• 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.

• 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.

• 말소리와 음성과학
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• 제3권1호
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• pp.135-143
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• 2011

This study evaluated the respiratory capacity of spastic cerebral palsy children who were grouped by GMFCS (Gross Motor Function Classification System) levels and identified the acoustic characteristics of three different types of Korean stops (stop consonants) which are needed for the temporal coordination of larynx and supra-larynx, in these children. Thirty-two children with dysarthria due to spastic cerebral palsy were divided into two subgroups: 14 children classified at GMFCS levels I~III were placed in Group 1 and 18 classified at GMFCS levels IV~V were placed in Group 11, and 18 children with normal speech were selected and placed in the control group. /a/ pronged phonation (sustained vowel /a/) and nine Korean VCV syllables were used. Examined acoustic characteristics were maximum phonation time (MPT) and closure duration and aspiration duration. The results were as follows: 1) The MPTs of the cerebral palsy (CP) groups, both Group I and Group II, were significantly shorter than those of the normal group. 2) The closure durations of the two CP groups were longer than those of the normal group for all 9 target syllables. 3) The aspiration durations of the two CP groups were longer than those of the normal group. 4) The closure duration of the normal and CP Group I was significantly different among tense, aspirated, and lax. However, the CP Group II was different from normal. 5) The aspiration duration of the normal and CP Group I was significantly different among aspirated, tense, and lax. However, the CP Group II was different from normal. 6) The place of articulation influenced less than the manner of articulation on closure and aspiration duration.

• 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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• 제26권3호
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• pp.209-215
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• 2014

Purpose: The purpose of this study is to examine the effects of postural control training using a horseback riding simulation on the spinal alignment of children with cerebral palsy. Methods: This study was conducted with 30 children with cerebral palsy at levels I~IV in the Gross Motor Function Classification System (GMFCS), and they were randomly divided into a control group and a hippotherapy group. Both the control group and the experimental group received NDT for 30 minutes per session, four times per week for ten weeks, while the experimental group also received hippotherapy 15 minutes per session, four times per week for ten weeks, after the neurodevelopmental treatment (NDT). The horseback riding simulators (JOBA, EU7805, Panasonic) used in this study simulated actual horse movements. Trunk imbalance, pelvic torsion, and pelvic tilt were measured in each group before the exercise and five weeks and ten weeks after the beginning of the exercise using a spinal structure analysis system (ABW Mapper). Results: The Intra-group effects on trunk imbalance, pelvic torsion, and pelvic tilt according to the exercise periods after the hippotherapy were tested, and the results showed significant interaction effects between the groups and the periods (p<0.05). Conclusion: The horseback riding simulation exercise was shown to be effective for the spinal alignment of children with cerebral palsy. Therefore, additional studies should be conducted with more children with CP divided by type.

• The Journal of Korean Physical Therapy
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• 제26권4호
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• pp.269-273
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• 2014

Purpose: The purpose of this study is to examine the effects of using a horseback riding simulation on static balance in children with cerebral palsy. Methods: This study was conducted with 30 children with cerebral palsy at levels I~IV in the Gross Motor Function Classification System (GMFCS), who were randomly divided into a control group and a hippotherapy group. Both the control group and the experimental group received NDT for 30 minutes per session, four times per week, for ten weeks, while the experimental group also received hippotherapy, 15 minutes per session, four times per week, for ten weeks, after the neurodevelopmental treatment (NDT). The horseback riding simulators JOBA (JEU7805, Panasonic, 일본) used in this study simulated actual horse movements; static balance was measured in each group before the exercise and five weeks and ten weeks after the beginning of the exercise using a pedoscan system (Diers Pedo, Germany). Results: The intergroup effects on static balance were tested, and the results showed no significant differences (p<0.05). Conclusion: The horseback riding simulation exercise was shown to be effective for the static balance of children with cerebral palsy. Therefore, additional studies should be conducted with more children with CP divided according to type.

• The Journal of Korean Physical Therapy
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• 제30권1호
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• pp.35-40
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• 2018

Purpose: This study examined whether the quality of life of parents of children with cerebral palsy is affected by the functions, activities, participation, and environmental factors using an ICF-CY check list. Methods: This study recruited in 26 parents of children with cerebral palsy. The functions, activities, participation, and environmental factors of the children were evaluated using ICF-CY checklist. To measure the quality of life of parents, this study used world health organization quality of life (WHOQOL-BREF), which was composed of a total of 26 questions. The GMFCS (gross motor function classification system) was used to assess the degree of disability in the children. Multiple regression analysis was performed to examine the effects of the ICF-CY checklist on the quality of life. Correlation analysis was performed to examine the correlation between GMFCS and WHOQOL. Results: The functions, activities, participation, and environmental factors were significantly different from WHOQOL-BREF. On the other hand, the contextual factor showed a significant difference in the neuromusculoskeletal and movement-related functions (b7), and service, systems, and policies (e5)(p<0.05). Conclusion: This study suggests that the functions and environmental factors affect the quality of life of parents of children with cerebral palsy. Therefore, these findings suggest that contextual factors, such as neuromusculoskeletal and movement-related functions (b7), and service, systems and policies (e5), which can be facilitators, should be considered for improving the quality of life of parents of children with cerebral palsy.

• 대한정형외과학회지
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• 제54권4호
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• pp.309-316
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• 2019

목적: 뇌성마비 환자의 주거 환경과 재활 접근성을 조사하여 현재 시행되고 있는 장애인 주거 관련 법률에 대한 문제점에 대해 고찰해보고 장애인 건강권에 관한 법률 제정의 기초 자료를 제공하고자 한다. 대상 및 방법: 주거, 재활, 접근성 3개의 키워드로 문헌을 검색하여 주거 환경, 재활 접근성이라는 2개의 아이템을 선정한 후 설문지를 작성하였다. 문항은 총 51문항을 작성하였고 그중 24문항은 리커트 척도, 27문항은 다지선다형으로 구성되어 있다. 뇌성마비 환자와 보호자를 대상으로 설문조사를 시행하였다. 결과: 연구대상자 100명 중 재가보호 중인 환자는 93명, 시설보호 중인 환자는 7명으로 나타났다. 재가보호 중인 경우 65%는 아파트에 거주하고 있었고, 주로 2층 이상의 지상층에 거주하고 있었으며 그중 40%는 엘리베이터가 없는 건물에 거주하고 있었다. 연구 대상자의 Gross Motor Function Classification System (GMFCS) 단계에 따라 GMFCS I, II, III은 보행가능군, IV, V는 보행불가군으로 나누어 군별로 느끼는 어려움을 조사하였다. 재가보호 중인 경우 두 군 모두 혼자서 재활센터 방문하는 것을 가장 어려워했고, 시설보호 중인 경우 보행가능군은 혼자 시설 밖으로 나가기, 보행불가군은 혼자서 화장실 이용하기를 가장 어려워하는 것으로 나타났다. 응답자의 83%는 뇌성마비 환자에게 재활이 필요하다고 생각하지만, 실제로 재활을 받는 뇌성마비 환자는 33%에 불과했다. 재활을 받는 경우, 평균 주 3.6회, 회당 39분 동안 치료를 받는다고 응답하였다. 결론: 주거약자법은 접근로와 관련된 규정이 없고 장애인등편의법에서는 공동주택에 대한 주 출입구 접근로의 항목만 규정하고 있다. 하지만 본 연구에서 단독주택에 거주하는 뇌성마비 환자는 18%로, 이들은 접근로가 확보되지 않은 주거 환경에서 살고 있다. 뇌성마비 환자들이 고층으로 이동하기 위한 수단에 대한 법률은 없으며, 실내로 진입하기 위한 접근로에 관한 법률은 미흡한 실정이다. 현재 시행 중인 장애인등편의법, 주거약자법 그리고 2017년 12월에 시행된 장애인건강권법의 성공적인 시행을 위해서는 장애인과 보호자가 현실적으로 느끼는 어려움을 반영한 시행 규칙이 제정되어야 할 것이다. 이를 위해 본 연구 결과를 바탕으로 대규모 설문을 통해 뇌성마비 환자의 주거와 재활에 대한 조사가 필요하다고 생각한다.

• 한국콘텐츠학회논문지
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• 제10권6호
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• pp.480-488
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• 2010

이 연구의 목적은 PBS(Pediatric Balance Scale)와 WeeFIM(Functional Independence Measure for Children)을 이용해 전자게임을 이용한 가상현실프로그램이 경직성 뇌성마비 아동의 균형 및 일상생활활동에 미치는 영향을 알아보고 평가도구 간의 상관관계를 구하는데 있다. 대동작기능분류체계 제 I, II 단계의 경직성 뇌성마비 아동 20명을 가상현실군과 대조군으로 10명씩 무작위 배치하여 주 3회, 매 30분씩 12주간 운동을 실시하였다. 가상현실군은 근력운동과 가상현실프로그램을, 대조군은 근력운동만 실시하였다. 그 결과, 가상현실군에서 실험 후에 균형과 일상생활활동이 유의하게 향상되었고(p<0.05), PBS와 WeeFIM 간에 유의한 상관관계를 나타냈다(p<0.05). 가상현실프로그램은 경직성 뇌성마비아동의 균형과 일상생활 활동을 향상시킬 수 있는 흥미로운 중재법으로 사용될 수 있을 것이며, PBS는 뇌성마비아동의 기능을 예측할 수 있는 유용한 평가도구 임을 알 수 있었다. 또한 저렴한 비용의 가상현실프로그램을 홈 프로그램으로도 이용할 수 있을 것이다.

• 동의신경정신과학회지
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• 제28권2호
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• pp.49-59
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• 2017

Objectives: To measure the quality of life in patients according to virtual cerebral palsy severity by using the Korean version of EQ-5D-Y proxy, Visual Analogue Scale (VAS), and Time Trade-Off method (TTO). Methods: The study was conducted in parents of children and adolescents aged 4 to 15 years in Seoul. We analyzed the difference in the utility value according to five levels of cerebral palsy severity in the Gross Motor Function Classification System (GMFCS) and test-retest reliability. Results: 1. There were significant differences in VAS, TTO, and EQ-5D-Y proxy according to the cerebral palsy severity (p<.001). 2. VAS was significantly different according to the respondent's visit to the medical institution, the presence of disease in the respondent, a visit to the child's medical institution, the age of the child, and the sex of the child. The value of TTO was significantly different according to the respondent's visit to the medical institution, respondent's sex, and the age of the child. Also, EQ-5D-Y proxy was significantly different according to the age of the child. 3. Intraclass correlation coefficient values were more than 0.6 for both VAS and TTO at all stages. But for the EQ-5D-Y proxy, the value was less than 0.6 at all stages. Conclusions: The quality of life assessment using EQ-5D-Y proxy showed significant differences in the severity of cerebral palsy. However, large-scale studies using EQ-5D-Y proxy are needed because of low test-retest reliability.