• 대한물리의학회지
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• 제12권3호
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• pp.79-84
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• 2017

PURPOSE: The purpose of this study is to examine how task-oriented training focused on lower extremity strengthening can affect mobility function and postural stability. METHODS: The study's subjects included 10 children with cerebral palsy: 7 girls and 3 boys between the ages of 4 and 9 whose Gross Motor Functional Classification System (GMFCS) level was I or II. Their functional mobility was gauged using the Gross Motor Function Measurement (GMFM), and their postural stability was evaluated using a force platform. Participants received task-oriented training focused on lower extremity strengthening for 5 weeks. The study used a paired t-test to investigate the difference in mobility function and postural stability of children with cerebral palsy before and after the lower extremity strengthening exercise. RESULTS: The GMFM dimensions D (standing) (p<.02) and E (walking) (p<.001) improved significantly between the pre-test and post-test. A significant increase in the posturographic center of pressure (CoP) shift and surface area of the CoP were found overall between the pre-test and post-test (p<.001). CONCLUSION: The present study provides evidence that an 8-week task-oriented training focused on strengthening the lower extremities is an effective and feasible strategy for improving the mobility function and postural stability of children with cerebral palsy.

• 한국전문물리치료학회지
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• 제19권3호
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• pp.81-90
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• 2012

The aim of the current study was to assess the effectiveness of backward gait training on the treadmill in patients with spastic diplegic cerebral palsy (CP). Twelve patients with spastic diplegic CP participated in the study. An 8-week course of backward gait training was administered to the subjects for 3 days per week. Pre-intervention and post-intervention assessments of temporal-spatial gait parameters, the symmetry of the bilateral lower extremity weight bearing, and gross motor function were analyzed using motion analysis system, force plate, and Gross Motor Function Measurement (GMFM). There were significant improvements (p<.05) in the measures of both step length and right stance phase time. Joint kinematics showed increase in right hip abduction in initial contact and terminal swing, right hip external rotation and knee flexion in mid-swing, left ankle dorsiflexion in initial contact and terminal swing (p<.05). The symmetry of the bilateral lower extremity weight bearing and GMFM also significantly increased (p<.05). These findings indicate that backward gait training using a treadmill is beneficial for patients with spastic diplegic CP.

• 대한통합의학회지
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• 제2권4호
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• pp.59-68
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• 2014

Purpose : The purpose of this study was to evaluate the effects of aquatic exercise program on Gross motor function and lower limb control of children with spastic cerebral palsy. Method : The subjects of this study are children with spastic cerebral palsy; 2 patients who agreed with this research, were picked up. Subjects received aquatic exercise training for 6 weeks, which consists of 2 times per week, 30 min of working pattern with floating device for each session. Gross motor function and lower limb control for walking were measured GMFM and SCALE. The intervention were compared by measuring before and after. Result : In GMFM and SCALE of both subjects, the intervention has been improved after the experiment compared to their original status before the intervention. Conclusion : Therefore, the Aquatic exercise is effective in improvement of to improve the gross motor function and lower limb control in chidren with spastic cerebral palsy.

• 대한물리치료과학회지
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• 제15권2호
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• pp.79-86
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• 2008

Background: The purpose of this study was to present a practical method of medical treatment to improve the balance and motor ability of the mentally retarded child with a single mentally retarded child-subject. Methods: The subject of the study was a 39-month-old mentally retarded female. This study included a 2-week basic period and a 13-week treatment period. The treatment method was based on the Bobath Approach. Gross motor function measurement (GMFM) was used to examine changes in motor ability, and the Pediatric Balance Scale (PBS) was used to measure changes in balance ability. The curative program was composed of normalization of muscle tone, strengthening of leg endurance and muscular strength, the improvement of trunk alignment, and the increase of balance. Visual rate of change was used to examine the results. Results: As a result of this study, balance ability increased on the Pediatric Balance Scale (PBS) by 24 points, and motor function increased in terms of Gross Motor Function Measurement (GMFM) by 6.9% (18 points). Standing increased by 41% (16 points), and walking, running, and jumping increased by 31.9% (23 points) compared to thebasic period. Therefore, the Bobath Approach appears to be an appropriate method to improve balance and motor ability in mentally retarded children. Conclusion: It is surmised that aggressive intervention by physical therapists and occupational therapists, and a follow-up study, are required for the growth of motor ability in mentally retarded children.

• 대한물리의학회지
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• 제9권3호
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• pp.293-299
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• 2014

PURPOSE: The purpose of this study was to investigate the effect of functional training using a sliding rehabilitation machine (SRM) on the mobility of the ankle joint and balance in children with cerebral palsy (CP). METHODS: The subjects consisted of 11 children who were diagnosed with spastic CP. They carried out the functional training using the SRM for 30 minutes, three times a week, for 8 weeks. Before and after all of the training sessions, the subjects were tested using the Pediatric Balance Scale (PBS) and Gross Motor Function Measurement (GMFM), range of motion (ROM) in the ankle joint, the pennation angle of the gastrocnemius muscle and the fascicle length of gastrocnemius muscle were measured to determine the mobility of the ankle joint and balance ability. RESULTS: There were significant differences between the pre-test and post-test in the PBS and GMFM. The ROM of the ankle joint was significantly increased after the functional training using the SRM. Moreover, the fascicle length was increased and the pennation angle was decreased after the functional training using the SRM, but the difference was not significant. CONCLUSION: These results suggest that functional training using the SRM may have some effect on the mobility of ankle joint and balance in children with CP. According to the results, this study could present an approach to the rehabilitation or treatment of children with CP.

• 대한통합의학회지
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• 제4권4호
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• pp.53-65
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• 2016

Purpose : The purpose of this study is to evaluate the effects of virtual reality based exercise program on gross motor function and balance of children with spastic cerebral palsy. Method : Subjects of this study, among the children who received the diagnosis spastic cerebral palsy, for children total of 8 people have agreed to research. Experimental group 4 people, control group 4 people, was a total of 8 people. Group-specific arbitration method, was applied to Nintendo Wii Fit game (experimental group) and exercise program (control group). Each training courses 30 minutes for 4 weeks, examined the changes in Gross Motor Function Measure(GMFM) and Pediatrics Balance Scale(PBS) ability to examine a total of 4-week course effectively. The intervention were compared by measuring before and after. Result : There were significant improvements in the subscales of the gross motor function and balance test of those who practiced with the Nintendo Wii Fit game, while the control group showed no significant changes. Conclusion : Therefore, the virtual based on exercise is effective in improvement of to improve the gross motor function and balance in children with spastic cerebral palsy.

• 한국전문물리치료학회지
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• 제24권1호
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• pp.51-60
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• 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.

• The Journal of Korean Physical Therapy
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• 제28권4호
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• pp.232-242
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• 2016

Purpose: This study was conducted to develop a Korean version of the pediatric functional muscle test (K-PFMT) for children with motor developmental disorders, and to verify its reliability and validity. Methods: The subjects were 40 children, aged below 5 years. Each was scored on the K-PFMT by 14 physical therapists to determine inter-rater reliability and internal consistency. Additionally, 3 of the 14 therapists tested 20 children again one or two weeks later to determine test-retest reliability. The internal consistency was calculated by Cronbach's alpha. The inter-rater and test-retest reliability were calculated using the intraclass correlation coefficient (ICC). One-way ANOVA and the paired t-test were used to compare differences among the three evaluator groups and between the test and retest group. Concurrent validity was evaluated by Pearson's correlation with a total score of GMFM. Results: Chronbach's alpha was over 0.98 for each test item and 0.99 for the total items. There was no significant differences in the score of K-PFMT among the three evaluator groups except for a few items. The test-retest ICC was from 0.89 to 1.00 and from 0.82 to 1.00, respectively. There was no significant difference between the test and retest group, except for a few items. There were high significant correlations between K-PFMT and GMFM. Conclusion: This study showed that a K-PFMT with relatively high reliability and validity was successfully developed. The K-PFMT will be a useful tool for measurement of muscle strength of children with motor developmental disorder.

• The Journal of Korean Physical Therapy
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• 제29권1호
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• pp.16-26
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• 2017

Purpose: This study was conducted to develop a Korean version of the trunk control measurement scale (TCMS) and examine the reliability and concurrent validity of the K-TCMS in children with cerebral palsy. Methods: Subjects for the study were 23 children with cerebral palsy (CP)(mean age: 84.70 months) recruited from one CP clinic. For the interrater and test-retest reliabilities, four raters (A, B, C, D) measured the K-TCMS two times using video clips with an interval of two weeks. For the concurrent validity, the Korean version of the gross motor function measure (K-GMFM) was chosen. Inter-rater reliability and test-retest reliability of the three K-TCMS subscale (static sitting balance, dynamic sitting balance and dynamic reaching) scores and the total scores were investigated using the intra-correlation coefficient ($ICC_{3,1}$). Spearman's correlation coefficient (r) was calculated to investigate the concurrent validity. Results: The inter-rater reliability of the K-TCMS subscales and total scores were all high ($ICC_{3,1}=0.968-0.992$). For the test-retest reliability, $ICC_{3,1}=0.827-0.962$. The concurrent validity between the K-TCMS's total and three subscale scores and K-GMFM's total score were r=0.600-0.667. Conclusion: The results suggest that the K-TCMS can be used in clinical and research settings as a standardized tool for CP children. The K-TCMS might be also useful for selecting treatment goals and planning interventions for children with cerebral palsy.

• 대한물리의학회지
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• 제14권4호
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• pp.71-80
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• 2019

PURPOSE: This study examined whether a task-oriented training program is an effective intervention to improve the body function, activity, and participation of children with cerebral palsy (CP). METHODS: Ten children with CP (7-13 years old) performed a task-oriented training program for eight weeks (three sessions per week, 30 minutes each). The taskoriented training program consisted of eight activities. The subjects' body function was assessed using a handheld dynamometer, goniometer, Modified Ashworth Scale (MAS), Balance Performance Monitor (BPM), and the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP). The subjects' activity and participation were assessed using the Gross Motor Function Measure (GMFM) and Timed Up and Go (TUG) test. RESULTS: Task-oriented training provided significant improvements in the subjects' body function. The subjects improved the bilateral isometric muscle strength of the hip flexors, extensors and abductors, knee flexors and extensors, and ankle dorsi- and plantar flexors (p<.05). Bilateral passive hip flexion, abduction, and external rotation, knee flexion, and ankle dorsi- and plantar flexion were also increased (p<.05). In addition, the MAS score of the hip adductors decreased (p<.05) and the BOTMP score increased after training (p<.05). The subjects' activity and participation also improved significantly after training, increasing the GMFM score (p<.05) and decreasing the TUG score (p<.05). On the other hand, the BPM score did not change after training. CONCLUSION: This study suggests that a task-oriented training program can be an effective intervention to improve the body function, activity, and participation for children with CP.