• 대한한방소아과학회지
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• 제31권1호
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• pp.82-91
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• 2017

These are three case reports on developmental delay that were treated with Korean medicine more than one year. A child with spastic cerebral palsy was treated only with acupuncture in one case, and in another case, two children with cerebral palsy were treated with both acupuncture and Korean herbal medication: Gami-Dossi-pyengwisan and Gami-Guibiondam-tang. After more than a year of treatment period, all three children showed improvement of general condition and motor function, measured by Gross Motor Function Measure, compare to average of children with cerebral palsy. According to this result, Korean medicine treatment can be helpful in improvement of spasticity and developmental delay due to cerebral palsy. Further studies with more cases and well-designed randomized controlled trials should be performed to establish proper guideline of Korean medicine treatment for cerebral palsy.

• 대한통합의학회지
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• 제10권2호
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• pp.155-167
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• 2022

Purpose : Accumulation of accurate data regarding the use and adequacy of subsidies is important to provide optimal development rehabilitation services. However, no reports have discussed the status regarding the use and adequacy of subsidies available for motor development rehabilitation as a part of development rehabilitation services in children and adolescents with cerebral palsy. In this study, we investigated the current use and subsidy adequacy of motor development rehabilitation as an essential part of development rehabilitation services in children and adolescents with cerebral palsy. Methods : The study included parents of children and adolescents with cerebral palsy, who underwent motor development rehabilitation of development rehabilitation services (n=148). The participants were administered a questionnaire to investigate the current use and subsidy adequacy of the motor development rehabilitation part of development rehabilitation services. Results : Most respondents indicated that 310,000-410,000 /month was an appropriate subsidy and agreed that the subsidy should be extended to adults with cerebral palsy. We observed a significant difference in the appropriate subsidy based on age groups (p=.029), as well as type of development rehabilitation service most needed (p=.005) and whether or not agree to extend the subsidy to adults according to gross motor function classification system level (p=.015). There were significant relations of appropriate subsidy (p<.001) and appropriateness of copay (p=.004) according to degree of transportation cost burden. Moreover, there were significant relations of appropriateness of current subsidy (p=.015) and appropriate subsidy (p<.001) according to degree of inconvenience of using transportation. Conclusion : This study highlights the need to increase subsidies for motor development rehabilitation of development rehabilitation services and that the subsidy should be determined based on the burden of transportation costs and the inconvenience of using transportation. Development rehabilitation service for adults with cerebral palsy should also be supported.

• 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.

• 대한물리의학회지
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• 제14권2호
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• pp.97-105
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• 2019

PURPOSE: This study examined the factors related to school-based activity performance in school-aged children with spastic cerebral palsy (CP). METHODS: The Gross Motor Function Systems (GMFCS), Manual Ability Classification System (MACS), Communication Function Classification System (CFCS) as functional classifications, and the physical activity performance of the School Function Assessment (SFA) were measured in 79 children with spastic CP to assess the student's performance of specific school-related functional activities. RESULTS: All the function classification systems were correlated significantly with the physical activity performance of the SFA ($r_s=-.47$ to -.80) (p<.05). The MACS (${\beta}=-.59$), GMFCS (${\beta}=-.23$), CFCS (${\beta}=-.21$), and age (${\beta}=-.15$) in order were predictors of the physical activity performance of the SFA (84.8%)(p<.05). CONCLUSION: These functional classification systems can be used to predict the school-based activity performance in school-aged children with CP. In addition, they can contribute to the selection of areas for intensive interventions to improve the school-based activity performance.

• The Journal of Korean Physical Therapy
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• 제24권6호
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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.

• Clinical and Experimental Pediatrics
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• 제65권3호
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• pp.142-149
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• 2022

Background: Individuals with Down syndrome present with several impairments such as hypotonia, ligament laxity, decreased muscle strength, insufficient muscular cocontraction, inadequate postural control, and disturbed proprioception. These factors are responsible for the developmental challenges faced by children with Down syndrome. These individuals also present with balance dysfunctions. Purpose: This systematic review aims to describe the motor dysfunction and balance impairments in children and adolescents with Down syndrome. Methods: We searched the Scopus, ScienceDirect, MEDLINE, Wiley, and EBSCO databases for observational studies evaluating the motor abilities and balance performance in individuals with Down syndrome. The review was registered on PROSPERO. Results: A total of 1,096 articles were retrieved; after careful screening and scrutinizing against the inclusion and exclusion criteria, 10 articles were included in the review. Overall, the children and adolescents with Down syndrome showed delays and dysfunction in performing various activities such as sitting, pulling to stand, standing, and walking. They also presented with compensatory mechanisms to maintain their equilibrium in static and dynamic activities. Conclusion: The motor development of children with Down syndrome is significantly delayed due to structural differences in the brain. These individuals have inefficient compensatory strategies like increasing step width, increasing frequency of mediolateral center of pressure displacement, decreasing anteroposterior displacement, increasing trunk stiffness, and increasing posterior trunk displacement to maintain equilibrium. Down syndrome presents with interindividual variations; therefore, a thorough evaluation is required before a structured intervention is developed to improve motor and balance dysfunction.

• 한국전문물리치료학회지
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• 제17권4호
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• pp.69-76
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• 2010

The purposes of this study were to examine the reliability and validity of Korean translation of Pediatric Evaluation of Disability Inventory (PEDI-K) in school-aged children with cerebral palsy (CP). The PEDI-K, Functional Independence Measure for Children (WeeFIM) and Gross Motor Function Classification System (GMIFCS) were completed in 104 school-aged children with CP by therapists. The internal consistency of the PEDI-K was calculated by Cronbach's alpha (${\alpha}$) for assessing reliability. Concurrent validity was evaluated by correlation with the subsets of WeeFIM. Discriminant validity was assessed by comparing GMFCS levels with tests of the PEDI-K. The results showed that internal consistency was good (Cronbach's ${\alpha}$ ranged from .97~.98). Concurrent validity was demonstrated. The correlation with WeeFIM was high in the Functional Skills (self-care, r=.74~.94; mobility, r=.59~.91; social function, r=.65~.93) and in the Caregiver Assistance (self-care, r=.75~.94; mobility, r=.63~.90; social function, r=.78~.96). Discriminant validity was demonstrated on significant decreases in domain scores with increasing GMFCS levels. Reliability and validity have been demonstrated on the PEDI-K. This study extends usage of PEDI-K in clinical activities and research.

• 대한통합의학회지
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• 제7권3호
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• pp.117-125
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• 2019

Purpose : The purpose of this study was to determine the effects of simultaneous application of focal vibration stimulation and task-oriented training on the improvement in upper extremity motor function after stroke. Methods : The study period was from January to April 2019; 23 patients who fulfilled the study eligibility criteria were enrolled. The participants were divided into two groups: the experimental group with vibration stimulation and task-oriented training and the control group with only task-oriented training. Training was conducted in a total of 20 sessions, 5 times a week for 30 minutes a day for 4 weeks. The amount of use of the affected and unaffected side by accelerometers, and Box and Block test (BBT), Action Research Arm Test (ARAT) was measured with a pre-test, a post-test. Wilcoxon Signed Rank Test and Analysis of Covariance were used to compare and analyze the changes within and between the groups. Results : Both the groups showed statistically significant changes in the results of the BBT and the ARAT, as well as the amount of use of the affected and unaffected side. Regarding the use of the affected side, BBT results, and the grasp and gross movement item of the ARAT showed significant changes in the experimental group compared with the control group. Conclusion : We found that simultaneous application of focal vibration stimulation and task-oriented training was more effective than task-oriented training alone. A large-scale comparative study involving a group that is only given vibration stimulation should be conducted for more generalizable results.

• 한국전문물리치료학회지
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• 제19권1호
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• pp.86-93
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• 2012

The purpose of this study was to assess the feasibility of task-oriented arm training for chronic hemiparetic stroke patients. The experimental design in this study was the pre-test and post-test with control group for 4-week intervention. Thirty patients with chronic hemiparetic stroke were recruited from 2 rehabilitation units. The subjects were divided randomly into experimental and control groups. The experimental group conducted task-oriented approach, involving 3 subparts of upper extremity activities, and the control group involved in the general upper extremity exercises. Functional movements of the upper extremities were assessed using clinical measures, including the Fugl-Meyer Assessment-Upper Extremity Section, Box and Block Test, and Action Research Arm Test. The score of Fugl-Meyer Assessment showed greater increases in the experimental group than in the control group after training. The improvement in Box and Block Test between pre-test and post-test measurements was significantly greater after task-oriented arm training compared to general upper extremity exercises. Action Research Arm Test scores also improved after task-oriented arm training compared to exercises in the control group. The task-oriented arm training improves the gross and fine motor activities and encouraging the use of the paretic arm through activity dependent intervention expedites the recovery of functional activities in the upper extremities for chronic hemiparetic stroke.

• 대한한방소아과학회지
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• 제23권3호
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• pp.89-108
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• 2009

Objectives The purpose of this study is to report the clinical effects of oriental medical treatment on developmental disorder induced by traumatic brain injuries. Methods The patients were treated with herb medicine, acupunctures, moxibustions, and negative pressures, and then evaluated by manual muscle tests, gross motor function measurements, sequenced language scales for infants. Results The patient's manual muscle power, motility, cognition, speech were significantly improved after six weeks of oriental medical treatment. Conclusions This study showed that oriental medical treatments were effective on developmental disorder induced by traumatic brain injuries. However, further clinical studies were needed.