• The Journal of Korean Physical Therapy
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• v.28 no.1
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• pp.22-26
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• 2016

Purpose: The purpose of this study was to evaluate the relation between PBS scores and GMFCS levels and to examine whether pediatric balance scale (PBS) scores were useful for predicting gross motor functional classification system (GMFCS) levels in children with cerebral palsy. Methods: This cross-sectional study was performed conducted for to evaluatione of PBS and GMFCS using in 26 children with cerebral palsy (16 males and 10 females with GMFCS level I to III). PBS total and item scores at different levels of GMFCS were measured. Results: The hHigh PBS item average scores obtained from standing and postural change dimensions except sitting dimension were observed at the low levels of GMFCS and these results were statistically significant (p<0.05). The relation between PBS (standing and postural change dimensions) and GMFCS levels were was significantly different, except the relation between PBS sitting dimension and GMFCS levels showing a ceiling effect. Conclusion: GMFCS is designed to for classificationy of gross motor functions emphasizing on walking movement and PBS is was developed to for evaluatione of functional balance. Based on the results of this study showing high relation between GMFCS levels and PBS scores, PBS scores can be used for predicting GMFCS levels.

• Physical Therapy Korea
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• v.17 no.3
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• pp.40-47
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• 2010

The purposes of this study were to compare the reliability and validity of an 88-item version of the Gross Motor Function Measure (GMFM-88) and a 66-item version of GMFM (GMFM-66) in children with cerebral palsy (CP). The GMFM was completed in 154 children with CP (age range = 6~12). The internal consistency of the GMFM was calculated by Cronbach's ${\alpha}$ for judging reliability. The reliability of GMFM-88 and GMFM-66 were both above .99. The validity of measurement obtained by the GMFM was assessed by examining the unidimensionality of items and by comparing Gross Motor Function Classification System (GMFCS) levels with tests of the GMFM. Both the GMFM-88 and GMFM-66 were satisfied with unidimensionality. Discriminant validity was demonstrated on significant decreases in scores with increasing GMFCS levels in both measurements. However, GMFM-66 was a more sensitive discriminant in GMFCS level 1 and level 2 and in level 2 and level 4. This study reported a comparison of the reliability and validity of GMFM-88 and GMFM-66. The results of this study have implications for the information on the psychometric properties of two versions of GMFCS. This information will be useful for the selection of tools in clinics.

• The Journal of the Korea Contents Association
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• v.14 no.5
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• pp.262-271
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• 2014

The purpose of this study was to find the effect of Day Hospital Rehabilitation programs on gross motor function in children with cerebral palsy. The subjects were 57 children with spastic cerebral palsy with no previous botulinum toxin injection or operation history within 6 months. The Gross Motor Function Measure(GMFM) score and Gross Motor Function Classification System(GMFCS) were used to evaluate as functional change and functional level. The Programs for Day Hospital Rehabilitation period for cerebral palsy children was 8 weeks. The results of the study are as follows: 1, GMFM Score of pre- and post-programs for Day Hospital Rehabilitation showed the statistically significant difference(p <.001). 2, The age group in 1-2 was higher than age 5-6 group, 3-4 was higher than age 5-6 group by Post-hoc analysis. Lastly, there was significantly different of GMFM in GMFCS level(p<.05), especially mild(GMFCS level I) and moderate(GMFCS level II, III) of CP showed that gross motor function was significantly different than severe(GMFCS level IV, V). The programs for Day Hospital Rehabilitation was effective on gross motor function for children with cerebral palsy, and for early intervention needs to mild, moderate CP, and below age 4 group.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.1
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• pp.211-219
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• 2012

This study was performed to search for correlation between activity limitation level and participation restriction of children with cerebral palsy by investigating the activity limitation level through the use of the GMFCS E&R and the MACS and by figuring out participation restriction level through questionnaire survey. This study was performed, from May 1, 2010 to August 31, 2010, on 152 children with cerebral palsy ranging from 4 to 12 years, who are receiving rehabilitation therapy in the hospitals and community clinics in Busan and Gyeongnam province. The levels of activity limitation were assessed by using GMFCS E&R and MACS, and a questionnaire survey was conducted for participation restriction of the participating children. Spearman rank correlation was used for correlation analysis with the statistical software, SPSS 12.0. Majority of the children scored level 5 in both GMFCS E&R and MACS which is high frequency of activity limitation levels. Children in these levels also showed severe or complete participation restriction for mobility, education, and social relations. The analysis showed a significantly positive correlation between activity limitation level and participation restriction. Therefore this study may be useful in assessing the functional movement component of participation in children with cerebral palsy and developing the intervention plan for participation.

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

• Journal of the Korean Society of Physical Medicine
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• v.12 no.2
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• pp.67-74
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• 2017

PURPOSE: The purpose of this study was to investigate the difference and relationship between sensory processing abilities, gross motor and fine motor capabilities in children with cerebral palsy. METHODS: 104 children with cerebral palsy participated in the study. Sensory processing abilities of the subjects were measured by Short Sensory Profile (SSP). Gross and fine motor abilities were each measured using the Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS), respectively. RESULTS: There were significant correlations between SSP level and GMFCS (R=.72, p<.00) or MACS (R=.77, p<.00) levels. Significant differences were showed each gross motor (p=.01) and fine motor level (p=.00) among sensory processing level of children. In addition, sub-items of sensory processing as Tactile sensitivity, Movement sensitivity, Auditory filtering and Low energy/Weak were significantly were showed significant correlations gross motor and fine motor level (p=.01). Also, multiple regression result was showed that as MACS level and GMFCS level were higher, the SSP total score was higher all of participants (adjusted $R^2=.62$). CONCLUSION: Sensory processing abilities of children with cerebral palsy were related with gross motor and fine motor capabilities. Also gross motor and fine motor capabilities are as higher, the sensory processing skill was well of cerebral palsy.

• The Journal of Korean Physical Therapy
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• v.25 no.5
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• pp.246-251
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• 2013

Purpose: The purpose of this study was to provide quantitative data regarding development of the chest wall in children with cerebral palsy (CP) according to Gross Motor Function Classification System (GMFCS) levels and age using the radiological image diameter measurement method. Methods: Subjects included 112 children with CP and 110 healthy children, All of the children underwent simple chest x-ray. The diameters of the upper chest ($D_{apex}$) and lower chest ($D_{base}$) were measured on the anteroposterior (AP) view of a chest x-ray, and the $D_{apex}$ to $D_{base}$ ratio was calculated. Chest wall ratios were compared among children with CP at GMFCS levels I ~ III, GMFCS levels IV and V, and healthy children. Results: The results showed significant differences between the upper and lower chest wall diameters of children with CP at GMFCS levels IV and V, and healthy children (F=4.54, p=0.01; F=3.20, p=0.04). Results of comparison between the chest wall ratios of children with CP and healthy children, showed that the upper chest walls of healthy children were significantly larger in children younger than 48 months (p<0.05), and both the upper and lower chest walls of healthy children were significantly larger compared to children with CP in children older than 48 months (p<0.05). Conclusion: Radiographic measurement for examination of chest wall development is relatively simple, and the results yield quantitative data on development of the chest wall for children with CP. In addition, therapeutic interventions may be considered based on the results.

• The Journal of Korean Physical Therapy
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• v.24 no.6
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• pp.398-404
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• 2012

Purpose: This is designed to study the effect of weight-support walking training through motor learning on motor functions of children with cerebral palsy, in particular their activity of daily living and balance. Methods: Thirteen children with spastic cerebral palsy, at gross motor function classification system (GMFCS) levels III~IV, underwent treadmill walking training. It used principles of weight support, 4 times a week for 7 weeks, 10 minutes at a time, before and after neurodevelopmental physical therapy. Everyday functions were measured using Functional Independence Measure for Children (Wee-FIM). The ability to keep their balance was measured using electronic measuring equipment from good balance system and the assessment was made before and after the experiment. Results: There were significant differences (p<0.05) between pre and post experiment levels of functional independence in everyday life, in self-care activities, mobility, locomotion and social cognition. With regard to changes in standing balance, there were significant differences before and after the experiment (p<0.05) in GMFCS level III. There was a reduction in the agitation velocity in the x- and y-axes which measures the left-to-right shaking; in GMFCS level IV, velocity moment was reduced. Conclusion: Walking training using a treadmill can help improve the everyday activity and balance in children with spastic cerebral palsy. It can also be served as a useful purpose as a method of intervention in pediatric care.

• The Journal of Korean Physical Therapy
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• v.30 no.3
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• pp.90-95
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• 2018

Purpose: To investigate the relationship between gross motor capacity and neuromuscular function in children with cerebral palsy (CP) through a short-term intensive intervention. Methods: Twenty-four children younger than 6 years of age (17 boys, 7 girls, mean $age{\pm}standard$ deviation, $42.71{\pm}14.43months$) who were diagnosed with CP underwent short-term intensive treatment for 8 weeks. An evaluation of gross motor function capacity using the gross motor function measure (GMFM-66 and GMFM-88) was performed to measure muscle strength, selective motor control (SMC), and spasticity, factors related to neuromusculoskeletal function. Changes in spasticity, strength, range of motion, selective motor function, and exercise intensity scores were evaluated in terms of the gross motor function classification system (GMFCS) and ages. Results: The GMFM-88 and GMFM-66 scores significantly increased, by $4.32{\pm}4.04$ and $2.41{\pm}1.51%$, respectively, following the 8-week intervention. The change in the GMFM-66 score did not reflect a statistically significant difference in the GMFCS level. However, there was a statistically significant difference in the GMFM-88 score change in individuals at GMFCS Level III, the strength and spasticity of subjects at GMFCS Levels I-II did not significantly differ (p<0.05). The changes in the GMFM-66 scores for strength, SMC, range of motion (ROM), and spasticity significantly differed according to age (p<0.05) in children aged 36 months and older. Overall, there was a statistically significant difference in strength, SMC, and spasticity (p<0.05) before and after intensive short-term treatment. Conclusion: The 8-week short-term intensive care intervention improved the motor function score of study participants, emphasizing the need for early intervention and additional research in this area.

• Child Health Nursing Research
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• v.30 no.1
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• pp.7-16
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• 2024

Purpose: Children with cerebral palsy (CP) and their parents experience various problems that can affect their quality of life. This study examined factors affecting the quality of life of children with CP. Methods: A cross-sectional study was conducted in Yogyakarta, Indonesia, from January to August 2019. The participants were consecutively recruited children with CP aged 2 to 18 years and their parents. Ninety-eight children with CP and their parents, specifically their mothers, were recruited. Children's health-related quality of life (HRQoL) was measured using the Pediatrics Quality of Life Cerebral Palsy. Parental HRQoL and stress were measured using the WHOQOL-BREF and Parenting Stress Index (PSI). Results: Functional level V was the most common category for both Gross Motor Function Classification System (GMFCS) and Bimanual Fine Motor Function (BFMF) (35% and 28%, respectively). Children's mean HRQoL was medium (49.81±20.35). The mean total PSI score was high (94.93±17.02), and 64% of parents experienced severe stress. Bivariate analysis showed that GMFCS, BFMF, number of comorbidities, presence of pain, and parental stress were significantly correlated with the total score for children's HRQoL (p<.05). Multiple linear regression analysis (p<.05) demonstrated that more severe GMFCS and parental stress were associated with lower mean HRQoL scores in children. Conclusion: Factors including the level of GMFCS and parental stress affected the HRQoL of children with CP. Parental stress management should be included in the comprehensive management of these children.