• Physical Therapy Korea
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• v.17 no.4
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• pp.69-76
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• 2010

The purposes of this study were to examine the reliability and validity of Korean translation of Pediatric Evaluation of Disability Inventory (PEDI-K) in school-aged children with cerebral palsy (CP). The PEDI-K, Functional Independence Measure for Children (WeeFIM) and Gross Motor Function Classification System (GMIFCS) were completed in 104 school-aged children with CP by therapists. The internal consistency of the PEDI-K was calculated by Cronbach's alpha (${\alpha}$) for assessing reliability. Concurrent validity was evaluated by correlation with the subsets of WeeFIM. Discriminant validity was assessed by comparing GMFCS levels with tests of the PEDI-K. The results showed that internal consistency was good (Cronbach's ${\alpha}$ ranged from .97~.98). Concurrent validity was demonstrated. The correlation with WeeFIM was high in the Functional Skills (self-care, r=.74~.94; mobility, r=.59~.91; social function, r=.65~.93) and in the Caregiver Assistance (self-care, r=.75~.94; mobility, r=.63~.90; social function, r=.78~.96). Discriminant validity was demonstrated on significant decreases in domain scores with increasing GMFCS levels. Reliability and validity have been demonstrated on the PEDI-K. This study extends usage of PEDI-K in clinical activities and research.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.3
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• pp.293-299
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• 2014

PURPOSE: The purpose of this study was to investigate the effect of functional training using a sliding rehabilitation machine (SRM) on the mobility of the ankle joint and balance in children with cerebral palsy (CP). METHODS: The subjects consisted of 11 children who were diagnosed with spastic CP. They carried out the functional training using the SRM for 30 minutes, three times a week, for 8 weeks. Before and after all of the training sessions, the subjects were tested using the Pediatric Balance Scale (PBS) and Gross Motor Function Measurement (GMFM), range of motion (ROM) in the ankle joint, the pennation angle of the gastrocnemius muscle and the fascicle length of gastrocnemius muscle were measured to determine the mobility of the ankle joint and balance ability. RESULTS: There were significant differences between the pre-test and post-test in the PBS and GMFM. The ROM of the ankle joint was significantly increased after the functional training using the SRM. Moreover, the fascicle length was increased and the pennation angle was decreased after the functional training using the SRM, but the difference was not significant. CONCLUSION: These results suggest that functional training using the SRM may have some effect on the mobility of ankle joint and balance in children with CP. According to the results, this study could present an approach to the rehabilitation or treatment of children with CP.

• Phonetics and Speech Sciences
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• v.9 no.4
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• pp.129-136
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• 2017

This study investigates the effect of voice quality on speech intelligibility and the relationship between voice quality and intelligibility for children with spastic CP. We recruited 36 children with spastic CP (mean age 10.43 year, 17 girls, 19 boys, spastic type 34, mixed 2) from a special school and a rehabilitation hospital. Voice samples for the perceptual analysis of voice quality were extracted from a sustained vowel /a/ and were rated on the GRBAS scales by two experienced speech language pathologists. Ten adult subjects with no hearing problems evaluated speech intelligibility for the 37 words listed in the Assessment of Phonology and Articulation for Children on a 7-point interval scale. The children with spastic CP were divided into three groups according to the rated G scores on the GRBAS scales (G1(n)=10, G2(n)=13, G3(n)=13). Analyses of ANCOVA and Pearson correlation showed that there was a significant difference in speech intelligibility among three groups. There was also a significant correlation in G scale (grade), A scale (asthenia), B scale (breathy) score, and speech intelligibility. These findings suggest that poor speech intelligibility of spastic CP might be related to asthenia and breathiness. Vocal intensity should be increased and vocal functioning should be improved for speech therapy to improve speech intelligibility of the children with spastic CP.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.4
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• pp.391-398
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• 2014

PURPOSE: The purpose of the present study was to examine the effect of gluteal taping on posture and balance during standing in children with hemiplegic cerebral palsy (CP). METHODS: The subjects of this study were 13 children (six females, seven males; mean aged 8.5) with hemiplegic CP who were gross motor function classification system (GMFCS) level I. The change of posture and balance during standing before and after gluteal taping were measured using inclinometer, gross motor function measure, and functional reaching test. The collected data were analyzed using the paired t-test. RESULTS: The results of this study were as follows : 1) There were statistically significant decrease in the ant. tilt angle of pelvis after gluteal taping in children with hemiplegic CP (p<.05). 2) There were statistically significant increase in functional reaching test after gluteal taping (p<.05). 3) There was no statistically significant difference in gross motor function measure, but significant increase in one leg standing was observed (p<.05). CONCLUSION: As the above results, we suggest that gluteal taping could be effective on improving body alignment and dynamic balance ability during standing in children with hemiplegic CP. Further studies will be required for the short and long term effects of gluteal taping on improving postural symmetry and balance.

• Physical Therapy Korea
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• v.17 no.4
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• pp.41-48
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• 2010

The WeeFIM is an outcome measure used worldwide to evaluate the functional abilities of children. The aim of this study was to evaluate the psychometric properties of WeeFIM in Korean children with cerebral palsy (CP) using the Rasch model. The mean age of the participants (92 boys and 53 girls) was 10.6 years (SD=2.3, range 5~15 years). The Winsteps software was used for analyzing the internal construct validity and reliability of WeeFIM. For analyzing the internal validity the motor and cognitive area items of the WeeFIM were analyzed both together and separately. When all 18 items were analyzed 4 were considered to be misfits; upper extremity dressing, lower extremity dressing, toileting, and comprehension. When only the 13 motor items were analyzed, toileting, bladder management, and bowel management were considered misfits. In addition, only comprehension was considered as a misfit among the 5 cognitive items. The most difficult motor items were stair climbing, and bathing. The simple ones were eating, bowel management, and bladder management. The most difficult cognitive item was problem solving, and the simplest one was comprehension. The person separation indexes and reliability for combined and divided instruments were reported as excellent. These results demonstrated the applicability of WeeFIM to Korean CP children with satisfactory reliability and validity. Further studies should include young children with CP and compare item difficulty among the different types of CP. In addition, the Korean normative data of nondisabled children should be used to compare the cultural differences between Korea and other countries.

• The Journal of Korean Physical Therapy
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• v.20 no.1
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• pp.49-56
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• 2008

Purpose: Lack of a valid prognosis of gross motor development in children with cerebral palsy (CP) and the absence of longitudinal data on which to base an opinion in Korea have made it difficult to plan treatment and counsel prognosis issues accurately. The purposes of this study were to examine whether the Gross Motor Function Classification System (GMFCS) is valuable to prognostication about gross motor progress in children with CP in Korea. Methods: Medical records of 61 patients were retrospectively reviewed that visited outpatient department and were diagnosed as CP. Various information was surveyed including CP type, visual acuity, cognitive function, motor acquisition age, ambulatory status, development curves of Gross Motor Function Measure (GMFM) according to each of the 5 level of GMFCS. All of them were compared with other studies. Also the gross motor development curves and the maximum GMFM score derived from this study were compared with the Palisano's report and the Rosenbaum's report. Results: Based on a total of 494 GMFM assessments provided by this study, the 5 distinct motor development curves and the maximum GMFM score were created. These observations is corresponding with the Palisano's and the Rosenbaum`s Development curves. Conclusion: The 5 distinct motor development curves (GMFCS) that were created by Palisano's and Rosenbaum's study is useful in Korea, providing parents and clinicians with a means to plan interventions and to judge progress over time.

• Physical Therapy Rehabilitation Science
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• v.6 no.2
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• pp.77-82
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• 2017

Objective: Swimming and water-based exercise (WE) programs can provide vigorous physical activity in a fun and a motivating environment. The properties of water, may make it easier for children with cerebral palsy (CP) to move and to participate in an WE program. The aims of this study was to evaluate the effect of WEs on postural control in children with spastic CP. Design: Quasi-experimental design (one group pretest-posttest design). Methods: Twenty preschoolers with spastic CP participated in this study. Prior to the application, sufficient warm-up training was performed to allow the subjects to adapt to the water. Afterwards, three different types of underwater leg exercises for the flexor, extensor, and adductor/abductor of muscles of the lower limb were performed. The WE program lasted during 8 weeks, with one-40 minute sessions per week (8 training session). The usual care was performed during the training session. The Korean-trunk control measurement scale (K-TCMS) and weight distribution variability (difference of both Fz) were measured before and after training session. Results: According to the results, the K-TCMS scores of the three sub-levels, including static sitting, dynamic sitting, and dynamic reaching, was significantly increased after the training session (p<0.05). Also, the weight distribution variability was significantly decreased after 8 weeks (p<0.05). Conclusions: We suggest that WEs may improve the postural control ability in children with spastic CP. Furthermore, we support the need for additional research on the effect of WE on gait or activity of daily living performance with a control group included.

• Physical Therapy Korea
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• v.24 no.2
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• pp.58-65
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• 2017

Background: Children with cerebral palsy (CP) have impaired postural control, but critically require the control of stability. Consequently, therapeutic interventions for enhancing postural control in children with CP have undergone extensive research. One intervention is sensorimotor training (SMT) using a Flexi-bar, but this has not previously been studied with respect to targeting trunk control in children with CP. Objects: This study was conducted to determine the effect of SMT using a Flexi-bar on postural balance and gait performance in children with CP. Methods: Three children with ambulatory spastic diplegia (SD) participated in the SMT program by using a Flexi-bar for forty minutes per day, three times a week, for six weeks. Outcome variables included the pediatric balance scale (PBS), trunk control movement scale (TCMS), 10 meter walking test (10MWT), and 3-dimensional movement coordination measurement. Results: The SMT provided no statistically significant improvement in PBS, TCMS, 10MWT, or 3-dimensional movement coordination measurement. However, positive changes were observed in individual outcomes, as balance and trunk control movement were improved. Conclusion: SMT using a Flexi-bar may be considered by clinicians as a potential intervention for increasing postural balance and performance in children with SD. Future studies are necessary to confirm the efficacy of Flexi-bar exercise in improving the functional activity of subjects with SD.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.3
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• pp.51-59
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• 2019

Purpose : To evaluate the effect of comprehensive art therapy on physical function and activities of daily living in children with cerebral palsy (CP). Methods : Ten ambulant children with diplegic (n=8) or hemiplegic (n=2) CP participated in this study. All were randomly assigned to either the art therapy group (n=5) or the control group (n=5). Both groups received physical therapy based on neurodevelopmental techniques for 20 minutes a day, 1 day a week, for a period of 12 weeks. Children in the art therapy group received additional comprehensive art therapy for 70 minutes once a week for 3 months. Tests for various measurements-Motricity Index (MI) for strength, Trunk Control Test (TCT) for trunk ability, Gross Motor Function Measure (GMFM) and Gross Motor Function Classification System (GMFCS) for gross motor function, Denver Developmental Screening Test-II (DDST-II) for developmental milestones, Functional Independence Measure of Children (WeeFIM) for abilities to complete daily activities, Leg and Hand Ability Test (LHAT) for limb function-were performed before and after treatments. Results : The upper extremity and whole extremity strengths of MI, self-care and total scores of WeeFIM, and leg and arm functions of LHAT improved significantly only for individuals in the art therapy group after the art therapy (p<.05). The value of MI after treatment was at the upper extremity and whole extremity strengths the leg function of LHAT was also significantly improved compared to the control group (p<.05). Conclusion : This study revealed that comprehensive art therapy along with physiotherapy was effective in increasing upper extremity strength and leg ability in children with CP. This suggests that comprehensive art therapy may be a useful adjunctive therapy for children with CP.

• Journal of Society of Preventive Korean Medicine
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• v.23 no.2
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• pp.25-42
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• 2019

Objectives : The purpose of this study was to identify factors that affect the utilization of Korean medicine (KM) among children with cerebral palsy (CP) and explore a processing model of decision-making by their parents. Methods : We conducted an individual in-depth interview with 21 mothers of children with CP who were recruited during the observational study. A grounded theory of Strauss and Corbin was used for qualitative analysis. Thus, collected data were classified into open coding including 121 concepts, 27 sub-categories and 7 categories. Results : The central phenomenon of the process of using KM for children with CP is 'KM as an optional treatment not essential'. Therefore there are many obstacles to starting KM treatment and it is easily interrupted for various reasons, unlike general rehabilitation treatment. However, if the patient experiences the therapeutic effect, the parents want to continue KM treatment. They try to provide treatment as much as possible if they can afford it. The parents give priority to general rehabilitation treatment and value the information and experience provided by the caregivers in similar situation as well as expert opinions. Conclusions : To expand and generalize KM treatment for children with CP, efforts to change interventional conditions such as treatment effect, treatment cost, treatment compliance, and convenience of treatment based on the understanding of the strategy used by the parents in KM utilization.