.58{\pm}0.44%BW/cm^2$, after $3.40{\pm}0.31%BW/cm^2$, right foot: before $2.75{\pm}0.19%BW/cm^2$, after $3.26{\pm}0.18%BW/cm^2$) with more weight shift on right foot than left foot, but was not statistically significant (p>0.05), and bilateral symmetry of both feet decreased (before $0.31{\pm}0.36%BW/cm^2$, after $0.13{\pm}0.20%BW/cm^2$) (p<0.05). Conclusion: The findings of this study indicated that the trunk stabilization exercise has a positive impact on static and dynamic foot pressure in children with spastic diplegic cerebral palsy.
Purpose: The purpose of the present study was to investigate the effects of toe wedges on the gait ability of adolescents with spastic diplegic cerebral palsy. Methods: Six adolescents with spastic diplegic cerebral palsy participated in this study. During the participants walked with- and without toe wedges, the gait ability was analyzed using the electronic walkway system. Gait parameters, including velocity, cadence, step length, stride length, single support time, and double support time, were collected and analyzed. Results: When the participants walked with toe wedges, there were significant improvements in gait velocity, cadence, and double support time compared to those without toe wedges (p<0.05). However, there were no significant differences in step length, stride length, and single support time. Conclusion: Toe wedges may have a positive effect on the gait ability of adolescents with spastic diplegic cerebral palsy. However, it is necessary to conduct high-quality studies to identify the effects of toe wedges.
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