• Journal of the Korean Society of Physical Medicine
• /
• v.13 no.1
• /
• pp.121-128
• /
• 2018

PURPOSE: This study assessed the effect of exercise intervention methods on diaphragm movement, pulmonary function, and pulmonary strength in children with cerebral palsy (CP). METHODS: A total of 28 children with CP were randomly allocated to the general exercise group (n=9, GEG), respiratory exercise group (n=10, REG), and intensive exercise group (n=9, IEG). The exercise intervention was performed for 12 weeks. This study measured diaphragm movement, pulmonary function, and pulmonary strength under two different conditions before and after each exercise. Ultrasonography was used for measuring diaphragm movement, and Pony Fx was used to measure the forced expiratory volume in one second ($FEV_1$), peak expiratory flow (PEF), maximum inspiratory pressure (MIP), and maximum expiratory pressure (MEP). A Mann-Whitney test and ANOVA with a significance level of .05 were used for statistical analysis. RESULTS: Significant change was observed between the REG and the IEG as well as between the GEG and the IEG (p<.05). No significant difference was observed between the GEG and the REG. The diaphragm movement, $FEV_1$ PEF, MIP, and MEP were most improved in the IEG (p<.01). CONCLUSION: This study confirmed that intensive exercise is the most effective treatment method for improving diaphragm movement and respiratory function in CP children.

• Physical Therapy Korea
• /
• v.21 no.3
• /
• pp.55-62
• /
• 2014

This study investigated the relationship between function classification systems and the Pediatric Evaluation of Disability Inventory (PEDI) functional skills in children with cerebral palsy (CP). Two hundred and eleven children with CP participated in this study. The Korean-Gross Motor Function Classification System (K-GMFCS), Korean-Manual Ability Classification System (K-MACS), Korean-Communication Function Classification System (K-CFCS), and self-care, mobility, and social function domains of the Korean-Pediatric Evaluation of Disability Inventory (K-PEDI) functional skills were measured by physical therapists or occupational therapists. All of the function classification systems were significantly correlated with PEDI functional skills ($r_s$=-.549 to -.826) (p<.05). Especially, K-GMFCS, K-MACS, and K-CFCS were correlated significantly with mobility, self-care, and social function, respectively. Using stepwise multiple regression analysis, we established that K-GMFCS, K-MACS, and K-CFCS were predictors of self-care skills (74.3%) and mobility skills (79.5%) of the K-PEDI (p<.05). In addition, K-CFCS and K-MACS were predictors of social function (65.9%) of the K-PEDI (p<.05). The information gathered in this study using the levels measured in the function classification systems may be useful to clinicians for estimating the PEDI functional skills in children with CP.

• Physical Therapy Rehabilitation Science
• /
• v.10 no.1
• /
• pp.22-31
• /
• 2021

Objective: This review aims to analyze the effects of electromechanically assisted walking in patients with cerebral palsy(CP). Design: A systematic review and meta-analysis. Methods: We reviewed systematically using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist guidelines. The inclusion criteria for this study were all CP patients. The intervention was electromechanically assisted walking. The outcome measures included gait parameters, function, spasticity. Studies excluded from this review were excluded from the review if they were non-English languages and if the study was not published as a full report, and if they were not randomized controlled trials (RCTs) designs. The RevMan 5.4 program was used to evaluate and explain the results. The risk of bias was evaluated independently by two reviewers. The quantitative meta-analysis, including mean differences (MD) and associated standard deviations (SD) from baseline and follow-up assessments, were recorded. Results: A total of 634 articles were searched. Two hundred eighty-nine duplicate articles were excluded, and 345 of 634 originals were left for selection. Of these 74 papers, 44 were out of topic, and 19 reported no mean or standard deviation values. And one was a non-experimental study. Finally, ten studies were included. All 10 RCTs of electromechanically assisted walking were analyzed. The meta-analysis showed a significant improvement in gait cycle (95% CI (confidence intervals), 0.09 to 0.19, I2=0%), Gross Motor Function Measure (GMFM) D (95% CI, 3.27 to 13.17, I2=0%) and GMFM E (95% CI, 0.22 to 6.41, I2=0%). Conclusions: Electromechanically assisted training helps in walking in patients with CP.

• Journal of The Korean Dental Society of Anesthesiology
• /
• v.8 no.1
• /
• pp.22-28
• /
• 2008

Background: Cerebral palsy (CP) is non-progressive disorder of motion and posture. In CP patient, there are difficulties in dental treatment because of uncontrolled movement of limb and head, and conjoined disabilities such as cognitive impairment, sensory loss, seizures, communication and behavioral disturbances. It is reported that CP patients have high incidence in caries and a higher prevalence of periodontal disease. But, despite the need for oro-dental care, these patients often are unlikely to receive adequate treatment without sedation or general anesthesia because of uncontrolled movements of the trunk or head. Methods: We reviewed the 58 cases of 56 patients with CP who underwent outpatient general anesthesia for dental treatment at the clinic for the disabled in Seoul National University Dental Hospital. Results: The mean age was 19 (2-54) years. The number of male patient was 40 and that of female was 18. They all had severe spastic cerebral palsy and 22 had sever mental retardation, 15 epilepsy, 8 organic brain disorder, 1 blindness, 2 deafness and cleft palate. For anesthesia induction, 14 cases was needed physical restriction who had sever mental retardation and cooperation difficulty, but 44 cases showed good or moderate cooperation. Drugs used for anesthesia induction were thiopental (37 cases), sevoflurane (14 cases), ketamine (3 cases ) and propofol (4 cases). All patients except one were done nasotracheal intubation for airway management and 4 cases were needed difficult airway management and 1 patient already had tracheostomy tube. Mean total anesthetic time was $174{\pm}56$ min and staying time at PACU was $88{\pm}39$ min. There was no death or long term hospitalization because of severe complications. Conclusion: If general anesthesia is needed, pertinent diagnostic tests and workup about anomaly, and appropriate anesthetic planning are essential for safety.

• Journal of Korean Neurosurgical Society
• /
• v.45 no.4
• /
• pp.240-242
• /
• 2009

Oculomotor nerve palsy (ONP) with subarachnoid hemorrhage (SAH) occurs usually when oculomotor nerve is compressed by growing or budding of posterior communicating artery (PcoA) aneurysm. Midbrain injury, increased intracranial pressure (lCP), or uncal herniation may also cause it. We report herein a rare case of ONP associated with SAH which was caused by middle cerebral artery (MCA) bifurcation aneurysm rupture. A 58-year-old woman with clear consciousness suffered from headache and sudden onset of unilateral ONP. Computed tomography showed SAH caused by the rupture of MCA aneurysm. The unilateral ONP was not associated with midbrain injury, increased ICP, or uncal herniation. The patient was treated with coil embolization, and the signs of oculomotor nerve palsy completely resolved after a few days. We suggest that bloody jet flow from the rupture of distant aneurysm other than PcoA aneurysm may also be considered as a cause of sudden unilateral ONP in patients with SAH.

• Journal of Korean Physical Therapy Science
• /
• v.26 no.3
• /
• pp.15-22
• /
• 2019

Background: The purpose of this study is to explore the effect of the functions of GMFM and ICF-CY on the activities and participation of ICF-CY sub-items. Design: Cross-sectional study. Method: This study compared and analyzed 95 children with cerebral palsy [type of CP: spasticity 86 (90.5%), hypotonia 4 (4.2%), mixed 5 (5.3%); type of palsy: quadriplegia 13 (13.7%), diplegia 71 (74.7%), hemiplegia 11 (11.6%)] using sub-items of functions, activities and participation from GMFM and ICF-CY. Result: The results show that the activities and participation of ICF-CY (9 sub-items) have significant effect on the functions of GMFM and ICF-CY (8 sub-items) (p<0.05). Conclusion: It is intended to provide data to establish practical therapeutic goals and interventions for functions, activities and participation, which are sub-categories of ICF-CY in cerebral palsy.

• Physical Therapy Korea
• /
• v.24 no.1
• /
• pp.51-60
• /
• 2017

Background: In cerebral palsy (CP), parents' quality of life and rearing attitude are considered possible factors that influence patients' quality of life, function level, and performance in daily activities. Despite these facts, little attention has been given to demonstrate a relation between these factors. Objects: This study aimed to demonstrate the relationship between parents' quality of life, functional level, and performance in daily activities, the quality of life of school-aged children with spastic CP. Methods: This study included 24 parents of school-aged children with spastic CP. The KIDSCREEN-52 and World Health Organization quality of life (WHOQOL)-BREF questionnaires (including physical, psychological, social, and environmental domains) were used as research tools to assess the quality-of-life profiles of the children with spastic CP and those of their parents, respectively. In addition, the function levels and performance in daily activities of the children with CP were assessed by using the gross motor function measure (GMFM) and modified Barthel index (MBI). Correlation and multiple regression analyses were performed to clarify the determinants of the quality of life of the children with CP. Results: The KIDSCREEN-52 score correlated with the total score (r=.735, p<.01) and all domains of the WHOQOL-BREF questionnaire (physical: r=.542, p<.01; psychological: r=.690, p<.01; social: r=.568, p<.01; and environmental: r=.783, p<.01). In addition, significant correlation was found between the KIDSCREEN-52 and MBI scores (r=.411, p<.05), and between the MBI and GMFM scores (r=.427, p<.05). After controlling for age, gender, paralytic type, GMFM, and MBI, the WHOQOL-BREF score ($R^2=.621$), particularly in the environmental domain ($R^2=.699$), remained independently related to the quality of life of the children. Conclusion: These findings suggest that the quality of life of school-aged children with spastic CP can be influenced by the quality of life of their parents. This study provides useful information for future studies to investigate the quality of life of children with CP.

• Journal of the Korean Society of Physical Medicine
• /
• v.7 no.3
• /
• pp.339-348
• /
• 2012

Purpose : The purpose of this study is to compare muscle activations of neck, trunk and leg in cerebral palsy of spastic diplegia with genu recurvatum and knee flexion contracture, when using anterior and posterior walkers. Methods : We selected 21 cerebral palsy and received the written consent to participate in this study. The inclusion criteria for participation required patients to have spastic diplegic CP; to be between 3~6 years of age, to have a GMFCS III grade, to have no botulinum toxin injection and orthopedics surgery within before six months starting the study. Measurements of muscle activities (sternocleidomastoid, splenius capitis, rectus abdominis, erector spinea, gluteus maximus, rectus femoris, medial hamstring and calf muscles) were evaluated anterior and posterior walker ambulations. Statistical evaluation of these data were accomplished by utilizing the paired t-test and independent t-test by SPSS 20.0 program. Significance level was set at p<.05. Results : The following results were obtained. There was significant difference on muscle activation of neck, trunk and legs(soleus except) in anterior and posterior walkers. There was no significant difference in muscle activation of neck but significant difference in muscle activation of trunk, legs between genu recurvatum and knee flexion contracture(rectus abdominis, medial hamstring when using anterior walker, rectus abdominis, erector spinea, gluteus maximus, medial hamstring when using posterior walker). Conclusion : The conclusion of this study is the different knee joint forms would have different effect on muscle activation of trunk and legs while cerebral palsy of spastic diplegic ambulated with anterior walker and posterior walker.

• Therapeutic Science for Rehabilitation
• /
• v.12 no.2
• /
• pp.55-68
• /
• 2023

Objective : This study aims to analyze the effects of visual perception intervention by systematically reviewing the studies that applied visual perception intervention to children with cerebral palsy. Methods : The databases used were PubMed, EMbase, Science Direct, ProQuest, Koreanstudies Information Service System (KISS), Research Information Sharing Service (RISS), and the National Assembly Library. The keywords used were cerebral palsy, CP, and visual perception. According to the PRISMA flowchart, 10 studies were selected from among studies published from January 1, 2012 to March 30, 2022. The quality level of the selected studies, the demographic characteristics of study participants, the effectiveness of interventions, area and strategies of intervention, assessment tools to measure the effectiveness of interventions, and risk of bias were analyzed. Results : All selected studies confirmed that visual perception intervention was effective in improving visual perception function. In addition, positive results were shown in upper extremity function, activities of daily living, posture control, goal achievement, and psychosocial areas as well as visual perception function. The eye-hand coordination area was intervened in all studies. Conclusion : In visual perception intervention, It is necessary to evaluate the visual perception function by area, and apply systematically graded customized interventions for each individual.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.12 no.12
• /
• pp.5709-5714
• /
• 2011

The purpose of this study was to investigate the utility of function classification system in children with cerebral palsy (CP). For this, relationship among the Manual Ability Classification System (MACS), the Gross Motor Function Classification System (GMFCS), and the functional status (WeeFIM) in children with cerebral palsy form September 2008 to August 2010. The participants was 217 children with CP in this study. The 217 children were evaluated by using the MACS for their hand function and by using the GMFCS for their motor function. The functional status were assessed by using the Functional Independence Measure of Children (WeeFIM). The GMFCS have a significant correlation with total score and domains of WeeFIM (p<.05) There were a significant correlation with total score and domains of WeeFIM (p<.05) except no significancy with communication domain in dyskinesia type. The highest number of participants were in level 1 (20.3) and level 5 (40.6%) for GMFCS. For MACS, the highest number of participants were level 2 (48.8%) and level 5 (16.6%). The function classification of GMFCS and MACS in practice will provide usefulness for assessment of function in children with CP.