• 대한통합의학회지
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• 제6권1호
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• pp.99-105
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• 2018

Purpose : The purpose of this study was to evaluate the effect of craniocervical flexion exercise on deep cervical flexor thickness and gait in children with hemiplegic cerebral palsy. Methods : Twelve children with hemiplegic cerebral palsy were recruited for this study. All subjects performed active craniocervical flexion exercise 3times a week over the course of 6weeks. using a pressure bio feedback unit. Ultrasonography was used to assess deep cervical flexor thickness, and a 10m walking test was used to assess gait function. For the statistical analysis, a paired t-test was used to compare the differences pre- and post-value. SPSS Statistics version 20.0 was used for statistical analysis, and statistical significance was defined as a p-value less than 0.05. Result : The results of this study indicate that children with hemiplegic cerebral palsy experienced statistically significant positive changes in both deep cervical flexor thickness (p<.05). and gait(p<.05) following the intervention. Conclusion : In conclusion, craniocervical flexion exercise can positively affect deep cervical flexor thickness in children with hemiplegic cerebral palsy, which in turn positively affects gait.

• The Journal of Korean Physical Therapy
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• 제25권3호
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• pp.155-159
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• 2013

Purpose: Circumference of the chest and waist can be one of clinical indicator to reflect respiratory function in children with cerebral palsy. In this study, we compared to differences in the chest/waist circumference and maximal phonation time between children with spastic diplegia and hemiplegia. Methods: Seventeen children with spastic diplegic and hemiplegic cerebral palsy were recruited, who were matched to gender, age, height, weight, and body mass index for control of the known factors affected to respiratory function. The chest/waist circumference and were measured in each group, when children took a breath at rest and at maximal voluntary inspiration/expiration. Results: No significant differences were found in the chest and waist circumference and expansion between the two groups. However, only in the waist expansion, children with diplegic CP were significantly lower extensibility of lung, compared to the other group. In comparison of the maximal phonation time, a significant lower score was shown in children with spastic diplegic CP, compared to children with hemiplegic CP. Conclusion: Our results indicated that children with spastic diplegic CP had smaller chest wall and waist, compared to children with spastic hemiplegic CP. In addition, they showed a shorter time for sustaining phonation than spastic hemiplegic CP did. Therefore, spastic diplegic CP will be required for careful monitor regarding respiratory function in rehabilitation settings.

• The Journal of Korean Physical Therapy
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• 제27권2호
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• pp.81-84
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• 2015

Purpose: The purpose of this study was to compare the effect of 'knowledge of result' and 'knowledge of performance', two types of extrinsic feedbacks, during the sit-to-stand movement in children with hemiplegic cerebral palsy. Methods: A total of ten children with hemiplegic cerebral palsy (ages 8 to 12 years) were recruited for the study. Subjects with hemiplegic cerebral palsy performed sit-to-stand movement in front of a mirror. Their performance was supervised and revised for normal movement by a pediatric physiotherapist. In the knowledge of the result, subjects performed sit-to-stand using a chair with an armrest in their mind with normal movement. In the knowledge of performance, subjects performed sit-to-stand under verbal instructions. Randomized cross over trials were used in this study. Main outcome measurements were as follows: mediolateral speed, anteroposterior speed, velocity moment, extent in mediolateral direction, extent in anteroposterior direction, and vertical distance of the center of pressure. Results: The mediolateral speed and extent of center of pressure was higher for 'knowledge of performance' in comparison with the other type of extrinsic feedbacks (p<0.05). The other parameters, including anteroposterior speed and extent, and vertical speed of the center of pressure, did not differ between the two types of extrinsic feedbacks (p>0.05). Conclusion: These findings suggested that training in sit-to-stand movement with 'knowledge of result' may result in better use of extrinsic feedback.

• The Journal of Korean Physical Therapy
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• 제12권1호
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• pp.163-172
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• 2000

The purpose of this study was to provide experimental evidence and theoretical background for the applicability of bilateral transfer paradigm to the rehabilitation programs for children with hemiplegic cerebral palsy. Children with hemiplegia, which means unilateral motor disabilities, display abnormal motor and postural patterns of the affected side due to hemiparesis, spasticity, and sensory disorders, resulting in a decreased motor abilities of the affected side compared to unaffected side. Accordingly, they tend to rely on the unaffected limb for everyday activities, which further deteriorates the functions of the affected side by causing associated reaction, abnormal postural patterns, and hypertonus. Rehabilitation programs developed for children with hemiplegic cerebral palsy include neurodevelopmental treatment, application of cast or splint to unaffected limb, neuromuscular electrical stimulation, and task oriented model. These programs, however, have several drawbacks, such as discontinuity in treatment effect and psychological hatred to the force use of the affected side. In order to solve these problems and enhance the efficiency of the rehabilitation programs, it is required to maximize the use of the affected side without hatred. Characteristics of the control system, such as temporal coupling and spatial assimilation between limbs and neural crosstalk at different levels of central motor pathway, suggest that the bilateral transfer paradigm may enhance the efficiency of the rehabilitation programs for children with hemiplegic cerebral palsy.

• 대한감각통합치료학회지
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• 제10권2호
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• pp.11-22
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• 2012

목적 : 본 연구는 체계적 고찰을 통해 뇌성마비 유형 중 편마비 아동에게 적용된 수정된 강제유도 운동치료의 프로토콜(protocol)과 중재 효과를 알아보고자 한다. 연구방법 : 검색용어는 "Constraint Induced Movement Therapy", "modified Constraint Induced Movement Therapy", "Cerebral Palsy", "Hemiplegia"를 사용하였고, 수정된 강제유도 운동치료가 처음 제시된 2001년부터 2011년 5월까지 학회지에 게재된 논문을 PubMed, Medline, Ovid를 이용하여 검색한 후 자료를 분석하였다. 결과 : 총 10개의 연구가 분석되었고, 뇌성마비 편마비 아동에게 수정된 강제유도 운동 치료를 적용한 결과 상지운동 기능 및 움직임의 질이 향상되었고, 일상생활에서 환측의 상지 사용 빈도가 증가하였음을 나타내었다. 결론 : 분석논문의 수가 적어 다양한 질적 수준의 연구를 포함한 제한점은 있지만, 아동의 특성에 맞도록 제한시간과 제한방법을 조절하고 다양한 치료 활동을 적용한다면 수정된 강제유도 운동치료가 뇌성마비 편마비 아동의 기능회복에 효과적으로 사용되어질 수 있을 것으로 기대된다.

• The Journal of Korean Physical Therapy
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• 제35권2호
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• pp.48-52
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• 2023

Purpose: This study was undertaken to determine whether the position of cane use affects the distribution of weight-bearing on both feet of children with hemiplegic cerebral palsy in a standing posture. Methods: Twenty participants with cerebral palsy were recruited as volunteers for this study. Using the Zebris FDM-System, weight-bearing distribution according to the method of using a cane was measured under three conditions in randomized order: (1) standing unaided (no cane); (2) standing with the affected side using the cane; and (3) standing with the non-affected side using the cane. The cane was matched by measuring length-from-floor to the greater trochanter of the subject, and was placed 15 cm outward from the little toe on the supporting side. Results: Evaluating the method of using a cane under the three conditions, we determined that pressure of the foot on the affected side was higher in the order: standing with affected side using cane > standing unaided (no cane) > standing with non-affected side using cane (p<0.05). In the post-hoc analysis, a significant difference was observed between (i) standing unaided (no cane) and standing with the affected side using cane, and (ii) standing with affected side using cane and standing with non-affected side using cane (p<0.05). Conclusion: This study suggests that induced weight-bearing methods using a cane on the affected side could increase the weight-bearing capacity on the affected side in children with spastic hemiplegic cerebral palsy, which will have a positive effect on reducing asymmetry weight support.

• Annals of Clinical Neurophysiology
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• 제7권1호
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• pp.34-36
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• 2005

Two hemiplegic cerebral palsy patients were studied to investigate the cortical mechanisms underlying preserved somatosensory capacity, using functional MRI(fMRI). Tactile stimulation was performed by brushing of palm, during fMRI study. By the affected hand stimulation, contralateral primary somatosensory cortex was activated in patient 1 and cortical area anterior to the lesion site was activated in patient 2. We suggest that reorganization of the somatosensory cortex after brain injury can be induced by recruitment of undamaged areas adjacent to lesion site.

• 대한물리치료과학회지
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• 제8권2호
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• pp.1099-1104
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• 2001

The purpose of this single subject case study was to evaluate the effectiveness of a swedish knee cage worn to prevent genu recurvatum in right spastic hemiplegic with cerebral palsy. The subject was a 6-year-old female who had right side hemiparesis with genu recurvatum on affected side for the 18 month from January 1998 to June 1999. As a result, genu recurvatum of the patient was reduced the 7 degree after the putting on the swedish knee cage.

• 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.

• 재활치료과학
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• 제4권1호
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• pp.7-17
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• 2015

목적 : 본 연구의 목적은 집중적 양손활동훈련을 편측 뇌성마비 아동에게 적용한 후 상지 재활 효과와 양손 협응 능력의 변화를 살펴본 연구에 대해서 분석하는 것이다. 연구방법 : 2004년부터 2014년 현재까지 국내 외 학회지에 게재된 논문을 RISS, Pubmed를 통해 검색하였다. 1, 2차 분류를 통해 총 6개의 실험연구 논문이 대상논문으로 선정되었다. 결과 : 선정된 6편의 문헌은 모두 국외 논문이었으며, PEDro score는 5점 이상으로 높은 편 이었다. 사용된 중재는 강제유도운동치료의 변형형태가 가장 많았으며, 상지기능과 양손 협응 측정 위한 평가도구로는 AHA와 JTTHF가 가장 많은 빈도를 보였고, 그 외 QUEST, ABILHAND-Kids, COPM, GAS, PEDI, 3-D movement kinematics가 중재효과의 다양한 측면을 평가하는데 사용되었다. 고찰 : 본 연구를 통하여 집중적 양손활동훈련이 편측 뇌성마비아동의 상지 기능뿐만 아니라 양손 협응에 긍정적인 영향을 준다는 것을 확인하였고, 더 나아가 양손 협응이 요구되는 대부분의 일상생활의 참여에 도움을 줄 수 있음을 알아보았다. 이와 같은 결과는 작업치료사로서 국내 임상가들에게 편측 뇌성마비 아동을 위한 새로운 중재방법의 기초자료를 제시하고, 효과적인 치료 접근법을 알려주는 데 도움이 될 것이다.