• Physical Therapy Korea
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• v.30 no.4
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• pp.253-260
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• 2023

Cerebral palsy (CP) is a prevalent neurodevelopmental disorder characterized by motor and postural impairments caused by central nervous system dysfunction. It significantly impacts children's daily functioning and quality of life. Physical therapy is a crucial intervention for children with CP that aims to improve motor skills and functional abilities. This study aimed to provide a comprehensive overview of holistic physical therapy approaches methods specifically designed for children with CP and examine recent research trends and their implications for optimizing outcomes in this population. This study employed a narrative review approach, conducting a comprehensive examination of the current literature pertaining to physical therapy methods for children with CP. The review encompassed studies exploring assessment techniques, evidence-based interventions, and innovative approaches in the field. It was discerned that encompassing physical therapy strategies, which encompass individualized treatment plans, evidence-based interventions, and the integration of innovative techniques, yield a favorable influence on the motor skills and functional capacities of children with CP. This review synthesizes the current knowledge on effective physical therapeutic strategies for children with CP. Furthermore, this review highlights the need for continued research and innovation in the field of pediatric physical therapy for CP.

• Journal of Korean Physical Therapy Science
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• v.10 no.2
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• pp.42-52
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• 2003

An assessment of the subtalar joint in cerebral palsies can contribute to predict the function of ambulation in CP children. Ambulation is one of the most important function to guarantee the CP children independent life. This paper is to investigate some relationships between the function of standing and walling and the assessment of the subtalar joint in children with Cerebral palsy. And also to present the correlation between the ambulation and the Gross Motor Function Measures in children with cerebral palsy. Sixty-eight children with cerebral palsy were participated in this study. Evaluations of the subtalar pint parameters were performed by the goniometer and the angle finder, and the GMFM scores were measured by their teacher and researcher trained technically. A regression analysis was applied to figure out the relationship between the subtalar pint parameters(ROM and RCSP) and the function of standing and walking. A correlation analysis was employed to see how much the subtalar pint parameters could be predicted from GMFM scores in walling and standing. The results were as follows: 1) The significant differences were not observed between the total ROM, RCSP and the function of standing(F=8.065, p<.001) and walking(F=6.511, p<.001) in CP children. 2) The subtalar pint parameters(total ROM, RCSP) have the lower relevance to the function of standing and walling in CP children.(p>.05) 3) The total ROM and RCSP in both feet have the significant differences between the CP children and the normal children.(p<.001) 4) The GMFM scores were significantly correlated with the function of walling and standing in CP children.(r=247, p<.05) In this research, it is found that the significant relevance between the quantitative analysis of subtalar pint in children with cerebral palsy and the gross motor function of ambulation in standing and walling. However, it is difficult to predict the direct relationship of subtalar pint parameters and the function of ambulation, because subtalar pint scores and GMFM are only measured as quantities not qualities. Therefore, it is more reasonable to investigate the influence of subtalar pint parameters on ambulation in children with cerebral palsies, adding to the multifocal assessment of the children, rather than vice versa.

• Journal of International Academy of Physical Therapy Research
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• v.8 no.2
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• pp.1195-1200
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• 2017

The purpose of this study was to effects of hippotherapy on functional ability of children with cerebral palsy (CP). Fifty-seven children with CP participated were randomly divided into two groups. All of the groups received thirty minutes of conventional physical therapy program for three times a week per twelve weeks, however experimental group received additional fifteen minutes of the hippotherapy. Gross Motor Function Measure(GMFM) was used to compare the effects of hippotherapy. The results were as followings: GMFM score in dimensions A and B significantly increased in the control group after intervention. All dimensions of GMFM was significantly increased in experimental group after intervention. All dimensions of GMFM were significantly different between experimental group and control group. These results suggest that hippotherapy can be considered as a therapeutic method for physical therapy for the children with CP to improve the functional movements.

• Physical Therapy Korea
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• v.19 no.4
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• pp.16-23
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• 2012

This study examined the effects of custom-made foot orthotics on the temporal-spatial gait parameters in children with cerebral palsy. Twenty spastic bilateral cerebral palsy (spastic CP) children (11 boys and 9 girls) participated in this study. GAITRite was used to examine the velocity, cadence, step length differential, step length, stride length, stance time, single support time, double support time, base of support, and toe angle while walking with and without foot orthotics. The differences in temporal-spatial parameters were analyzed using paired t-test. The significance level was set at .05. The velocity, cadence, both step lengths, both stride lengths, both bases of support and right toe angle significantly increased when the children with spastic CP with foot orthotics compared to without foot orthotics (p<.05). The step length differential between the two extremities, left stance time and left single support time, significantly decreased with foot orthotics (p<.05). Right stance time, right single support time, both double support times and left toe angle showed little change (p>.05). This study demonstrated that foot orthotics were beneficial for children with spastic CP as a gait assistance tool.

• Physical Therapy Korea
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• v.23 no.4
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• pp.63-70
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• 2016

Background: The Pediatric Balance Scale (PBS) and the Fullerton Advanced Balance (FAB) scale were used to assess balance function in patients with balance problem. These multidimensional clinical balance scales provide information about potential risk factors for falls. Objects: The purpose of this study was to investigate and compare the predictive properties of the PBS and FAB scales relative to fall risk in children with cerebral palsy (CP) using a receiver operating characteristic analysis. Methods: In total, 49 children with CP (boy=21, girl=28) who were diagnosed with level 1 or 2 according to the Gross Motor Function Classification System participated in this study. The PBS and FAB were performed, and verified cut-off score, sensitivity, specificity, and the area of under the curve (AUC). Results: In this study, the PBS scale was as a predictive measure of fall risk, but the FAB was not significant in children with CP. A cut-off score of 45.5 points provided optimal sensitivity of .90 and specificity of .69 on the PBS, and a cut-off score of 21.5 points provided optimal sensitivity of .90 and specificity of .62 on the FAB. Both scales showed moderately accurate of AUC with .79 and .76, respectively. Conclusion: The PBS is a useful screening tool for predicting fall risk in children with cerebral palsy, and those who score 45.5 or lower indicate a high risk for falls and are in need of balance intervention.

• The Journal of Pediatrics of Korean Medicine
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• v.30 no.4
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• pp.66-76
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• 2016

Objectives This study aims to investigate current status of the Korean medicine treatment on the cerebral palsy (CP) via interviewing the doctors who have expertise in CP children. Methods From June 2015 to May 2016, the surveys and in-depth interviews were conducted on the fifteen Korean medicine doctors. Results Based on the surveys and interviews, widely-used treatments were body acupuncture and herbal decoction. Scalp acupuncture, intradermal acupuncture and manipulation were also used frequently. Experts stated Korean medicine could be more effective in younger patients, patients with cognitive or language problem. They also stated that Korean medicine has its advantage on strengthening the body to help grow and develop in CP children. However, the absence of guideline related to Korean medicine treatment in CP children as well as high cost are the problems. Finally, the issues regarding Korean medicine treatment in CP children, based on the in-depth interviews, emerged when western medicine is used simultaneously, when having seizure during treatment. Further research is needed for better understanding. Conclusions This study provided current status of the evidence-based Korean medicine treatment in CP children. However, further studies about the addressed issues are needed.

• The Journal of Korean Physical Therapy
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• v.22 no.3
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• pp.37-44
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• 2010

Purpose: The purpose of this study was to describe the functional (mobility, self-care, social ability) and health-related quality of life in children with cerebral palsy (CP). Methods: A cross- sectional survey of 202 children with CP, mean age $5.91{\pm}1.57$ years, was carried out using the Gross Motor Function Classification System (GMFCS), Gross Motor Function Measure (GMFM), Pediatric Evaluation of Disability Inventory (PEDI), and Child Health Questionnaire (CHQ). Results: The functional assessment of children with CP showed that a more severe GMFCS level was associated with lower functional abilities (p<0.05). The health-related quality of life assessment showed that psychosocial well-being was less impaired than physical well-being. The internal consistency of the three instruments was satisfactory (cronbach's ${\alpha}$>0.80). The three different scales were correlated from moderate to strong (r=0.44 to 0.92). It was also found that mobility, tone distribution, and the parents' education level exerted a significant effect on the quality of life of children with CP (p<0.05). Conclusion: These findings suggest that children with CP have reduced function and quality of life and these are influenced by various factors. However, planning and application of various task-oriented functional interventions to childhood CP may be useful.

• The Journal of Korean Physical Therapy
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• v.27 no.2
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• pp.106-111
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• 2015

Purpose: Impaired reaching movement is commonly observed in children with cerebral palsy. The purpose of this study was to determine whether the inclination of seat surface can influence the reaching movement in children with spastic diplegic cerebral palsy (CP). Methods: The subjects were 31 children, 16 children with spastic bilateral CP and 15 typically developing (TD) children. The children performed static sitting and forward reaching under three conditions: a horizontal seat surface (Horizontal $0^{\circ}$), a seat surface inclined anterior 15 degrees (Ant $15^{\circ}$), and a seat surface inclined posterior 15 degrees (Post $15^{\circ}$). A 3-axis accelerometer ('ZSTAR3') was used for analysis of the reaching movement. A 3-axis accelerometer was attached on the manubrium of the sternum, lateral epicondyle of the humerus, and styloid process of the ulna. We measured the reaction time, movement time, and data amount during reaching the 8 cm target with an index finger on the three inclined seat surfaces. Results: Reaction time and movement time for CPs showed significant delay; comparing the TD's and CP's amount was significantly greater than the TD's during reaching task (p<0.05). In particular, CP's reaction time and movement time on a seat surface inclined Ant $15^{\circ}$ was significantly more delayed compared with the other seat surfaces (p<0.05). Conclusion: Our results suggest that seat-inclination intervention may provide an ergonomic approach for children with spastic cerebral palsy.

• Journal of Korean Physical Therapy Science
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• v.29 no.4
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• pp.27-42
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• 2022

Background: Although children with cerebral palsy (CP) are able to walk independently, gait imbalance occurs due to abnormal muscle tone, musculoskeletal deformity, loss of balance, and selective motor control impairment. Gait restriction in the community and school is a major problem of rehabilitation in CP. Home-based therapy (HBT) provides a variety of interventions in which the therapist and the parent work together to resolve the activities and problems caused by the child's body structure. Therefore, we investigate the effectiveness of home-centered therapy on gross motor function in CP and try to present the possibility of clinical application. Design: A Systematic Review Methods: Research papers were published from Jan, 2012 to Jan, 2022 and were searched using Medline and PubMed. The search terms are 'family-centered' OR 'home-based' AND 'cerebral palsy'. A total of nine papers were analyzed in this study. The paper presented the quality level based on Physiotherapy Evidence Database (PEDro) scores to assess the quality of randomized clinical trials studies. Results: The results showed that HBT for strengthening exercise in lower extremity has a positive effect on the isokinetic torque and gross motor function. home-based treadmill therapy in CP is effective to perform at least 12 sessions of treadmill HBP in which the therapist determines the treadmill speed every week and the child's own gait pattern is modified. Conclusion: These results suggest that it will be important data for founding evidence on the effectiveness of home-centered therapy on gross motor function in children with cerebral palsy to advance clinical protocols.

• Physical Therapy Korea
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• v.17 no.1
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• pp.62-68
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• 2010

The purposes of this study were to examine inter-rater reliability of the Manual Ability Classification System (MACS) by children's age and to identify the correlation between the MACS and the Gross Motor Function Classification System (GMFCS) in children with cerebral palsy (CP). Twenty-six children with CP older than two years participated. Children with CP were classified according to the MACS and the GMFCS by two physical therapists. Inter-rater reliability was analyzed using the Intraclass Correlation Coefficients (ICCs). The results showed that the reliability of the MACS for children aged 2~3 years was .88 and for children aged above 4 years was .98 (p<.05). Children with quadriplegia had a higher level of MACS than children with spastic hemiplegia and diplegia. A moderate relationship between the MACS and the GMFCS was found in all children (rater 1, r=.631; rater 2, r=.438). The MACS will be used for classification of children with CP according to the manual abilities. Thus, it offers a reliable method for communicating between therapists about the manual ability of children with CP who are older than 2 years.