• 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.

• 한국콘텐츠학회논문지
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• 제9권7호
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• pp.248-256
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• 2009

이 연구는 뇌성마비 아동의 손 기능을 평가하기 위해 개발된 손 기능 분류 체계(Manual Ability Classification System: MACS)를 이용하여 경직형 뇌성마비 아동의 손 기능을 평가하고 손 기능과 기능적 수행도 평가인 일상생활활동평가(Functional Independence Measure of Children: WeeFIM), 대운동 기능 분류체계(Gross Motor Function Classification System: GMFCS)의 관계를 알아보고, 이를 통해 뇌성마비 아동의 손 기능 평가 체계로써의 MACS에 대한 기초의 자료를 제공하는데 그 목적이 있었다. 경직형 뇌성마비 아동 60명을 대상으로 아동의 손 기능과 대동작 기능, 일상생활활동을 평가하였다. 평가한 자료를 바탕으로, MACS와 WeeFIM 및 GMFCS와의 관계와 손 기능 수준에 따른 일상생활활동의 차이를 알아보았다. 그 결과, MACS와 GMFCS의 상관은 유의수준.05에서 유의한 것으로 나타났으며, 그 정도는 r =.659이었다. WeeFIM과의 상관을 알아본 결과에서도 총점과의 상관은 유의수준.05에서 유의한 것으로 나타났으며, 그 정도는 r = -.576이었다. 손 기능 분류 체계로 평가한 수준에 따른 일상생활 활용의 차이를 알아본 결과 유의한 차이가 있는 것으로 나타났다(p <.05). 뇌성마비 아동의 손 기능 평가 도구로써 MACS는 임상적으로 유용한 평가 체계로 사용될 수 있음을 알 수 있다.

• 대한물리의학회지
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• 제9권4호
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• pp.391-398
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• 2014

PURPOSE: The purpose of the present study was to examine the effect of gluteal taping on posture and balance during standing in children with hemiplegic cerebral palsy (CP). METHODS: The subjects of this study were 13 children (six females, seven males; mean aged 8.5) with hemiplegic CP who were gross motor function classification system (GMFCS) level I. The change of posture and balance during standing before and after gluteal taping were measured using inclinometer, gross motor function measure, and functional reaching test. The collected data were analyzed using the paired t-test. RESULTS: The results of this study were as follows : 1) There were statistically significant decrease in the ant. tilt angle of pelvis after gluteal taping in children with hemiplegic CP (p<.05). 2) There were statistically significant increase in functional reaching test after gluteal taping (p<.05). 3) There was no statistically significant difference in gross motor function measure, but significant increase in one leg standing was observed (p<.05). CONCLUSION: As the above results, we suggest that gluteal taping could be effective on improving body alignment and dynamic balance ability during standing in children with hemiplegic CP. Further studies will be required for the short and long term effects of gluteal taping on improving postural symmetry and balance.

• 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.

• The Journal of Korean Physical Therapy
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• 제29권3호
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• pp.115-121
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• 2017

Purpose: The aim of this study was to investigate applicability of the GMFM-88 in planning intervention for CP children. Specifically, this study assessed functional improvement after a four-week GMFM-88 item-based training in CP children divided into three age groups (${\leq}24$ months, 25-48 months, and >48 months) and five levels of the gross motor function classification system (GMFCS). Methods: Subjects were 264 children with CP (mean age 32.90 months) recruited from one CP clinic. The GMFM-88 item-based training was planned for each child, after an interview with its caregiver. To investigate functional improvement after the intervention, minimum important difference (MID) and MID proportion for the change in scores of GMFM-88 were calculated. Results: The GMFM-88 scores increased after the interventions in all three age groups (p<0.05). In particular, children with CP aged ${\leq}24$ months and at the GMFCS level II showed greater functional improvement after training. Conclusion: This study found that the GMFM-88 item-based training would be used to plan activity-oriented intervention both in clinic and home in each CP child.

• 한국전문물리치료학회지
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• 제17권3호
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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.

• 재활복지
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• 제20권3호
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• pp.125-139
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• 2016

본 연구의 목적은 뇌성마비 아동의 운동활동에 대한 3가지 개념(능력, 수행능력, 수행)을 구분하고 능력(표준화된 환경에서 할 수 있는 것), 수행능력(일상 환경에서 할 수 있는 것), 수행(일상환경에서 하는 것) 사이의 관련성을 평가하기 위한 것이다. 연구는 평균연령 6.6세의 뇌성마비 아동 40명(남자 19명, 여자 21명)의 평가 기록을 이용한 단면조사 분석으로 수행되었다. 대운동기능분류체계(GMFCS)에 따른 중증도는 1단계 13%, 2단계 10%, 3단계 43%, 4단계 33%, 4단계 3%였다. 운동활동 능력은 대동작기능평가(GMFM)를 이용하여 측정되었다. 수행능력과 수행은 소아장애평가척도(PEDI)의 2가지 척도(기능적 기술, 보호자 도움)를 사용하였다. 연구결과 능력과 수행 사이의 상관관계는 0.811(p<.05)이었고, 수행능력과 수행 사이의 상관관계는 0.845(p<.05)로 가장 높았다. 능력과 수행 사이의 상관관계는 0.711(p<.05)로 가장 낮았다. 뇌성마비 아동의 운동에 대한 능력과 수행능력은 일상생활에서의 수행을 완전히 반영하지 못한다. 수행에는 배경요인(특히, 가족기능과 같은 사회적 요인)이 영향을 미치기 때문이다. 따라서 본 연구는 뇌성마비 아동의 능력, 수행능력, 수행에 대해 명확하게 구분하여 평가하는 것이 필요하다고 제안한다.

• 한국전문물리치료학회지
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• 제17권1호
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• pp.62-68
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• 2010

The purposes of this study were to examine inter-rater reliability of the Manual Ability Classification System (MACS) by children's age and to identify the correlation between the MACS and the Gross Motor Function Classification System (GMFCS) in children with cerebral palsy (CP). Twenty-six children with CP older than two years participated. Children with CP were classified according to the MACS and the GMFCS by two physical therapists. Inter-rater reliability was analyzed using the Intraclass Correlation Coefficients (ICCs). The results showed that the reliability of the MACS for children aged 2~3 years was .88 and for children aged above 4 years was .98 (p<.05). Children with quadriplegia had a higher level of MACS than children with spastic hemiplegia and diplegia. A moderate relationship between the MACS and the GMFCS was found in all children (rater 1, r=.631; rater 2, r=.438). The MACS will be used for classification of children with CP according to the manual abilities. Thus, it offers a reliable method for communicating between therapists about the manual ability of children with CP who are older than 2 years.

• 대한한의학회지
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• 제42권4호
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• pp.61-74
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• 2021

Objectives: This study aimed to analyse: 1) the clinical effectiveness and safety of traditional Korean Medicine (TKM) and frequency of TKM therapies used and their relationship with conventional treatments. Methods: This prospective observational study enrolled children with cerebral palsy (CP) aged 6-78 months (n=126). The children who used herbal medication for >30 days or acupuncture treatment >12 sessions within 6 months were defined as the integrated rehabilitation (IR) group; the remaining participants were included in the conventional rehabilitation (CR) group. Results: Changes in the Gross Motor Function Measure-66 (GMFM-66) were greater in the IR group (6.4±6.1) than in the CR group (4.6±5.8). The reduction in the number of other health problems was greater in the IR group than in the CR group. The GMFM-66 improvement was greatest in gross motor function classification system level 1. There was no between-group difference in the frequency of rehabilitation therapy (10.9±6.6 and 12.0±9.9 in the IR and CR groups, respectively). Conclusion: TKM may offer additional benefits in terms of the GMFM-66 score and other health problems. However, there is a need for further randomized controlled trials involving a restricted CP type and a controlled treatment type and intensity to confirm these findings.

• 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.