• The Journal of Korean Physical Therapy
• /
• 제22권4호
• /
• pp.43-48
• /
• 2010

Purpose: This study was designed to determine the test-retest, inter-rater, and intra-rater reliability of the Pediatric Balance Scale (PBS) when applied to children with cerebral palsy (CP). Methods: Subjects were out-patient children with cerebral palsy at four CP clinics in Gyeonggyi-do and Chungcheong nam-do. For test-retest and inter-rater reliability studies, the PBS was used twice on 7 separate days by twenty-four children with CP. To assess intra-rater reliability, 10 CP subjects were selected by random sampling. Four pediatric-trained physical therapists with 2-13 years of clinical experience scored the children’s performance blindly, while replaying videotaped data. Results: There was no significant difference in total scores (ICC 3,1=0.89, 0.93, 0.90, and 0.91) measured by each of the four therapists on two occasions. The Inter-rater reliability assessed the 1st and 2nd time was high (1stICC 3,1=0.91, 2nd ICC 3,1=0.93). The intra-rater reliability measured by each of the four therapists using the 2nd scores was also high (ICC 3,1=0.98, 0.99, 0.97, and 0.98). Conclusion: The PBS is reliable. We believe that it can be used in characterizing children with CP.

• 대한물리의학회지
• /
• 제11권3호
• /
• pp.119-124
• /
• 2016

PURPOSE: The aim of this study was to evaluate activation of accessory respiratory muscles using electromyography during chest expansion upper extremity flexion, abduction, and external rotation exercises with an elastic band in children with cerebral palsy. METHODS: The subjects were 10 children with cerebral palsy. The inclusion criterion for participation was a Gross Motor Function Classification System level of I to III. The subjects were instructed to perform upper extremity flexion, abduction, and external rotation exercises with inspiration, and extension, adduction, and internal rotation exercises with expiration while seated on a chair without a backrest. PM (Pectoralis major), SCM (sternocleidomastoid), RA (rectus abdominis), and EO (external oblique) muscle activities were measured using electromyography. RESULTS: All tested muscles showed a statistically significant increase in activity after elastic band exercise. There were significant differences in PM, SCM, RA, and EO results after chest expansion exercise using elastic band. SCM showed the largest increase in activity after use of elastic bands, at $52.37{\pm}45.88$%, followed by the RA ($50.56{\pm}79.31$), EO ($35.42{\pm}35.45$), and PM ($31.72{\pm}25.64$). The increase in the SCM was greatest, followed by increases in the RA, EO, and PM CONCLUSION: These finding suggest that activity of accessory respiratory muscles increases with use of elastic bands during chest expansion exercise in cerebral palsy.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제22권2호
• /
• pp.122-131
• /
• 2019

The majority of children with cerebral palsy (CP) have feeding difficulties and are especially prone to malnutrition. The early involvement of a multidisciplinary team should aim to prevent malnutrition and provide adequate nutritional support. Thorough nutritional assessment, including body composition, should be a prerequisite for the nutritional intervention. As in typically-developed children nutritional support should start with dietary advice and the modification of oral feeding, if safe and acceptable. However, for prolonged feeding, in the presence of unsafe swallowing and inadequate oral intake, enteral nutrition should be promptly initiated and early gastrostomy placement should be evaluated and discussed with parents/caregivers. Gastrointestinal problems (oropharyngeal dysfunction, gastroesophageal disease, and constipation) in children with CP are frequent and should be actively detected and adequately treated as they can further worsen the feeding process and nutritional status.

• 대한물리의학회지
• /
• 제16권3호
• /
• pp.123-130
• /
• 2021

PURPOSE: Robotic gait training is being used increasingly to improve the gross motor performance and gait speed. The present study examined the effectiveness of a novel end-effector type of robotic gait training (RGT) system on standing, walking, running, and jumping functions, as well as the gait speed in children with spastic cerebral palsy. METHODS: Eleven children with spastic cerebral palsy Gross Motor Function Classification System (GMFCS) levels I-III (6 males; age range, 15.09 ± 1.44 years) were examined. They underwent 24 sessions (30 minutes/sessions, one time/day, three days/week for eight consecutive weeks) of RGT. The Gross Motor Function Measure-88 D domain (GMFM D), and GMFM E were assessed with a pretest and posttest of RGT. The setting was a one-group pretest-posttest design. RESULTS: A comparison of the pre-test and post-test show that the outcomes in post-test of GMFM D (p < .01), GMFM E (p < .05), and 10MWT were improved significantly after RGT intervention. CONCLUSION: The present study provided the first evidence on the effects of an eight-weeks RGT intervention in participants with spastic CP. The outcomes of this clinical study showed that standing performance, locomotion function, and gait speed increased in after 24 sessions of the end-effector RGT system in children with spastic cerebral palsy.

• The Journal of Korean Physical Therapy
• /
• 제27권2호
• /
• pp.106-111
• /
• 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.

• 대한물리치료과학회지
• /
• 제27권1호
• /
• pp.18-25
• /
• 2020

Purpose: The purpose of this study was to investigate the improve on brain activity during action observation training for cerebral palsy of diplegia. Design: Randomized controlled trial. Methods: 18 subjects were divide into two groups: action observation training group and a control group. Action observation group practiced repeatedly the action with their motor skill and control group practiced conventional physical therapy. The subjects participated in eighteen 30-min sessions, 3 day a week, for 6week. To confirm the effects on brain activity were evaluated. Results: The results show that the Mu-rhythm was statistically significant increase on the C3 of the action observation training group (p<0.05). Conclusion: The action observation training improves brain activity of a cerebral palsy with diplegia. These results suggest that the action observation training is feasible and beneficial for improving brain activation for the cerebral palsy with diplegia. In the future, I think we need to be actively utilized to the action observation training program in the clinical with the neuromuscular development treatment. And the study on the various the action observation training program that can improve the function of the children with cerebral palsy is thought necessary.

• Physical Therapy Rehabilitation Science
• /
• 제11권1호
• /
• pp.24-31
• /
• 2022

Objective: This study attempted to find out if it changes the child's ability to perform daily life activities when visiting the familiar environment and daily living space of children with cerebral palsy and conducting a home activity support program for children and parents. Design: Randomized Controlled Trial Methods: Among 22 children aged 3 to 12 years old, they were assigned to the intervention group and control group. Of these, 12 boys and 10 girls participated in the study. Gross motor function measure and upper extremity function evaluation were used to measure the physical function of children with cerebral palsy, and self-care skills, mobility and social functions were evaluated in the pediatric evaluation of disability inventory. In addition, a parenting sense of competence was used to find out the efficacy of parents in raising children. After the pre-evaluation, basic rehabilitation treatment and intervention programs were applied to the intervention group, and only basic rehabilitation treatment was performed to the control group, and post-evaluation was performed 8 weeks later. Results: As a result of the study, among the items that measured the gross motor function, upper limb function, and daily life performance ability of the intervention group in the difference between the intervention group and the control group, statistically improved in personal processing and movement (p<0.05). In addition, the parenting sense of competence children in the intervention group was statistically significant (p<0.05). Conclusions: The home activity support program will help strengthen the ability of cerebral palsy children to perform daily life as a way to set mutually agreed goals with their families or children and achieve them in a familiar environment.

• Child Health Nursing Research
• /
• 제13권1호
• /
• pp.90-101
• /
• 2007

Purpose: To evaluate the effects of abdominal meridian massage either with the use of aroma oils or without using the oils for the relief of constipation in institutionalized children with cerebral palsy. Method: Using a nonequivalent control group pretest-posttest design, 40 children were randomly assigned to experimental (n=21) and control (n=19) groups. The experimental group received abdominal meridian massage with mixture of aroma oils, and the control group received abdominal meridian massage only. Prior to the intervention, baseline data were collected, and then abdominal meridian massage with or without aroma oils were given to both groups every morning for 15 minutes a day, six days a week, for 2 weeks. Outcome measures were number of bowel movements, amount of stool (gm), and frequency of laxatives, suppositories or enema. Using SPSS/Win 12.0 program, data were analyzed by $X^2$ test, t-test, and repeated measures ANOVA. Results: Children in the experimental group defecated a larger volume of stool, and used fewer laxatives than those in the control group. The treatment effects lasted for 1 week after treatment. Conclusion: Abdominal meridian massage with aroma oils appears to be an effective adjunct maneuver in relieving constipation among institutionalized children with cerebral palsy.

• 한국전문물리치료학회지
• /
• 제23권4호
• /
• pp.63-70
• /
• 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.

• 한국전문물리치료학회지
• /
• 제19권4호
• /
• pp.16-23
• /
• 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.