• Journal of the Korean Society of Physical Medicine
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• v.8 no.4
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• pp.637-645
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• 2013

PURPOSE: The purpose of this study was to examine the effect of using a suspension device for arm reaching activity on trunk stability and gross motor function of children with spastic diplegia cerebral palsy. METHODS: The subject in this study consisted of 11, GMFCS(Gross Motor Function Classification System) III~IV children with spastic diplegia cerebral palsy, all of whom agreed to participate in the study. All subjects were divided into two groups: the experimental group using a suspension device, and the control group using no suspension device. For each group, a thirty-minute intervention was done twice per week during 8 weeks. Before and after intervention, each test was measured using TIS(Trunk Impairment Scale), GMFM (Gross Motor Function Measure) and PRT(Pediatric Reaching Test) to change trunk stability, gross motor function and arm reaching activity. The data were analyzed with the Wilcoxon signed rank test. RESULT: All two groups had a meaningful increase in GMFM-Sit data measured before and after intervention. The experimental group had a significant increase from an average of 78.83 to an average of 84.83 in GMFM-Crawling. For both groups, there was a substantial increase in the change in sitting position and arm reaching. CONCLUSION: According to the results of this study, the arm reaching activity using suspension device had an effect on trunk stability and gross motor function and it changed arm reaching activity.

• Physical Therapy Korea
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• v.21 no.3
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• pp.55-62
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• 2014

This study investigated the relationship between function classification systems and the Pediatric Evaluation of Disability Inventory (PEDI) functional skills in children with cerebral palsy (CP). Two hundred and eleven children with CP participated in this study. The Korean-Gross Motor Function Classification System (K-GMFCS), Korean-Manual Ability Classification System (K-MACS), Korean-Communication Function Classification System (K-CFCS), and self-care, mobility, and social function domains of the Korean-Pediatric Evaluation of Disability Inventory (K-PEDI) functional skills were measured by physical therapists or occupational therapists. All of the function classification systems were significantly correlated with PEDI functional skills ($r_s$=-.549 to -.826) (p<.05). Especially, K-GMFCS, K-MACS, and K-CFCS were correlated significantly with mobility, self-care, and social function, respectively. Using stepwise multiple regression analysis, we established that K-GMFCS, K-MACS, and K-CFCS were predictors of self-care skills (74.3%) and mobility skills (79.5%) of the K-PEDI (p<.05). In addition, K-CFCS and K-MACS were predictors of social function (65.9%) of the K-PEDI (p<.05). The information gathered in this study using the levels measured in the function classification systems may be useful to clinicians for estimating the PEDI functional skills in children with CP.

• The Journal of the Korea Contents Association
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• v.9 no.5
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• pp.182-188
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• 2009

The purpose of this study was to investigate the effect of self-care training based on ICF(International Classification of functioning, Disability and Health) on functional independence in the young children with spastic cerebral palsy. Total of 43 young children(male=25, female=18; age range from 36month to 72month) with spastic cerebral palsy, classified at GMFCS(Gross Motor Function Classification System) levels III-IV. Total of 32sessions of a self-care training (eating, grooming, bathing, toileting) were given 4 times a week for 30minutes from August 1th to September 30th of 2008. Changes in the functional independence after the training obtained by Wee-FIM(Functional Independence Measure for Children). Results were as follows: Functional independence was significantly increased after the training. As a result, a self-care training should be applied as an effective intervention to improve the functional independence in the young children with spastic cerebral palsy.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.4
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• pp.45-53
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• 2019

PURPOSE: This study examined the differences in the trunk impairment scores according to the levels of the gross motor classification system by evaluating trunk control in children with spastic cerebral palsy using the index of trunk impairment. In addition, the characteristics of trunk control disabilities were investigated according to the cerebral palsy type. METHODS: The subjects were 49 children (mean age 8.57±1.83 years, 11 with hemiplegia, 26 with diplegia, and 12 with quadriplegia) with spastic cerebral palsy levels I to IV under the gross motor function classification system (GMFCS). The coordination and balance of the children with cerebral palsy were evaluated using the index for trunk impairment. Statistical analyses were performed using a Kruskal-Wallis test, and Bonferroni analyses were used as a post-hoc comparison for any significant results. RESULTS: The median of the total scores of trunk impairment was 13 (range, 9-17), which was 56% of the maximum score. The total score of trunk impairment and subscales differed significantly according to the disease severity and type of motor disability. The scores for children with quadriplegia were the lowest compared to children with hemiplegia and diplegia. CONCLUSION: Trunk control function in children with spastic cerebral palsy was reduced, and varied according to the disease severity and types of motor disabilities. The degree of trunk impairment differed from the trunk control ability according to the degree of motor disability of children with cerebral palsy.

• Journal of the Korean Society of Physical Medicine
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• v.16 no.3
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• pp.123-130
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• 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 the Korea Contents Association
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• v.12 no.7
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• pp.232-239
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• 2012

The purpose of this study was to investigate the relationship among functional evaluation systems, the Selective Motor Control Scale (SMC scale), the Gross Motor Function Classification System (GMFCS), the Gross Motor Function Measure (GMFM) and Activities of daily living in children with spastic cerebral palsy and to provide the foundation data about SMC scle for evaluation system of abilities of selective motor control in children with spastic cerebral palsy. For this, sixty eight children with spastic cerebral palsy were participated in this study. The children were evaluated by using the SMC scale for their selective motor control ability and by using the GMFCS and GMFM for their gross motor function. The activities of daily living were assessed by using the Functional Independence Measure of Children (WeeFIM). There were a significant correlation between the SMC scale and the GMFCS (r = -.485, p < .05). The good correlation between the SMC scale and GMFM was found (r = .482, p < .05). The activities of daily living were not a significant correlation with SMC scale (r = .019, p > .05). The SMC scale in practice will provide usefulness for assessment of abilities of selective motor control in children with spastic cerebral palsy.

• 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 Integrative Medicine
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• v.7 no.3
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• pp.51-59
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• 2019

Purpose : To evaluate the effect of comprehensive art therapy on physical function and activities of daily living in children with cerebral palsy (CP). Methods : Ten ambulant children with diplegic (n=8) or hemiplegic (n=2) CP participated in this study. All were randomly assigned to either the art therapy group (n=5) or the control group (n=5). Both groups received physical therapy based on neurodevelopmental techniques for 20 minutes a day, 1 day a week, for a period of 12 weeks. Children in the art therapy group received additional comprehensive art therapy for 70 minutes once a week for 3 months. Tests for various measurements-Motricity Index (MI) for strength, Trunk Control Test (TCT) for trunk ability, Gross Motor Function Measure (GMFM) and Gross Motor Function Classification System (GMFCS) for gross motor function, Denver Developmental Screening Test-II (DDST-II) for developmental milestones, Functional Independence Measure of Children (WeeFIM) for abilities to complete daily activities, Leg and Hand Ability Test (LHAT) for limb function-were performed before and after treatments. Results : The upper extremity and whole extremity strengths of MI, self-care and total scores of WeeFIM, and leg and arm functions of LHAT improved significantly only for individuals in the art therapy group after the art therapy (p<.05). The value of MI after treatment was at the upper extremity and whole extremity strengths the leg function of LHAT was also significantly improved compared to the control group (p<.05). Conclusion : This study revealed that comprehensive art therapy along with physiotherapy was effective in increasing upper extremity strength and leg ability in children with CP. This suggests that comprehensive art therapy may be a useful adjunctive therapy for children with CP.

• Journal of the Korean Society of Physical Medicine
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• v.12 no.3
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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.

• The Journal of Korean Physical Therapy
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• v.22 no.3
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• pp.37-44
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• 2010

Purpose: The purpose of this study was to describe the functional (mobility, self-care, social ability) and health-related quality of life in children with cerebral palsy (CP). Methods: A cross- sectional survey of 202 children with CP, mean age $5.91{\pm}1.57$ years, was carried out using the Gross Motor Function Classification System (GMFCS), Gross Motor Function Measure (GMFM), Pediatric Evaluation of Disability Inventory (PEDI), and Child Health Questionnaire (CHQ). Results: The functional assessment of children with CP showed that a more severe GMFCS level was associated with lower functional abilities (p<0.05). The health-related quality of life assessment showed that psychosocial well-being was less impaired than physical well-being. The internal consistency of the three instruments was satisfactory (cronbach's ${\alpha}$>0.80). The three different scales were correlated from moderate to strong (r=0.44 to 0.92). It was also found that mobility, tone distribution, and the parents' education level exerted a significant effect on the quality of life of children with CP (p<0.05). Conclusion: These findings suggest that children with CP have reduced function and quality of life and these are influenced by various factors. However, planning and application of various task-oriented functional interventions to childhood CP may be useful.