• 한국전문물리치료학회지
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• 제8권1호
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• pp.51-58
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• 2001

In children with cerebral palsy, bone density is decreased by disturbance of bone remodelling due to lack of normal weight bearing and muscle contraction through physical activity. Loss of bone density cause fracture, delays treatment with immobilization, and leads to functional limitation. The purpose of this study was to investigate bone mineral density of lumbar spine in children with spastic quadriplegia and diplegia. Six spastic quadriplegia and 14 spastic diplegia were evaluated in this study. QDR 4500 X-ray densitometer was used to measure bone density at lumbar spine (L1~L4). Children with cerebral palsy showed lower bone density than that of normal children. Bone density in children with spastic quadriplegia and diplegia was $-1.812{\pm}.962$, $-1.519{\pm}.935$, respectively. However, there was no significant differences in bone density between children with spastic quadriplegia and diplegia. There was no significant difference in bone density relation to motor development level, height, and weight. Further study is needed to find the appropriate interventions for preventing loss of bone density in children with cerebral palsy.

• 신경치료
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• 제22권3호
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• pp.11-18
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• 2018

Purpose This study is to investigate the effect of sling exercise on the balance capacity of spastic diplegia cerebral palsy patient based on Bobath concept. Methods A single subject experiment was designed targeting an 8year old child with the rigid bilateral cerebral palsy. The static balance test used the 30 second Rombug test of BT4, and the dynamic balance test used the timed up and go test. Results In the 30second Rombug test of BT4, the child had a smaller median outcome than baseline and withdrawal period. In the TUG test, the walking speed in the intervention period was improved comparing to the baseline and withdrawal period. Conclusion The sling exercise based on the Bobath concept has been proved that it is an effective intervention to improve the static and dynamic balance capacity of patients with rigid bilateral cerebral palsy.

• 대한물리의학회지
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• 제14권4호
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• pp.37-44
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• 2019

PURPOSE: The purpose of this study was to compare sitting balance and coordination spastic cerebral palsy in children using the Korean version of Trunk Impairment Scale (K-TIS) as well as to provide basic data about effective postural control treatment for clinicians handling these two types. METHODS: The K-TIS was measured in 29 children diagnosed with diplegic and quadriplegic cerebral palsy (18 with diplegia and 11 with quadriplegia). The average and standard scores of the children's K-TIS subscales and items of the two groups were measured. The two groups' subscales and items were analyzed by using the Mann-Whitney U test. RESULTS: Static sitting balance, dynamic sitting balance, coordination, and total score for children with diplegia were statistically high (p<.05). For all items under static sitting balance, the score for children with diplegia was higher. The first differences in the repeated items of dynamic sitting balance and coordination area that rotates between the upper and lower body were presented. CONCLUSION: The difference in balance and coordination in sitting positions is exhibited in children with diplegia and quadriplegia. For children with spastic quadriplegia, treatments should focus on static sitting balance and coordination, together with a focus on dynamic sitting balance and coordination.

• 한국전문물리치료학회지
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• 제22권4호
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• pp.79-86
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• 2015

This study examined the effects of trunk stabilization exercise on balance and trunk control in children with spastic diplegia. Four children with ambulatory spastic diplegia participated in the trunk stabilization exercise program using a Both Sides Utilized (BOSU) ball, 30 minutes a day, two times a week for eight weeks. Outcome variables included the pediatric balance scale, trunk control movement scale and multifidus thickness using ultrasound image. After trunk stabilization exercise, there was statistically no significant improvement in pediatric balance scale, trunk control movement scale and multifidus thickness. However, individual outcomes were observed with some positive changes. Balance, trunk control movement, and thickness of multifidus were found to be improved. Trunk stabilization exercise using a BOSU ball could improve trunk control and increase the thickness of multifidus in children with spastic diplegia. Further investigation is needed to evaluate subjects according to type of cerebral palsy and to understand the relationship between postural control and gait.

• 대한물리치료과학회지
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• 제19권3호
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• pp.23-30
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• 2012

The purpose of this study was to apply treadmill training through motor learning to cerebral palsy children and examine its effects on their Gross Motor Functions. The subjects of this study were 13 spastic diplegia children who had difficulty in independent gait, and GMFCS level III, IV. We performed treadmill gait training using the principle of weight bearing, based on 4times a week for 30 minutes before and after each session physical therapy we gave weight bearing treadmill training 5 to 10 minutes, during 7 weeks(April 9, 2012~May 26, 2012) fittingly for the children's gait characteristics. In order to test how the weight bearing treadmill training affects spastic diplegia children's gross motor functions, we measured body mobility with Gross Motor Function Measure (GMFM). These data were collected before and after the experiment and analyzed through comparison. Data collected from the 13 spastic diplegia children the results were as follows. For evaluating with regard to change in body mobility, significant difference was observed between before and after the experiment in measured gross motor functions, which were crawling, kneeling, standing, walking, jumping and running(p<0.05). According to the results of this study, when gait training through motor learning was applied to spastic cerebral palsy children, it made significant changes in their body mobility. Accordingly, for the effective application of gait training through motor learning to cerebral palsy children, it is considered necessary to make research from different angle on how such training affects children's mobility, activity of muscles in the lower limbs, and gait characteristics.

• 대한물리의학회지
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• 제8권4호
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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.

• 대한물리의학회지
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• 제14권4호
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• pp.45-53
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• 2019

PURPOSE: This study examined the differences in the trunk impairment scores according to the levels of the gross motor classification system by evaluating trunk control in children with spastic cerebral palsy using the index of trunk impairment. In addition, the characteristics of trunk control disabilities were investigated according to the cerebral palsy type. METHODS: The subjects were 49 children (mean age 8.57±1.83 years, 11 with hemiplegia, 26 with diplegia, and 12 with quadriplegia) with spastic cerebral palsy levels I to IV under the gross motor function classification system (GMFCS). The coordination and balance of the children with cerebral palsy were evaluated using the index for trunk impairment. Statistical analyses were performed using a Kruskal-Wallis test, and Bonferroni analyses were used as a post-hoc comparison for any significant results. RESULTS: The median of the total scores of trunk impairment was 13 (range, 9-17), which was 56% of the maximum score. The total score of trunk impairment and subscales differed significantly according to the disease severity and type of motor disability. The scores for children with quadriplegia were the lowest compared to children with hemiplegia and diplegia. CONCLUSION: Trunk control function in children with spastic cerebral palsy was reduced, and varied according to the disease severity and types of motor disabilities. The degree of trunk impairment differed from the trunk control ability according to the degree of motor disability of children with cerebral palsy.

• The Journal of Korean Physical Therapy
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• 제32권6호
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• pp.341-347
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• 2020

Purpose: The purpose of this study is to introduce a tool for evaluating eye movement and analyze the reliability of measurement based on 10 cases of evaluating the oculomotor function of children with spastic cerebral palsy Methods: The participants were selected by 6 medical and welfare institutions in Busan as GMFCS grade 1-3 among spastic diplegia and hemiplegia. Seven examiners evaluated 3 children for the evaluation of inter-rater agreement of Ocular Motor Score (OMS) and evaluated the condition of the ocular motor of 10 children using OMS, a re-examination was performed at six weeks after the initial examination. SPSS ver.25.0 was used to calculate the interclass correlation coefficient and Wilcoxon's signed-rank test, Mann Whitney-U test. Results: The inter-rater agreement of OMS was 0.89. Second mean values were decreased compared first examination in motility/ductions/version, saccades and smooth pursuit, but there was no significant difference. Children under 6 years old had a high mean value of saccades in first examination and the motility/ductions/version, fixation, saccades in second examination, but there was no significant difference. Spastic diplegia children's mean values were higher in head posture, fixation in 8 gaze directions than hemiplegia children in both first and second examination, but there were no significant differences. Conclusion: Ocular motor function in 10 children of spastic children who participated in the study and could see that the scores was differed depending on age, type, grade of cerebral palsy. OMS may be available for this purpose.

• 대한물리의학회지
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• 제7권3호
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• pp.339-348
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• 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.

• 대한감각통합치료학회지
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• 제13권2호
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• pp.21-29
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• 2015

목적 : 뇌성마비아동 중 양하지마비 아동과 일반아동을 대상으로 감각처리 능력을 비교하고자 하였다. 또한 아동을 학령전기와 학령기로 나누어 연령에 따른 감각처리 특성을 알아보고자 하였다. 연구방법 : 경직형 양하지마비 아동과 일반아동의 감각처리 능력을 알아보기 위해 단축형 감각프로파일(Short Sensory Profile: SSP)을 사용하였다. 연구대상은 뇌성마비 중 양하지마비 유형으로 진단받은 만 3~10세 아동과 일반아동을 대상으로 보호자가 직접 설문지 작성을 하도록 하였다. 2013년 11월부터 2014년 2월까지 설문지 배부 및 수거가 이루어 졌으며 경직형 양하지마비 아동 40명, 일반아동 40명의 자료가 분석에 사용되었다. 연구 분석은 집단별 비교를 위해 독립표본 t-test, 연령별 비교를 위해 Mann Whitney U-test를 사용하였다. 연구결과 : 단축형 감각프로파일 총점과 모든 영역에서 경직형 양하지마비 아동이 일반아동보다 점수가 낮게 나타났으며 촉각 민감성과 맛/냄새 민감성을 제외한 5가지 영역과 감각처리 총점에서 두 그룹 간 유의미한 차이가 있는 것으로 나타났다. 학령전기 아동은 총점과 움직임 민감성, 과소반응/특정자극 찾기, 청각 여과하기, 활력이 부족하고 허약함, 시각/청각 민감성에서 일반아동과 유의미한 차이를 보였으며 학령기 아동은 움직임 민감성, 활력이 부족하고 허약함, 시각/청각 민감성에서 유의미한 차이를 보였다. 결론 : 본 연구 결과는 경직형 양하지마비 아동의 감각처리 평가 시 기초자료로 사용될 수 있으리라 생각된다. 앞으로 뇌성마비의 다른 유형을 대상으로 하는 감각처리 능력에 대한 연구가 이루어져야 할 것이다.