• 한국전문물리치료학회지
• /
• 제5권1호
• /
• pp.79-90
• /
• 1998

Neurodevelopmental treatment(NDT) is a widely used technique by physical and occupational therapists in the treatment of neuromuscular disorders. Childeren with cerebral palsy are frequently referred for physical and occupational therapy, yet the effectiveness of treatment has not been well-documented. More than 40 years ago, the Bobath introduced a treatment concept for individuals with central nervous system impairment. A theoretical framework for the approach was based on the common belief in the 1940s that the nervous system functions in a hierarchy. Clinical aspects of the NDT approach have grown and changed during the past 40 years. This article details the original NDT concepts and looks at the concept with regard to newer theoretical frameworks of nervous system.

• The Journal of Korean Physical Therapy
• /
• 제29권4호
• /
• pp.211-217
• /
• 2017

Purpose: The purpose of this study was to trace the development of premature babies who had undergone neurodevelopmental treatment in the neonatal intensive care unit and to identify the effects of early neurodevelopmental treatment on the development of premature babies. Methods: Fifty-one premature babies, who had been hospitalized in the neonatal intensive care unit and received an infant motor performance test and Bayley scales-III evaluation of their developments during the six months of corrected age were included. They were divided into three groups: the intervention group (n=16), control group (n=23), and comparison group (n=12), depending on the risk of developmental delays and the existence of an intervention. The results of this study were analyzed using SPSS 22.0 for windows. The statistical significance level was set at ${\alpha}=0.05$. Results: Regarding the infant motor performance test scores for each group before the intervention, at two weeks after the start of intervention, and at post-conception of 40 weeks, the intervention group showed a significantly higher improvement than the control or comparison group (p<0.01). With respect to the Bayley scales-III at the corrected age of six months, the intervention group exhibited statistically significant differences from the control group in the domains of language and fine movements (p<0.01). Conclusion: The findings of this study could confirm that the early neurodevelopmental treatment of premature babies in the neonatal intensive care unit has continuous effects on the development of premature babies even after being discharged from the hospital.

• The Korean Journal of Physiology and Pharmacology
• /
• 제23권6호
• /
• pp.467-474
• /
• 2019

Exposure to lead during pregnancy is a risk factor for the development of psychiatric disorders in the offspring. In this study, we investigated whether exposure to low levels of lead acetate (0.2%) in drinking water during pregnancy and lactation causes behavioral impairment and affects the expression of proteins associated with neurodevelopment. Lead exposure altered several parameters in rat offspring compared with those unexposed in open-field, social interaction, and pre-pulse inhibition tests. These parameters were restored to normal levels after clozapine treatment. Western blot and immunohistochemical analyses of the hippocampus revealed that several neurodevelopmental proteins were downregulated in lead-exposed rats. The expression was normalized after clozapine treatment (5 mg/kg/day, postnatal day 35-56). These findings demonstrate that downregulation of several proteins in lead-exposed rats affected subsequent behavioral changes. Our results suggest that lead exposure in early life may induce psychiatric disorders and treatment with antipsychotics such as clozapine may reduce their incidence.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• 제31권3호
• /
• pp.97-104
• /
• 2020

Deep learning (DL) is a kind of machine learning technique that uses artificial intelligence to identify the characteristics of given data and efficiently analyze large amounts of information to perform tasks such as classification and prediction. In the field of neuroimaging of neurodevelopmental disorders, various biomarkers for diagnosis, classification, prognosis prediction, and treatment response prediction have been examined; however, they have not been efficiently combined to produce meaningful results. DL can be applied to overcome these limitations and produce clinically helpful results. Here, we review studies that combine neurodevelopmental disorder neuroimaging and DL techniques to explore the strengths, limitations, and future directions of this research area.

• Journal of Genetic Medicine
• /
• 제19권2호
• /
• pp.94-99
• /
• 2022

Lesch-Nyhan disease (LND) is a rare X-linked recessive inherited purine metabolic disorder that accompanies neurodevelopmental problems. Neurofibromatosis type 1 (NF1) is a relatively common autosomal dominant inherited genetic disorder characterized by tumors in various systems. Some children with NF1 also accompanies neurodevelopmental problems. Here, we describe a 5-year-old boy with a maternally inherited pathogenic variant in NF1 and hypoxanthine-guanine phosphoribosyltransferase (HPRT). He was referred for severe neurodevelopmental impairment and hyperuricemia. His mother was diagnosed with NF1 and the patient was also suspected of having NF1 because of cafe au lait macules. He had dystonia, rigidity, cognitive deficit, and speech/language impairment. Serum and urine uric acid concentrations were elevated. He had more severe neurodevelopmental delay than patients with only NF1, so his clinical symptoms could not be fully understood by the disease alone. To find the cause of his neurologic symptoms and hyperuricemia, the patient and his mother underwent a whole-exome sequencing test. As a result, the pathogenic variant c.151C>T (p.Arg51Ter) in HPRT1 was identified as hemizygote in the patient and heterozygote in his mother. The pathogenic variant c.7682C>G (p.Ser2561Ter) in NF-1 was identified as heterozygotes in both of them. Although the clinical symptoms of both diseases were overlapping and complicated, genetic testing was helpful for accurate diagnosis and treatment. Therefore, we suggest to consider preemptive genetic evaluation if there are symptoms not sufficiently explained by known existing diseases. And it is considered valuable to review this rare case to understand the clinical course and possible synergic effects of these diseases.

• 신경정신의학
• /
• 제57권2호
• /
• pp.190-208
• /
• 2018

Objectives To initiate and develop a treatment guideline in multidisciplinary approaches for related professions who are either working and/or living with children and adolescents with neurodevelopmental disorders who show behavioral problems. Methods To collect and reflect opinions from multiple professions who assumedly have different interventions or mediations on behavioral problems, a self-report survey and Focus Group Interview (FGI) were conducted for a group of child and adolescent psychiatrists, behavioral therapists, special education teachers, social welfare workers, and caregivers. Results According to a self-report survey and FGI results from multiple professional groups, aggressive behavior is the mostly common behavioral problem necessitating urgent interventions. However, both mainly used intervention strategies and effective treatment methods were different depending on professional backgrounds, such as pharmacological treatment, parent training, and behavior therapy, even though they shared an importance of improving communication skills. In addition, there was a common understanding of necessity to include parent training in a guideline. Lastly the data suggested lack of proper treatment facilities, qualified behavior therapists, and lack of standardized treatment guideline in the field needed to be improved for a quality of current therapeutic services. Conclusion It is supported that several subjects should be included in the guidelines, such as how to deal with aggressive behavior, parent training, and biological aspects of neurodevelopmental disorders. Also, it is expected that publishing the guideline would be helpful to above multiple professions as it is investigated that there are lack of treatment facility and qualified behavioral therapists compared to need at the moment.

• The Journal of Korean Physical Therapy
• /
• 제31권5호
• /
• pp.279-285
• /
• 2019

Purpose: This study examined the effects of spinal stabilization exercises using visual feedback on the gross motor function and balance of the sitting posture in children with cerebral palsy. Methods: The subjects were 18 children with cerebral palsy aged 8-15 years in the I-III stages of the Gross Motor Function Classification System. The subjects were divided into an experimental group (n=9) and control group (n=9). The experimental group was treated with 30 minutes of neurodevelopmental treatment and 20 minutes of spinal stabilization exercises using visual feedback. The control group was treated with 30 minutes of neurodevelopmental treatment and 20 minutes of spinal stabilization exercises without visual feedback. Both groups participated in the experiment twice a week for eight weeks. The Gross Motor Function Measurement was performed to evaluate the changes between pre- and the post-intervention in gross motor function. The Seated Limit of Stability Surface Area was measured to evaluate the changes in trunk balance. Results: Both experimental and control groups showed a significant increase in the gross motor function and trunk balance (p<0.05). The experimental group showed a significant increase in gross motor function compared to the control group (p<0.05). The experimental group showed a significant increase in the dynamic trunk balance in all directions when measuring the Seated Limit of Stability Surface Area (p<0.05). Conclusion: Spinal stabilization exercises using visual feedback for the neurodevelopmental treatment of children with cerebral palsy can improve their gross motor function and trunk balance when in a sitting posture more effectively.

• Clinical and Experimental Pediatrics
• /
• 제57권3호
• /
• pp.101-109
• /
• 2014

The use of glucocorticoids (GCs) in the perinatal period is suspected of being associated with adverse effects on long-term neurodevelopmental outcomes for preterm infants. Repeated administration of antenatal GCs to mothers at risk of preterm birth may adversely affect fetal growth and head circumference. Fetal exposure to excess GCs during critical periods of brain development may profoundly modify the limbic system (primarily the hippocampus), resulting in long-term effects on cognition, behavior, memory, co-ordination of the autonomic nervous system, and regulation of the endocrine system later in adult life. Postnatal GC treatment for chronic lung disease in premature infants, particularly involving the use of dexamethasone, has been shown to induce neurodevelopmental impairment and increases the risk of cerebral palsy. In contrast to studies involving postnatal dexamethasone, long-term follow-up studies for hydrocortisone therapy have not revealed adverse effects on neurodevelopmental outcomes. In experimental studies on animals, GCs has been shown to impair neurogenesis, and induce neuronal apoptosis in the immature brains of newborn animals. A recent study has demonstrated that dexamethasone-induced hypomyelination may result from the apoptotic degeneration of oligodendrocyte progenitors in the immature brain. Thus, based on clinical and experimental studies, there is enough evidence to advice caution regarding the use of GCs in the perinatal period; and moreover, the potential long-term effects of GCs on brain development need to be determined.

• The Journal of Korean Physical Therapy
• /
• 제32권3호
• /
• pp.146-151
• /
• 2020

Purpose: To identify the effect of breathing training on the physical function and psychological problems in patients with chronic stroke. Methods: In total, 26 patients with chronic stroke were randomly assigned to one of two groups: the experimental group, who underwent breathing training and neurodevelopmental treatment, and the control group, who underwent neurodevelopmental treatment (13 patients per group). Physical function was evaluated using the balance and Activities of Daily Living (ADL). Psychological problems were assessed using the Depression. Balance was measured using the Berg Balance Scale (BBS). ADLs were measured using the Modified Barthel Index (MBI). Depression was measured using the Beck Depression Inventory (BDI). The BBS, MBI, and BDI were recorded before and after the 4-week treatment. Results: As a result of comparison within groups, the experimental and control group showed significant difference for BBS, MBI and BDI after the experiment (p<0.05). In comparison between two groups, the experimental group showed more significant difference in BBS, MBI and BDI than the control group (p<0.05). Conclusion: This study showed that breathing training was effective improvement physical function, and psychological problems in patients with chronic stroke.

• 대한통합의학회지
• /
• 제10권1호
• /
• pp.119-128
• /
• 2022

Purpose : The purpose of this study was to examine the effects of applying occupational therapy that uses motion recognition on the physical self-efficacy, visual-motor integration ability, and play skills of children who have neurodevelopmental disorder before and after treatment. Methods : This The study chose 16 children with neurodevelopmental disorder as research subjects who were randomly and evenly allocated into an experimental group and a control group. The experiment followed a pretest-posttest design. As an intervention, the experimental group received motion recognition-based occupational therapy and a separate sensory integration program. The control group only participated in the separate sensory integration program. The eight-week experiment duration included 24 intervention sessions where the a 50-minute session was implemented three times a week for eight weeks. To compare the physical self-efficacy, visual-motor integration ability, and play skills before and after the intervention, measurement tools including the Physical self efficacy, Beery VMI-6, and Penn interactive peer play scale were used. All measured variables were analyzed and expressed as mean, standard deviation and percentage. Results : The motion recognition-based occupational therapy demonstrated a significant effect on improving the physical self-efficacy, visual-motor integration ability, and play skills of the experimental group. The intervention also caused a significant difference between the experimental group and control group in terms of the physical self-efficacy, visual-motor integration ability, and play skills. Conclusion : We confirmed the possibility motion recognition-based occupational therapy could be effective in improving the physical self-efficacy, visual-motor integration ability, and play skills for patients who have neurodevelopmental disorder. Based on the study result, further future studies are expected based on this study result that prove the application effect of the motion recognition-based occupational therapy using disabled and non- disabled children as subjects are expected in the future.