The purpose of this study was to examine the effects of sensory integration therapy (SIT) on sensory' motor development and adaptive behavior of cerebral palsy children. The design of this study was quasi experiments with a non-equivalent pre- and post-test control design. Subjects of the study were arbitrarily chosen based on predetermined selection criteria among the cerebral palsy children who were treated as out-patients at two rehabilitation hospitals one in Seoul, and the other in Kyunggi-do. The study was conducted between early April and late July in 2000. Fifteen children were in the experimental group and eleven in the control group. The allocation was done based on ease of experimental treatment. A five-step SIT program was devised from a combination of SIT programs suggested by Ayres(1985) and Finks(1989), and an author-designed SIT program for cerebral palsy children. The experimental group was subjected to 20 to 30 minutes of SIT per session. two sessions a week for ten -week period. The effects of SIT were measured with respect to 9 sub-areas that can be administered to cerebral palsy children out of a total of 17 sub-areas in the Southern California Sensory Integration Test (SCSIT) developed by Ayres (1980). In addition. the scale developed by Russell (1993) for Gross Motor Function Measure (GMFM). and Perception Motor Development Test developed by 中司利一 et al.(1987) were also applied. Adaptive behavior was analyzed using guidelines in two unpublished documents - School-Age Checklist for Occupational Therapy by the Wakefield Occupational Therapy Associates, and the OTA-Watertown Clinical Assessment by the Watertown Occupational Therapy Associates-, and an author-developed Adaptive Behavior Checklist. Collected data were statistically analyzed by SPSS PC for chi square test, Mann-Whitney test, Wilcoxon signed rank test, and paired t-test. The results were as follows: 1. In sensory development, the experimental group exhibited a score increase compared to the control group, but the difference was not statistically significant, Although the experimental group showed improvements in all. 9 sub-areas compared to the control group, only right-left discrimination exhibited statistically significant change. 2. In gross motor development, the experimental group showed improvements in score compared to the control group, but it was not statistically significant. In fine motor development, the experimental group exhibited statistically significant improvements compared to the control group. In sub-area analysis, figure synthesis showed positive change. 3. In adaptive behavior development, post-experimental adaptive behavior scores were higher compared to pre-experimental scores with statistical significance. Furthermore, sub-areas emotional behavior, perception behavior, gross-fine motor function, oral-respiration function, motor behavior, motor planning, and adaptive response exhibited higher scores after SIT. In conclusion SIT was found to be partially effective in sensory and fine motor development, effective in all adaptive behavior areas, and not effective in gross motor development. Thus, this study has shown that SIT is an effective intervention for sensory development, fine motor development, and adaptive behavior for cerebral palsy children. But, for the effectiveness of SIT on gross motor development, further studies employing longer-time experiments are recommended.
The purpose of this study was to apply treadmill training through motor learning to cerebral palsy children and examine its effects on their Gross Motor Functions. The subjects of this study were 13 spastic diplegia children who had difficulty in independent gait, and GMFCS level III, IV. We performed treadmill gait training using the principle of weight bearing, based on 4times a week for 30 minutes before and after each session physical therapy we gave weight bearing treadmill training 5 to 10 minutes, during 7 weeks(April 9, 2012~May 26, 2012) fittingly for the children's gait characteristics. In order to test how the weight bearing treadmill training affects spastic diplegia children's gross motor functions, we measured body mobility with Gross Motor Function Measure (GMFM). These data were collected before and after the experiment and analyzed through comparison. Data collected from the 13 spastic diplegia children the results were as follows. For evaluating with regard to change in body mobility, significant difference was observed between before and after the experiment in measured gross motor functions, which were crawling, kneeling, standing, walking, jumping and running(p<0.05). According to the results of this study, when gait training through motor learning was applied to spastic cerebral palsy children, it made significant changes in their body mobility. Accordingly, for the effective application of gait training through motor learning to cerebral palsy children, it is considered necessary to make research from different angle on how such training affects children's mobility, activity of muscles in the lower limbs, and gait characteristics.
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.
Purpose: This study examined the effects of a positioning education program through the brochure or oral explanations for the parents of premature infants with a brain lesion and investigated the satisfaction level of physical therapy of parents of premature infants with a brain lesion. Methods: Forty parents of premature infants with a brain lesion participated in this study. The recruited premature infants were randomized into groups A (n=20) and B (n=20) for the purpose of the positioning education method through brochure or oral explanations. The level of satisfaction and recognition for the positioning education program was investigated by the parents of 12 month old infants. The gross motor function, measure-88, was examined at three months, six months, nine months, and twelve months of the corrected age. Results: No significant differences in the recognition of the position education program, level of satisfaction of the environment, and the attitude of the therapist were noted (p>0.05). Significantly high levels of satisfaction with the program of group B given the brochure were noted. The gross motor function measure-88 was also similar in both groups (p<0.05). Conclusion: This study suggests that the parents were satisfied with the positioning education program of the brochure. The differences in educational methods did not affect the development of premature infants.
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.
Objective: The purpose of this study was to evaluate the relationship between quality of life (QoL) of the caregiver and disease severity with motor function in children with cerebral palsy (CP). Design: Cross-sectional study. Methods: Research data were collected in the Rehabilitation Clinic of Daegu University. The Gross Motor Function Measure (GMFM-88) and the functional independence measure (FIM) were used for assessment by three occupational therapists, and the 36-item short form health survey (SF-36) were applied to the caregivers. One hundred six caregivers of under 18 years who were diagnosed with CP completed a survey and interview. The caregivers' QoL was evaluated using Medical Outcomes Study SF-36. The children's motor function was scored using GMFM-88 in five dimensions: lying and rolling; sitting; crawling and kneeling; standing and walking, running and jumping and CP's FIM scores. Results: Out of the 8 domains of the Medical Outcomes Study SF-36, the "physical functioning", "physical role functioning", "mental health", and "bodily pain" domains were significantly correlated to "total" percentage scores of the GMFM-88 (p<0.05). In addition, the "mental health" domain was correlated to each subdomain of the GMFM-88, which includes, "lying and rolling", and "crawling and kneeling". Similarly, of Medical Outcomes Study SF-36, "physical functioning", "bodily pain", and "mental health" domains were significantly correlated with "transfer" and "locomotion" of FIM scores (p<0.05). Conclusions: This study showed that the QoL of the caregivers were well correlated with the motor function of children with CP. It is also important to support not only physical health but also psychological health of caregivers of children with CP, especially those with severe motor function.
These were two main purposes of this study. The first was to research the relevance between gross motor function measurement (GMFM) and the spatiotemporal parameters of gait in children with cerebral palsy. The second was to research the relevance between gross motor performance measure (GMPM) and the spatiotemporal gait parameters. Twelve children ($6.0{\pm}1.8$ years) with cerebral palsy participated in this study. GMFM and GMPM were performed and the spatiotemporal parameters of gait were measured by using WalkWay MG-1000. There were no significant correlations between the GMFM score and the stride length, step length, step width, cadence, and velocity (p>.05). The GMPM score also had no significant correlation with the spatiotemporal gait parameter (p>.05).
Objective: This study attempted to find out if it changes the child's ability to perform daily life activities when visiting the familiar environment and daily living space of children with cerebral palsy and conducting a home activity support program for children and parents. Design: Randomized Controlled Trial Methods: Among 22 children aged 3 to 12 years old, they were assigned to the intervention group and control group. Of these, 12 boys and 10 girls participated in the study. Gross motor function measure and upper extremity function evaluation were used to measure the physical function of children with cerebral palsy, and self-care skills, mobility and social functions were evaluated in the pediatric evaluation of disability inventory. In addition, a parenting sense of competence was used to find out the efficacy of parents in raising children. After the pre-evaluation, basic rehabilitation treatment and intervention programs were applied to the intervention group, and only basic rehabilitation treatment was performed to the control group, and post-evaluation was performed 8 weeks later. Results: As a result of the study, among the items that measured the gross motor function, upper limb function, and daily life performance ability of the intervention group in the difference between the intervention group and the control group, statistically improved in personal processing and movement (p<0.05). In addition, the parenting sense of competence children in the intervention group was statistically significant (p<0.05). Conclusions: The home activity support program will help strengthen the ability of cerebral palsy children to perform daily life as a way to set mutually agreed goals with their families or children and achieve them in a familiar environment.
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.
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.
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