• 한국전문물리치료학회지
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• 제8권3호
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• pp.97-105
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• 2001

The purpose of this study was to investigate the effect of functional strengthening exercise on static and dynamic standing balance in a child with cerebral palsy. The subject was a 7 year old boy with diplegia whose Gross Motor Function Measure (GMFM) score was 80% along with G1 of the lower extremities in Modified Ashworth Scale. The subject was ambulatory with some degree of limitation and demonstrated muscle weakness and strength asymmetry in the lower extremities. A changing criterion design for a single-subject research was used for this study. The functional strengthening exercise consisted of lower extremity ergometer exercise and knee exercise with grading movement in standing position, each for 20 minutes, which lasted 18 sessions for 6 weeks. A knee extensor strength test on both extremities and standing balance test were conducted after each functional strengthening exercise. Two types of standing balance were tested: one leg stance test and functional reach test. One leg stance test was to evaluate static standing balance, and functional reach test was to evaluate dynamic standing balance. The results showed that the functional strengthening exercise had some positive effects on improvement of both static and dynamic standing balance, and there was a positive correlation between the knee strength and standing balance.

• 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.

• 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.

• Physical Therapy Rehabilitation Science
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• 제10권1호
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• pp.22-31
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• 2021

Objective: This review aims to analyze the effects of electromechanically assisted walking in patients with cerebral palsy(CP). Design: A systematic review and meta-analysis. Methods: We reviewed systematically using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist guidelines. The inclusion criteria for this study were all CP patients. The intervention was electromechanically assisted walking. The outcome measures included gait parameters, function, spasticity. Studies excluded from this review were excluded from the review if they were non-English languages and if the study was not published as a full report, and if they were not randomized controlled trials (RCTs) designs. The RevMan 5.4 program was used to evaluate and explain the results. The risk of bias was evaluated independently by two reviewers. The quantitative meta-analysis, including mean differences (MD) and associated standard deviations (SD) from baseline and follow-up assessments, were recorded. Results: A total of 634 articles were searched. Two hundred eighty-nine duplicate articles were excluded, and 345 of 634 originals were left for selection. Of these 74 papers, 44 were out of topic, and 19 reported no mean or standard deviation values. And one was a non-experimental study. Finally, ten studies were included. All 10 RCTs of electromechanically assisted walking were analyzed. The meta-analysis showed a significant improvement in gait cycle (95% CI (confidence intervals), 0.09 to 0.19, I2=0%), Gross Motor Function Measure (GMFM) D (95% CI, 3.27 to 13.17, I2=0%) and GMFM E (95% CI, 0.22 to 6.41, I2=0%). Conclusions: Electromechanically assisted training helps in walking in patients with CP.

• The Journal of Korean Physical Therapy
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• 제29권1호
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• pp.16-26
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• 2017

Purpose: This study was conducted to develop a Korean version of the trunk control measurement scale (TCMS) and examine the reliability and concurrent validity of the K-TCMS in children with cerebral palsy. Methods: Subjects for the study were 23 children with cerebral palsy (CP)(mean age: 84.70 months) recruited from one CP clinic. For the interrater and test-retest reliabilities, four raters (A, B, C, D) measured the K-TCMS two times using video clips with an interval of two weeks. For the concurrent validity, the Korean version of the gross motor function measure (K-GMFM) was chosen. Inter-rater reliability and test-retest reliability of the three K-TCMS subscale (static sitting balance, dynamic sitting balance and dynamic reaching) scores and the total scores were investigated using the intra-correlation coefficient ($ICC_{3,1}$). Spearman's correlation coefficient (r) was calculated to investigate the concurrent validity. Results: The inter-rater reliability of the K-TCMS subscales and total scores were all high ($ICC_{3,1}=0.968-0.992$). For the test-retest reliability, $ICC_{3,1}=0.827-0.962$. The concurrent validity between the K-TCMS's total and three subscale scores and K-GMFM's total score were r=0.600-0.667. Conclusion: The results suggest that the K-TCMS can be used in clinical and research settings as a standardized tool for CP children. The K-TCMS might be also useful for selecting treatment goals and planning interventions for children with cerebral palsy.

• 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.

• 대한물리의학회지
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• 제17권3호
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• pp.31-40
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• 2022

PURPOSE: This study was conducted to investigate the effects of postural control training using a visual blind board, on head control, trunk control, and the sitting abilities of children with moderate-to-severe cerebral palsy. METHODS: Ten children with moderate to severe cerebral palsy participated in this study. Postural control training with a visual blind board was given for 40 minutes per session, 3 times a week for 4 weeks (12 sessions). Before and after the intervention, head control, trunk control, and sitting abilities were quantified using the head control scale, Korean version-trunk control measurement scale, and the sitting part of the Korean version-gross motor function measure-88, respectively. RESULTS: Postural control with the visual blind board significantly improved the head control ability of children with moderate to severe cerebral palsy (p = .015). Their trunk control abilities also showed significant improvement after the intervention (p = .016). However, their sitting ability did not show a significant change. CONCLUSION: These results showed that postural control training using a visual blind board is effective in improving the head and trunk control abilities of children with cerebral palsy. Further studies with suitable sample sizes and control groups are needed to reach a conclusion about the use of postural control training with visual blind boards for improvement of postural control of children with moderate to severe cerebral palsy.

• 한국전문물리치료학회지
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• 제24권1호
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• pp.51-60
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• 2017

Background: In cerebral palsy (CP), parents' quality of life and rearing attitude are considered possible factors that influence patients' quality of life, function level, and performance in daily activities. Despite these facts, little attention has been given to demonstrate a relation between these factors. Objects: This study aimed to demonstrate the relationship between parents' quality of life, functional level, and performance in daily activities, the quality of life of school-aged children with spastic CP. Methods: This study included 24 parents of school-aged children with spastic CP. The KIDSCREEN-52 and World Health Organization quality of life (WHOQOL)-BREF questionnaires (including physical, psychological, social, and environmental domains) were used as research tools to assess the quality-of-life profiles of the children with spastic CP and those of their parents, respectively. In addition, the function levels and performance in daily activities of the children with CP were assessed by using the gross motor function measure (GMFM) and modified Barthel index (MBI). Correlation and multiple regression analyses were performed to clarify the determinants of the quality of life of the children with CP. Results: The KIDSCREEN-52 score correlated with the total score (r=.735, p<.01) and all domains of the WHOQOL-BREF questionnaire (physical: r=.542, p<.01; psychological: r=.690, p<.01; social: r=.568, p<.01; and environmental: r=.783, p<.01). In addition, significant correlation was found between the KIDSCREEN-52 and MBI scores (r=.411, p<.05), and between the MBI and GMFM scores (r=.427, p<.05). After controlling for age, gender, paralytic type, GMFM, and MBI, the WHOQOL-BREF score ($R^2=.621$), particularly in the environmental domain ($R^2=.699$), remained independently related to the quality of life of the children. Conclusion: These findings suggest that the quality of life of school-aged children with spastic CP can be influenced by the quality of life of their parents. This study provides useful information for future studies to investigate the quality of life of children with CP.

• 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.