• 대한물리치료과학회지
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• 제4권1호
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• pp.265-289
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• 1997

The purpose of this studied was to examine the reliability analysis of the GMFM in children with C.P. The subject of this study were 40 C. P patient who had been hospitalized Department of Sam-Yook Rehabilitation Hospital. Subjects were 28 boys and girls, aged 6 to 8 years. Reliability of each dimension of the GMFM were analyzed using Cronbach coefficients and to examine the intra-rater reliability were using Pearson correlation coefficients. The result of reliability analysis of the GMFM revealed higher reliability values. The reliability of the total dimension score was 95. Test-retest revealed intra-rater correlation coefficients from .71 to .98. The study presents that GMFM is useful in assessment of function of children with C. P by the quantitative description of the function.

• Clinical and Experimental Pediatrics
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• 제64권7호
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• pp.313-321
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• 2021

Here we describe the neurodevelopmental outcomes of very low birth weight (VLBW) infants (birth weight ≤1,500 g) at 3 years of age in the Neonatal Research Network of Japan (NRNJ) database in the past decade and review the methodological issues identified in follow-up studies. The follow-up protocol for children at 3 years of chronological age in the NRNJ consists of physical and comprehensive neurodevelopmental assessments in each participating center. Neurodevelopmental impairment (NDI)-moderate to severe neurological disability-is defined as cerebral palsy (CP) with a Gross Motor Function Classification System score ≥2, visual impairment such as uni- or bilateral blindness, hearing impairment requiring hearing amplification, or cognitive impairment with a developmental quotient (DQ) of Kyoto Scale of Psychological Development score <70 or judgment as delayed by pediatricians. We used death or NDI as an unfavorable outcome in all study subjects and NDI in survivors using number of assessed infants as the denominator. Follow-up data were collected from 49% of survivors in the database. Infants with follow-up data had lower birth weights and were of younger gestational age than those without follow-up data. Mortality rates of 40,728 VLBW infants born between 2003 and 2012 were 8.2% before discharge and 0.7% after discharge. The impairment rates in the assessed infants were 7.1% for CP, 1.8% for blindness, 0.9% for hearing impairment, 15.9% for a DQ <70, and 19.1% for NDI. The mortality or NDI rate in all study subjects, including infants without follow-up data, was 17.4%, while that in the subjects with outcome data was 32.5%. The NRNJ follow-up study results suggested that children born with a VLBW remained at high risk of NDI in early childhood. It is important to establish a network follow-up protocol and complete assessments with fewer dropouts to enable clarification of the outcomes of registered infants.

• 한국전문물리치료학회지
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• 제23권1호
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• pp.55-64
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• 2016

Background: The International Classification of Functioning, Disability, and Health-core set (ICF-core set) for children and youth (CY) with cerebral palsy (CP) provides a useful conceptual framework and a guide for health care planning and measuring the changes brought by interventions across a multitude of dimensions from body functions to personal activities, social participation, and environmental factors for them. Objects: This single case study was reported to illustrate the use of a goal directed approach in applying the ICF-core set for CY with CP from a physical therapist perspective. Methods: An eleven year old boy with spastic CP, Gross Motor Function Classification System (GMFCS) level V, and his mother participated in an evaluation of his functioning state. The intervention goal was set through an interview using the ICF-core set, Canadian Occupational Performance Measure (COPM) and Goal Attainment Scale (GAS). Physical therapy was carried out on an outpatient basis using a goal directed approach for 30 min, 1 time/week during 12 weeks and the boy's gross motor function was assessed using the Gross Motor Function Measure (GMFM)-66 version (item set 2) before and after the intervention. Results: As measured by the boy's mother, the COPM score showed a meaningful clinical change (performance=mean 3.5, satisfaction=mean 2.5) and the T-score of GAS changed 34.4 after the goal directed approach. The GMFM-66 (item set 2) score changed from 31.8 to 38.7 and evaluation using the ICF-core set displayed improvement in 6 items of activity level between before and after the intervention. Conclusion: The ICF-core set for CY with CP is useful for understanding the overall functioning of CY with this condition and provides an opportunity to share and integrate information and opinions from different disciplines. We consider it as a useful tool in the universal language for the therapy and education of CY with CP.

• 대한한방소아과학회지
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• 제35권1호
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• pp.139-147
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• 2021

Objectives The purpose of this study is to investigate differences in brain activities when Neurodevelopmental treatment (NDT) is used alone compare to NDT is combined with intradermal acupuncture (IDA) treatment, using functional infrared spectroscopy (fNIRS) Methods Three children less than 7 year-old with cerebral palsy were participated. On their first visit, only NDT was used. After a week, they were treated with both NDT and IDA. During the treatment, fNIRS was used to measure any changes in their brain activities. Results In first patient with NDT, oxyhemoglobin level was increased during Standing exercise and Gait training compared to resting state. When the patient was treated with NDT and IDA, oxyhemoglobin level was decreased during Standing exercise and Gait training compared to resting state, and the result was significant (p<0.05). In second patient, oxyhemoglobin level was decreased in Gait training compared to resting state when NDT was used, but the level was increased when NDT and IDA were used in Gait training compared to resting state (p<0.05). In third patient, the difference in oxyhemoglobin levels between Gait training and resting state was significant (p<0.05). Conclusions Treatment involving both NDT and IDA has more potential to improve brain activities compared to that of NDT alone, and no adverse effect was reported. In order to confirm the finding, larger scale randomized controlled trials are needed.

• 대한간호학회지
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• 제43권2호
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• pp.247-255
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• 2013

Purpose: This study was done to evaluate the effects of 3 times/week and 5 times/week abdominal meridian massage with aroma oils (AMMAO) on the relief of constipation among hospitalized children with disabilities involving the brain lesions (cerebral palsy, epilepsy, and others). Methods: The participants were 33 hospitalized children with a disability involving the brain (15 were in the 5 times/week of AMMAO group and 18 were in the 3 times/week of AMMAO group). Data were collected from March 21 to May 1, 2011. Chi-square test, t-test, and repeated measures ANOVA with SPSS 18.0 were used to evaluate the effects of AMMAO. Results: While there was no significant difference between the two groups, there was a significant difference within groups between baseline and the end of the intervention period for the following, frequency of suppository use or enemas, amount of stool, and number of bowel movements. Conclusion: The results of this study indicate that AMMAO is an effective nursing intervention in relief of constipation for hospitalized children with a disability involving the brain. Therefore it is recommended that AMMAO be used in clinical practice as an effective nursing intervention for relief of constipation to these children.

• 재활치료과학
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• 제2권1호
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• pp.13-23
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• 2013

강제유도운동치료는 최근 신경재활 분야에서 가장 주목 받고 있는 상지 재활 치료방법 중 하나로 하루 6시간씩 주 5일 2주간 강도 높은 훈련을 환측 팔에 제공하고, 건측의 사용을 억제하기 위해 깨어 있는 시간의 90%를 구속하는 치료방법이다. 최근에는 전통적인 강제유도운동치료의 임상적 한계를 바탕으로 수정된 강제유도운동치료가 많이 적용되고 있다. 수정된 강제유도운동치료는 하루 5시간씩 주 5일, 10주간 건측을 억제하고 하루 30분간 손상측을 치료하는 방법이다. 이는 일상생활 수행 평가인 소아 운동 활동 측정표(Pediatric Motor Activity Log; PMAL)와 상지 질적 평가(Quality of Upper Extremities Skills Test; QUEST), 환측의 상지 기능을 평가하는 멜버른 상지 평가(Melbourne Assessment of Unilateral Upper Limb Function; MAULF), 환측과 건측의 양손 협응을 보기 위한 Assisting Hand Assessment(AHA)를 통해 강제유도운동치료의 효과를 입증하였다. 본 고찰에서는 강제유도운동치료 적용 후, 신경학적 변화를 살펴본 연구를 중점적으로 분석하였다. 경직성 편마비형 뇌성마비 아동에게 강제유도운동치료 또는 수정된 강제유도운동치료를 적용한 결과, 신체부분의 움직임의 양에 따라 대뇌피질에 나타나는 신체 부위의 크기가 변한다는 것을 보여주었다. 또한 반대측 운동피질의 활성을 증가시켜주고, 동측 피질의 활성을 감소시켜 신경재조직에 영향을 주기 때문에 강제유도운동치료는 신경가소성의 원리를 이용한 상지 재활 치료 방법이라 하겠다.

• 대한감각통합치료학회지
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• 제19권3호
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• pp.32-43
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• 2021

목적 : 본 연구는 한글판 PDMS-2(Peabody Developmental Motor Scale-2)를 뇌성마비 아동과 일반아동을 대상으로 평가하여 구성타당도를 검증하고 뇌성마비 아동 10명을 대상으로 재평가하여 검사-재검사 신뢰도를 알아보고자 하였다. 연구방법 : 구성타당도 검증은 뇌성마비 아동과 일반아동 84명을 대상으로 하였다. 일반아동은 뇌성마비 아동과 연령이 6개월 이내로 비슷하고 성별이 일치하는 아동으로 매칭하여 선별하였고, 한글판 PDMS-2평가를 실시하여 두 집단의 표준점수 비교를 통해 구성타당도 검증을 하였다. 이 후 뇌성마비 아동 중 10명을 선정하여 2주 뒤 재평가를 실시하여 검사-재검사 신뢰도를 알아보았다. 결과 : 구성타당도 검증 결과 대근육, 소근육 영역별 점수와 하위 다섯 항목의 점수가 모두 통계적으로 유의미하게 나타났다(p=.000). 검사-재검사 신뢰도는 Pearson 상관계수 .989로 매우 높은 수준의 시간적 안정성을 나타냈다. 결론 : 본 연구를 통해 한글판 PDMS-2는 아동의 운동 발달 수준을 알아보기에 높은 신뢰도와 타당도를 가진 평가 도구임을 확인하였다. 추후 한글판 PDMS-2는 국내 임상 현장과 연구 도구로 유용하게 사용될 수 있을 것이다.

• 대한물리의학회지
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• 제8권1호
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• pp.137-145
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• 2013

PURPOSE: The purpose of this study is to examine assessment of test-retest reliability for 13 items of pediatric balance scales, then the intrarater reliability among the raters. METHODS: Study participants included 6 children with spastic cerebral palsy who could walk. Raters were consist of seventy-four, 2nd year physical therapy major students. The children's ability to achieve physical balance was wideotaped for PBS items. The raters watched the tapes and evlauated each child twice. Test-retest reliability was analyzed using the Spearman correlation, and interrater reliability was analyzed using the Kendall's coefficient of concordance for ranks. RESULTS: The total PBS scores averaged 49.22 and 50.06 for first and second tests. Test-retest reliability of PBS individual items were between low and high. The low itmes were 3 items, and high were 4 itmes. Interrater reliability were low agreement. CONCLUSION: Based on the study, the pediatric balance scale is an effective evaluating tool for measuring functional balance of school age child. However, the agreement of students or beginner's interpretation is necessary in conjunction to this study results. On top of that, it is important to provide detailed explanation and repetitive training, which improves the analysis reliability. Also, each category subscores level for the pediatric balance scale must be examined carefully in conjunction to performing test, only after improving match quality via preceding practice.

• Annals of Rehabilitation Medicine
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• 제42권6호
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• pp.854-862
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• 2018

Objective To investigate the effect of treadmill training with eyes open (TEO) and closed (TEC) on the knee joint position sense (JPS), functional balance and mobility in children with spastic diplegia. Methods Forty-five children with spastic diplegia aged 11-13 years participated in this study. They were randomly assigned to three groups of equal number. The control group (CON) underwent designed physical therapy program whereas, the study groups (TEO and TEC) underwent the same program, in addition to treadmill gait training with eyes open and closed, respectively. Outcome measures were the degree of knee joint position error, functional balance and mobility. Measurements were taken before and after 12 weeks of intervention. Results After training, the three groups showed statistically significant improvement in all measured outcomes, compared to the baseline with non-significant change in the knee JPS in the CON group. When comparing posttreatment results, the TEC group showed greater significant improvement in all measured outcomes, than the TEO and CON groups. Conclusion Treadmill training with eyes open and closed is effective in rehabilitation of children with diplegia, but blocked vision treadmill training has more beneficial effect.

• 대한한방소아과학회지
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• 제14권2호
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• pp.149-168
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• 2000

The Purpose of this study was to investigate the new effective oriential medicine tretments in pediatric disease and its clinical applicability The study was composed of 1245 new patients who had been treated at the all unit in the Dong-Seo oriential Medicine Hospitial for 1 year, from 1 April 1999 to 31 March 2000, and aged between 0 and 18 years. The chief complaint was mainly categorized by oral examination on patients and their care-givers. Result 1. The numbers of children who involved in this study is total 1245: Male children are 668 and female children are 577 children. The sex rate between male and female is 1.15 to 1. 2. Most of the above patients came to the hospital at first time from diseases such as musculoskelectal disease, weakness, asthma, cough, anorexia, common cold, rhiorrhea, sweating, dyspepsia, dematitis, night terror, obesity, stomach, short stature, Besides, they also came to the hospital at first time from various diseases such as epistasxis, pyrexia. Bell's palsy, nocturia, contipation, cerebral palsy, disorder, CVA. diarrhea. stress disease, Allergic disease, Tic disorder. Visual disorder, Kawasaki disease, Pierre Robin's syndrom, hematuria, edema and so on. 3. Looking at the frequent diseases, Respiratory dis. children including asthma, cough, rhiorrhea, sweating, common cold, pyrexia covers 36%, in 399 numbers. digestive dis. children including anorexia, dyspepsia, stomach, diarrhea, constipation, indigestion covers 19%, in 211 numbers. cadiovasculary disease children including arrthymia, terror in frequency, night crying, sediation, Tic disorder covers 8%, in 85 numbers. Hepatobiliary disease children including short stature, dizziness, visual difficulty, sprain, disorder of nail covers 21%, in 238 numbers. renal disease. children including nocturia, hematuria, hemation, disorder of hair, menorrhea, cerebral palsy, edema in 44 numbers. Fatigue children covers 13%. in 143 numbers. 4. In case of respatory disease children. total number is 399 children. dematitis children are 108 numbers and asthma children are 96 numbers. These show that children seem to the best have dematitis and asththma. The age from 0 to 6 is 290 numbers, covering 73 percentage. The others are covering 27 percentage. These data demonstrate that the age from 0 to 6 age could easily get these kinds - of diseases. The 29 percent of children had these kinds of diseases in spring. The 28 percent of children had these kinds of diseases in autumn. These show that children seem to frequently have these kinds of diseases in both spring and autumn season.(inter-season) 5. In case of digestive disease, anorexia covers 39%, in 83 numbers, dyspepsia covers 28%, in 59 numbers, anorexia and dyspepsia were the lagest group in digestive disease and the age from 0 to 6 covers 59%, in 125 numbers and the other age covers 39%. According to these data, infant seems to be vulnerable to these kinds of diseases. The 24 percent of children had these kinds of diseases in spring and summer. The 33 percent of children had these kinds of diseases in winter, which means that children mostly had winter. but decreased significant in autumn. 6. In case of cadiovasculary diseases, it can be divided into two categories: night covers 73% and nervous characteristics covers 27%. The age from 0 to 6 occupies 75%, and the other age occupies 25%. These data also show that infants can easily infected with these kinds of diseases. Analyzing by the season, summer could be the most frequent season that children have these kinds of diseases. but decreased in autumn. 7. In case of hepatobiliary children, sprains covers 166 numbers, fatigue covers 32 numbers, epistasxia covers 24 members, the reasion which sprain occupyied most of % were sprain covered ages. The age from 0 to 14 covers 59% and from 15 to 18 covers 41%. In the conclusion the adolescent seems to be vulnerable to sprains. In spring 29%, insummer 31%, in autumn 23%, and in winter 28% of children got these kinds of diseases, which show that children seems to have this kinds of disease in summer season. and decreased in autumn. 8. In case of renal disease. nocturia and hematuria covers 52%(occupied overhalf). The age from 0 to 6 covers 52%(occupied overhalf). Analyzing by season, in spring increased in summer(59%), decreased in autumn(45%) Conclusion 1. The chief complant in pediatric diseases that needed an oriental medical tretment was mainly the disease that tends to take iong time and the weakness. and appeared frequency in respiratory disease : 2. The oriential medical tretment was still preferred as a way to improve the weakness by patients, rather than a way to overcome their disease. In paticular, the study shows that the oriental medical tretment should be emphasized in terms of preventing the disease 3, The new disease, which were developed with the change of human life and envir oment(just like seual disorder, short stature, obesity, dynamic disorder, examinee disease), should be in vestigated as a new field of oriental medical tretment.