• 제목/요약/키워드: Gross Motor Function Classification

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뇌성마비 아동의 신체 기능수준과 재활 목적 치료 강도가 신체 기능향상에 미치는 영향: 6개월간 추적연구 (The Effects of Physical Function Level and Intensity of Treatment for Rehabilitation on Improvement of Physical Function in Children with Cerebral Palsy: Follow-up Study for 6 Months)

  • 김부영;윤영주;신용범;김수연;오태영
    • 대한물리의학회지
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    • 제13권1호
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    • pp.27-38
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    • 2018
  • PURPOSE: The purpose of this study was to find out the treatment patterns of Children with cerebral palsy, and to analyze the effect of physical function level and treatment intensity on improvement of physical function in children with cerebral palsy for six months. METHODS: Participants were 126 children (boys 83, girls 43) diagnosed cerebral palsy that the mean age was at 33months, ranged from 8 months to 77 months. We collected data related on demography and disable characteristic, treatment pattern using by questionnaire constructed ourselves for six months on caregivers. The treatment pattern includes, type, frequency, and institute of treatment. We performed the evaluation of Gross Motor Function Measurement (GMFM) and Pediatric Evaluation of Disability Inventory (PEDI) between pre and post for six months in order to find out improvement of physical function. We analyzed the effect of physical functional level measured by Gross Motor Functional Classification system, age, treatment intensity on physical function using by repeated measures ANOVA for SPSS PC ver. 22.0. RESULTS: The average of treatment frequency for physical therapy was 5.74 times per week, occupational therapy was 3.96 times, speech therapy was 2.96 times, treatment for accompanying disability was 3.12 times. Physical function level and age was significantly factors affecting improvement of physical function, there was no significant difference according to treatment intensity. CONCLUSION: We suggest that physical function and age might be important factors on improvement of physical function and professional rehabilitation team must consider the appropriate treatment type customized to each children.

경직성 뇌성마비 환아의 기립 및 보행에 필요한 거골하관절의 정량적 평가 및 분류에 관한 연구 (Quantitative analysis and classification of the subtalar joint in standing and walking of children with cerebral palsy)

  • 김미경;이석민;이재구
    • 대한물리치료과학회지
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    • 제10권2호
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    • pp.42-52
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    • 2003
  • An assessment of the subtalar joint in cerebral palsies can contribute to predict the function of ambulation in CP children. Ambulation is one of the most important function to guarantee the CP children independent life. This paper is to investigate some relationships between the function of standing and walling and the assessment of the subtalar joint in children with Cerebral palsy. And also to present the correlation between the ambulation and the Gross Motor Function Measures in children with cerebral palsy. Sixty-eight children with cerebral palsy were participated in this study. Evaluations of the subtalar pint parameters were performed by the goniometer and the angle finder, and the GMFM scores were measured by their teacher and researcher trained technically. A regression analysis was applied to figure out the relationship between the subtalar pint parameters(ROM and RCSP) and the function of standing and walking. A correlation analysis was employed to see how much the subtalar pint parameters could be predicted from GMFM scores in walling and standing. The results were as follows: 1) The significant differences were not observed between the total ROM, RCSP and the function of standing(F=8.065, p<.001) and walking(F=6.511, p<.001) in CP children. 2) The subtalar pint parameters(total ROM, RCSP) have the lower relevance to the function of standing and walling in CP children.(p>.05) 3) The total ROM and RCSP in both feet have the significant differences between the CP children and the normal children.(p<.001) 4) The GMFM scores were significantly correlated with the function of walling and standing in CP children.(r=247, p<.05) In this research, it is found that the significant relevance between the quantitative analysis of subtalar pint in children with cerebral palsy and the gross motor function of ambulation in standing and walling. However, it is difficult to predict the direct relationship of subtalar pint parameters and the function of ambulation, because subtalar pint scores and GMFM are only measured as quantities not qualities. Therefore, it is more reasonable to investigate the influence of subtalar pint parameters on ambulation in children with cerebral palsies, adding to the multifocal assessment of the children, rather than vice versa.

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뇌성마비 소아청소년의 발달재활서비스 운동발달재활 영역 이용 및 지원금 현황: 보호자 조사연구 (A Study of Current Use and Subsidy Adequacy of Motor Development Rehabilitation Part of Development Rehabilitation Service in Children and Adolescents with Cerebral Palsy: A Parental Survey)

  • 한승현;함석찬
    • 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.

Reliability and Validity of the Korean Translation of the Pediatric Evaluation of Disability Inventory in School-Aged Children With Cerebral Palsy

  • Kim, Won-Ho;Park, Eun-Young;Park, So-Yeon
    • 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.

Exploring the Relationship Between International Classification of Functioning, Disability, and Health Items Linked to Clinical Assessments in Children With Cerebral Palsy

  • Park, Sang-Duk;Yi, Sook-Hee;Kim, Jeong-Soo
    • 한국전문물리치료학회지
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    • 제28권4호
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    • pp.245-250
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    • 2021
  • Background: The International Classification of Functioning, Disability, and Health-Child and Youth version (ICF-CY) is designed to record the characteristics of developing children and examine the influence of a child's environment on their health. Objects: This study was designed to determine the relationship between the clinically extracted ICF-CY items and The Pediatric Evaluation of Disability Inventory (PEDI) and Gross Motor Function Measure (GMFM) items. Methods: Thirty patients (17 males and 13 females) who were hospitalized in a pediatric and youth patient unit of a rehabilitation hospital were included in the study. Four health professionals (two physical therapists and two occupational therapists) working independently linked the PEDI and GMFM-66 items to the activity and participation domains of the ICF-CY. Results: There were strong negative correlations between the ICF-CY subdomains and the PEDI subdomains (r = 0.76-0.95; p < 0.05). There were positive strong correlations between the ICF-CY subdomains and the GMFM-66 (r = 0.76-0.95; p < 0.05). Conclusion: The extracted ICF codes were a valid tool for evaluating the mobility and selfcare conditions of cerebral palsy in the pediatric rehabilitation area.

물리 및 작업치료 1년 후 대동작 기능분류체계에 따른 경직성 뇌성마비 아동의 일상생활동작 변화 (Changes in Activities of Daily Living of Children with Spastic Cerebral Palsy According to Gross Motor Function Classification System After One Year of Physical and Occupational Therapy)

  • 이관우;김원호
    • 한국산학기술학회논문지
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    • 제20권8호
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    • pp.431-440
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    • 2019
  • 이 연구는 경직성 뇌성마비 아동을 대상으로 1년간 물리 및 작업치료 후 대동작 기능분류체계에 따라 일상생활동작 변화정도가 차이가 있는지 그리고 소아장애척도지수와 아동용 일상생활 기능독립 측정 중 어떤 평가도구가 일상생활 동작의 변화에 민감하게 반응하는지를 알아보기 위해 시행되었다. 48명의 경직성 뇌성마비 아동이 참여하였고, 대동작 기능분류체계, 아동용 일상생활 기능독립 측정, 그리고 소아장애척도지수를 측정하였다. 연구결과, 대동작 기능분류체계는 소아장애척도지수와 유의한 상관을 보였지만(p<0.05) 아동용 일상생활 기능독립 측정과 유의한 상관을 보이지 않았다. 또한 중재 전과 후 일상생활동작의 변화는 아동용 일상생활 독립측정인 경우 유의한 차이를 보이지 않았지만, 소아장애척도지수인 경우 유의한 차이를 보였다(p<0.05). 대동작 기능분류체계에 따라 일상생활동작의 변화는 유의하게 차이가 있었으며, 기능수준이 높은 경우 일상생활동작이 변화가 유의하게 컸었다(p<0.05). 물리 및 작업치료 후 대동작 기능 분류체계에 따라 일상생활동작의 향상정도는 다르지만 임상적으로 의미 있게 향상되는 것으로 보이며, 소아장애척도지수는 일상생활동작의 변화에 민감하게 반응하므로 임상에서 폭 넓게 활용하는 것이 필요한 것으로 여겨진다.

GMFM과 ICF의 하위영역 기능이 ICF의 하위영역 활동과 참여문제에 미치는 영향 비교 (A Comparative Study on the Effects of GMFM and ICF Sub-item Function on the Sub-item Activity and Participation Restriction of the ICF)

  • 이진;김은경;전혜림
    • 대한물리치료과학회지
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    • 제26권3호
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    • pp.15-22
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    • 2019
  • Background: The purpose of this study is to explore the effect of the functions of GMFM and ICF-CY on the activities and participation of ICF-CY sub-items. Design: Cross-sectional study. Method: This study compared and analyzed 95 children with cerebral palsy [type of CP: spasticity 86 (90.5%), hypotonia 4 (4.2%), mixed 5 (5.3%); type of palsy: quadriplegia 13 (13.7%), diplegia 71 (74.7%), hemiplegia 11 (11.6%)] using sub-items of functions, activities and participation from GMFM and ICF-CY. Result: The results show that the activities and participation of ICF-CY (9 sub-items) have significant effect on the functions of GMFM and ICF-CY (8 sub-items) (p<0.05). Conclusion: It is intended to provide data to establish practical therapeutic goals and interventions for functions, activities and participation, which are sub-categories of ICF-CY in cerebral palsy.

Comparison of the Pediatric Balance Scale and Fullerton Advanced Balance Scale for Predicting Falls in Children With Cerebral Palsy

  • Kim, Gyoung-mo
    • 한국전문물리치료학회지
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    • 제23권4호
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    • pp.63-70
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    • 2016
  • Background: The Pediatric Balance Scale (PBS) and the Fullerton Advanced Balance (FAB) scale were used to assess balance function in patients with balance problem. These multidimensional clinical balance scales provide information about potential risk factors for falls. Objects: The purpose of this study was to investigate and compare the predictive properties of the PBS and FAB scales relative to fall risk in children with cerebral palsy (CP) using a receiver operating characteristic analysis. Methods: In total, 49 children with CP (boy=21, girl=28) who were diagnosed with level 1 or 2 according to the Gross Motor Function Classification System participated in this study. The PBS and FAB were performed, and verified cut-off score, sensitivity, specificity, and the area of under the curve (AUC). Results: In this study, the PBS scale was as a predictive measure of fall risk, but the FAB was not significant in children with CP. A cut-off score of 45.5 points provided optimal sensitivity of .90 and specificity of .69 on the PBS, and a cut-off score of 21.5 points provided optimal sensitivity of .90 and specificity of .62 on the FAB. Both scales showed moderately accurate of AUC with .79 and .76, respectively. Conclusion: The PBS is a useful screening tool for predicting fall risk in children with cerebral palsy, and those who score 45.5 or lower indicate a high risk for falls and are in need of balance intervention.

Factors affecting the health-related quality of life of children with cerebral palsy in Indonesia: a cross-sectional study

  • Ade Febrina Lestari;Mei Neni Sitaresmi;Retno Sutomo;Firda Ridhayani
    • Child Health Nursing Research
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    • 제30권1호
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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.

뇌성마비 아동을 대상으로 실시한 한국어판 아동 균형 척도의 라쉬분석 (Application of Rasch Analysis to the Korean Version of the Pediatric Balance Scale in Children With Cerebral Palsy)

  • 김경모
    • 한국전문물리치료학회지
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    • 제24권1호
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    • pp.41-50
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    • 2017
  • Background: The Pediatric Balance Scale (PBS) was developed to assess of balance ability in children with balance problem. The PBS was translated into Korean and its reliability had been studied. However, it had need to be verified using psychometric characteristics including item fit and rating scale. Objects: The purpose of this study was to investigate the item fit, item difficulty, and rating scale of the Korean version of PBS using Rasch analysis. Methods: In total, 40 children with cerebral palsy (CP) (boy=17, girl=23) who were diagnosed with level 1 or 2 according to the Gross Motor Function Classification System participated in this study. The PBS was performed, and was verified regarding the item fit, item difficulty, rating scale, and separation index and reliability using Rasch analysis. Results: In this study, the 'transfer', and 'turning to look behind left and right shoulders while standing still' item showed misfit statistics. in total 40 children with CP. Also, 'transfer', 'standing unsupported with feet together' and 'standing with one foot in front' items showed misfit statistics in diplegia CP group. Regardless of the classification of CP, the most difficult item was 'standing on one foot', whereas the easiest item was 'sitting with back unsupported and feet supported on the floor'. The 4 rating scale categories of PBS were acceptable with all criteria. Both item and person separation indices and reliability showed acceptable values. Conclusion: The PBS has been proven reliable, valid and is an appropriate tool, but it needs to modify the items of PBS according to CP classification.