• Title/Summary/Keyword: 뇌성마비 아동

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Acoustic Characteristics of Korean Alveolar Sibilant 's', 's'' according to Phonetic Contexts of Children with Cerebral Palsy (뇌성마비 아동의 음성 환경에 따른 치경마찰음 'ㅅ', 'ㅆ'의 음향학적 특성)

  • Kim, Sookhee;Kim, Hyungi
    • Phonetics and Speech Sciences
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    • v.5 no.2
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    • pp.3-10
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    • 2013
  • The purpose of this study is to analyze the acoustic characteristics of Korean alveolar sibilant sounds of children with cerebral palsy by acoustic analysis. Thirteen children with spastic cerebral palsy aging from 6 to 10 years old, were selected by an articulation test, and compared with a control group of thirty children. The meaningless monosyllable CV, disyllable VCV(/asa/) and frame sentence including target syllables CV were measured. C was from the /s, s'/, and V was from the set /a, i, u, ${\varepsilon}$, o, ɯ, ʌ/. Multi-Speech was used for data recording and analysis. As a result, the frication duration of lenis-glottalized alveolar sibilant of children with cerebral palsy was significantly shorter than that of the control group in CV, VCV and frame sentence. The vowel duration in the following lenis-glottalized alveolar sibilant of children with cerebral palsy was significantly longer than that of the control group in CV, VCV and frame sentence. The children with cerebral palsy showed frequency and intensity of friction intervals which were significantly lower than in the control group in CV, VCV and frame sentence. In the comparison of the lenis-glottalized alveolar sibilant by the children with cerebral palsy group's phonation types, the frication duration showed a significant difference between the phonation types in CV, VCV and between the phonetic contexts. The glottalized-sibilant was longer than the lenis-sibilant in all the phonetic contexts. The subsequent vowel duration showed a significant difference between the phonation types in VCV and between the phonetic contexts(p<.05). The vowel duration in the following glottalized-sibilant was longer than the vowel duration in the following lenis-sibilant in all the phonetic contexts. In the frequency there was a significant difference between the phonation types in CV, and in the intensity there was a significant difference between the phonation type in CV and VCV. The children with spastic cerebral palsy had difficulty in articulating the alveolar sibilant due to poor control ability in laryngeal, respiration and articulatory movements which require fine motor coordination. This study quantitatively analyzes the acoustic parameters of the alveolar sibilant in various phonetic contexts. Therefore, the results are expected to help provide fundamental data for an intervention of articulation treatment for children with cerebral palsy.

The Effects of Physical Function Level and Intensity of Treatment for Rehabilitation on Improvement of Physical Function in Children with Cerebral Palsy: Follow-up Study for 6 Months (뇌성마비 아동의 신체 기능수준과 재활 목적 치료 강도가 신체 기능향상에 미치는 영향: 6개월간 추적연구)

  • Kim, Bu-Young;Yun, Young-Ju;Shin, Yong-Beom;Kim, Soo-Yeon;Oh, Tae-Young
    • Journal of the Korean Society of Physical Medicine
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    • v.13 no.1
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    • pp.27-38
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    • 2018
  • PURPOSE: The purpose of this study was to find out the treatment patterns of Children with cerebral palsy, and to analyze the effect of physical function level and treatment intensity on improvement of physical function in children with cerebral palsy for six months. METHODS: Participants were 126 children (boys 83, girls 43) diagnosed cerebral palsy that the mean age was at 33months, ranged from 8 months to 77 months. We collected data related on demography and disable characteristic, treatment pattern using by questionnaire constructed ourselves for six months on caregivers. The treatment pattern includes, type, frequency, and institute of treatment. We performed the evaluation of Gross Motor Function Measurement (GMFM) and Pediatric Evaluation of Disability Inventory (PEDI) between pre and post for six months in order to find out improvement of physical function. We analyzed the effect of physical functional level measured by Gross Motor Functional Classification system, age, treatment intensity on physical function using by repeated measures ANOVA for SPSS PC ver. 22.0. RESULTS: The average of treatment frequency for physical therapy was 5.74 times per week, occupational therapy was 3.96 times, speech therapy was 2.96 times, treatment for accompanying disability was 3.12 times. Physical function level and age was significantly factors affecting improvement of physical function, there was no significant difference according to treatment intensity. CONCLUSION: We suggest that physical function and age might be important factors on improvement of physical function and professional rehabilitation team must consider the appropriate treatment type customized to each children.

The Effect of Positioning on the Hand Function and Correlation of Variable in Children with Cerebral Palsy(Spastic Diplegia) (자세변화에 대한 뇌성마비아동(경직성 양마비)의 손 기능 차이 비교와 제변수와의 상관관계의 연구)

  • Jung, Min-Ye;Current, Marion E.;Kwon, Hyuk-Cheol
    • Physical Therapy Korea
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    • v.3 no.3
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    • pp.44-58
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    • 1996
  • The purpose of this study was to compare and evaluate various hand functions in the most common position (chair sitting, standing, floor sitting) used by cerebral palsied children with spastic diplegia. The results, analysed statistically, could be useful in suggesting treatment strategy for the improvement of hand function in such patient. For this study, 27 children mild or moderate spastic diplegia were chosen. They were patients of the Rehabilitation Hospital, Yonsei University Medical Center. Both dominant and nondominant hands were tested by the Box and Block Test. Bilateral hand function was tested by bead striding and card sorting activities. Collected data was analysed using univariate correlation analysis and MANOVA. Results were as follows: 1) In chair sitting there was a significant positive correlation between dominant hand scores in the Bloc and Box Test and chronological age, gestation period, and time of treatment initiation. In bilateral hand function, card sorting scores correlated positively with time of treatment initiation. 2) In standing, there was a significantly positive correlation between dominant hand scores in the Block and Box Test and time of treatment initiation. 3) In floor sitting, there was a significantly positive correlation between the dominance hand scores in the Block and Box Test and the tine of treatment initiation. Bead stringing, a bilateral hand activity, correlated positively with gestation period and birth weight but negatively with the postnatal incubation period. 4) That score of children who walked showed no significant difference in any of the three postures. 5) Highest test scores in children who could nat walk were in the Box and Block Test for nondominant hand in bead stringing for bilateral hand function. There scores occurred with the children in thee chair sitting posture. The results showed that, in order to improve hand function in children with spastic diplegia, it is necessary to maintain a well supported upright trunk posture with variations allowed for relevance to the chosen position of thee improvements hand activity being performed.

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Lived experience of mothers who have child with cerebral palsy (뇌성마비아 어머니의 경험)

  • Lee Hwa Za;Kim Yee Soon;Lee Gee Won;Gwan Soo Za;Kang In Soon;An Hea Gyung
    • Child Health Nursing Research
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    • v.2 no.1
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    • pp.93-111
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    • 1996
  • The purpose of the study is to identify the lived experience of mothers who have children with cerebral palsy in order to understand their agony. Moreover, the result of study was to find some nursing intervention for disabled children and their mothers. For this purpose, ten mothers who are willing to cooperate with this research were selected at random from those who have children with the cerebral palsy, currently using the municipal facilities for the handicapped with cerebral malfunction. Data collection was done from October 4, 1994 th December 31, 1994. The data were collected by asking the mothers mentioned above with some unstructured open-ended questions, recorded on the tapes with permission by the interviewee in order to prevent missing of the interviewed contents. These collected data have been substantiated and properly analyzed on the basis of phenomenological approach initiated by Colaizzi's method. The results and validity are proved to be credible by means of the individual checking of the interviewed mothers. The results of this study are as follows : 1. When the mother is first informed of the diagnosis of cerebral palsy on her child, she usually misses the crucial timing needed for proper treatment of the child's disorder because she is notified through the doctor's indifference and his apparently inactive, matter-of-fact attitude. At first she suspects the doctor's diagnosis and tries to attribute it to the unknown cause from a certain genetic problem and then she quickly wants to deny the whole situation that her child is really suffering from the cerebral palsy. The reality is too much for her to accept as it is and she would not believe her child is abnormal. Therefore, she even attempts depend on the power of God for its solution. 2. The mother, who goes thorough this kind of uncommon experiences, is totally devoted to the treatment and care of the child and completely ignores her own life and happiness. At the same time, she feels sorry for her other normal children she believes having not enough care and concern. Also, she feels sorry for the sick child when the child's brothers or sisters show special concern for the patient out of sympathy. It is sorry and not satisfied for her that the child is growing with abnormality and neighbor other around have inappropriate attitudes. Likewise, she is discontent with her husband's lack of concern about the child's treatment. She believes that the health care system in this society isn't fulfilling its due purpose. In the state of her utmost distress and anxiety, she always feels the need of competent consultants, and is angry about that her child is treated as an abnormal being, she is trying to hide the child from other people and to make him or her disappear, if possible. Although she doesn't have harmonious relation with her husband, she id happy when he shows his affection for the child and she feels relieved and thankful when the relatives don't mention about the child's condition Since the child's overall status of health is continuously in unstable conditions, requiring her all-time readiness for an emergency, she feels guilty of her child's illness toward the fEmily members as if it was her own fault to have borne such an abnormal child and she feels responsible for the child morally and financially if necessary Because her life is centered on taking care of the child, she cannot afford to enjoy her own life and happiness. She is a lonely mother, fatigued, with no proper relationship with other people around her. With this sense of guilt and responsibility as a mother of an unusual disease, she has no choice but to grieve her destiny from which she is not allowed to escape. 3. Nevertheless, the mother with the child suffering from the cerebral palsy does not easily give up the hope of getting her child cured and she believes that in the long run, though slower than hoped, her abnormal son or daughter will be eventually cured to become a normal sibling someday. This kind of hope is sustained by the mother's strong faith coming from observing the progress of other similar children getting better. Sometimes she is encouraged to have this faith by other mothers who share the same painful experiences, believing that her child will improve even more rapidly than others with the same palsy. Full of hope, she painstakingly waits for the child's healing. Moreover, she plans to have another child. she thinks that the patient child's brothers and sisters only can truly understand and look after the patients. However, when she notices that the progress of other children under the treatment does not look so hopeful, she is distressed by the thoughts that her child may never get well. Too, she is worried that the patient's brother or sister will be born as the same invalid with the cerebral disease. She is discouraged to have another baby as much as she is encouraged to. She is also troubled by the thought that in case she has another baby, she will have to be forced. to neglect the patient child, especially when she does have an extra hand or some reliable person to help her with taking care of the patient.

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A Study on Children Suffering from Cerebral Palsy in Terms of ADL Evaluation (일상생활동작 평가를 통한 뇌성마비아동에 대한 연구)

  • Park Youn-ki;Lim Ho-Chan;Ahn Byung-Jub;Bae Sung-Soo
    • The Journal of Korean Physical Therapy
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    • v.1 no.1
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    • pp.27-45
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    • 1989
  • This study aims at helping cerebrally palsied children to overcome and minimize their sufferings, inducing them to perform ordinary activities of daily living for themselves by coducting ADL Tests which are fundamental activities in daily life and presenting treatment plan for their overall rehabilitation and basic data for achieving the training objective. For that purpose, 173 cerebrally palsied children were selected and given ADL performance Tests from Dec. 1987 to Oct. 1988 and the following results were obtained. 1. Correlation coefficients for each ADL category indicated significant statistical value at .01 level. 2. Correlation coefficient between school-year variable and ADL category variable was significant at .01 level. 3. Correlation between age variable and ADL variable category proved significant at .01 level as well. 4. Correlation coefficients between each category in terms of functional state of extremities were significant at .01 level. 5. The difference in ADL achievements between each category by school year were as follows ; 1) In the category of meeting nature's tall, the age span of more than 4 school years showed statistical significance. 2) In the category of putting off and on clothing, the age span of 3 school years indicated statistical significance. 3) In taking meals statistical significance was found in the age span of 4 school years. 4) In finger movements the age span of more the 4 school years indicated statistical significance. 5) In walking activities statistical significance was noticed in the age span of 2 or 3 school years. Besides, in category by school year, and exceptional case was noticed that the 6th graders were lower than the 5th graders in self-reliance rate. 6. the difference in ADL achievements by type of palsy, children of triplegia were the lowest, while those of monoplegia were the highest. 7. The difference in ADL achievements by kind of palsy, patients of athetosis showed lower rate of self-reliance than those of spasticity, and particularly the latter showed a high rate of self-reliance in taking meals$(83.5\%)$. The former were relatively low in self-reliance and lowerst in meeting nature's call $(59.8\%)$.

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Speech Evaluation Variables Related to Speech Intelligibility in Children with Spastic Cerebral Palsy (경직형 뇌성마비아동의 말명료도 및 말명료도와 관련된 말 평가 변인)

  • Park, Ji-Eun;Kim, Hyang-Hee;Shin, Ji-Cheol;Choi, Hong-Shik;Sim, Hyun-Sub;Park, Eun-Sook
    • Phonetics and Speech Sciences
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    • v.2 no.4
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    • pp.193-212
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    • 2010
  • The purpose of our study was to provide effective speech evaluation items examining the variables of speech that successfully predict the speech intelligibility in CP children. The subjects were 55 children with spastic type cerebral palsy. As for the speech evaluation, we performed a speech subsystem evaluation and a speech intelligibility test. The results of the study are as follows. The evaluation task for the speech subsystems consisted of 48 task items within an observational evaluation stage and three levels of severity. The levels showed correlations with gross motor functions, fine motor functions, and age. Second, the evaluation items for the speech subsystems were rearranged into seven factors. Third, 34 out of 48 task items that positively correlated with the syllable intelligibility rating were as follows. There were four items in the observational evaluation stage. Among the nonverbal articulatory function evaluation items, there were 11 items in level one. There were 12 items in level two. In level three there were eight items. Fourth, there were 23 items among the 48 evaluation tasks that correlated with the sentence intelligibility rating. There was one item in the observational evaluation stage which was in the articulatory structure evaluation task. In level one there were six items. In level two, there were eight items. In level three, there was a total number of eight items. Fifth, there was a total number of 14 items that influenced the syllable intelligibility rating. Sixth, there was a total number of 13 items that influenced the syllable intelligibility rating. According to the results above, the variables that influenced the speech intelligibility of CP children among the articulatory function tasks were in the respiratory function task, phonatory function task, and lip and chin related tasks. We did not find any correlation for the tongue function. The results of our study could be applied to speech evaluation, setting therapy goals, and evaluating the degree of progression in children with CP. We only studied children with the spastic type of cerebral palsy, and there were a small number of severe degree CP children compared to those with a moderate degree of CP. Therefore, when evaluating children with other degrees of severity, we may have to take their characteristics more into account. Further study on speech evaluation variables in relation to the severity of the speech intelligibility and different types of cerebral palsy may be necessary.

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A Long Term Follow Up Two Cases of Lesch-Nyhan Syndrome Pink Diaper (Lesch-Nyhan 증후군 장기 추적관찰: 분홍 기저귀)

  • Jae Young Kim;Wung Joo Song;Bong-Ok Kim;Harvey L. Levy;Sook Za Kim
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.24 no.1
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    • pp.26-36
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    • 2024
  • Lesch-Nyhan syndrome (LNS) is an Clinical symptoms can range from mild to severe depending on residual enzyme activity and genetic mutations. In Korea, 27 cases of LNS have been reported. We report the results of an 11-year comparative follow-up of two cases of children who visited because of pink diapers, one who died from LNS with no residual enzymes and one case with partial residual enzymes. Case 1: During follow-up, seizures, developmental delay, and regression were observed. The boy experienced insomnia and severe constipation. He exhibited self-mutilating behavior, a grand mal seizure, scoliosis with severe spasticity, truncal hypotonia, choreoathetoid movement, and ataxia. After prolonged emaciation, staghorn calculi, and recurrent pneumonia, the patient died suddenly at the age of 11 years. Genetic testing revealed a hemizygous HPRT1 variant (c.151C>T (p.Arg51Ter)). Uric acid level was 10.5 mg/dL (normal range: ~3.5-7.9) and HPRT activity 0.02 nmol/hr/spot (10-23.8 nmol/hr/spot). Case 2: During follow-up, the patient remained underweight. He has normal intelligence attending primary school. Self-mutilation symptoms were not observed. Regular renal ultrasonography did not reveal urolithiasis. The patient had a hemizygous HPRT1 variant (c.35A>C (p.Asp12Ala)). Uric acid level and HPRT activity were 11 mg/dL and 0.56 nmol/hr/spot. Pink diapers after the neonatal period and severe protein aversion, neurological problems, and kidney stones, differentiation for LNS is necessary. When suspected, serum uric acid levels, HPRT enzyme activity, and molecular biological tests may be helpful in predicting the prognosis of LNS.

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