• 대한통합의학회지
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• 제10권2호
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• pp.155-167
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• 2022

Purpose : Accumulation of accurate data regarding the use and adequacy of subsidies is important to provide optimal development rehabilitation services. However, no reports have discussed the status regarding the use and adequacy of subsidies available for motor development rehabilitation as a part of development rehabilitation services in children and adolescents with cerebral palsy. In this study, we investigated the current use and subsidy adequacy of motor development rehabilitation as an essential part of development rehabilitation services in children and adolescents with cerebral palsy. Methods : The study included parents of children and adolescents with cerebral palsy, who underwent motor development rehabilitation of development rehabilitation services (n=148). The participants were administered a questionnaire to investigate the current use and subsidy adequacy of the motor development rehabilitation part of development rehabilitation services. Results : Most respondents indicated that 310,000-410,000 /month was an appropriate subsidy and agreed that the subsidy should be extended to adults with cerebral palsy. We observed a significant difference in the appropriate subsidy based on age groups (p=.029), as well as type of development rehabilitation service most needed (p=.005) and whether or not agree to extend the subsidy to adults according to gross motor function classification system level (p=.015). There were significant relations of appropriate subsidy (p<.001) and appropriateness of copay (p=.004) according to degree of transportation cost burden. Moreover, there were significant relations of appropriateness of current subsidy (p=.015) and appropriate subsidy (p<.001) according to degree of inconvenience of using transportation. Conclusion : This study highlights the need to increase subsidies for motor development rehabilitation of development rehabilitation services and that the subsidy should be determined based on the burden of transportation costs and the inconvenience of using transportation. Development rehabilitation service for adults with cerebral palsy should also be supported.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권2호
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• pp.122-131
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• 2019

The majority of children with cerebral palsy (CP) have feeding difficulties and are especially prone to malnutrition. The early involvement of a multidisciplinary team should aim to prevent malnutrition and provide adequate nutritional support. Thorough nutritional assessment, including body composition, should be a prerequisite for the nutritional intervention. As in typically-developed children nutritional support should start with dietary advice and the modification of oral feeding, if safe and acceptable. However, for prolonged feeding, in the presence of unsafe swallowing and inadequate oral intake, enteral nutrition should be promptly initiated and early gastrostomy placement should be evaluated and discussed with parents/caregivers. Gastrointestinal problems (oropharyngeal dysfunction, gastroesophageal disease, and constipation) in children with CP are frequent and should be actively detected and adequately treated as they can further worsen the feeding process and nutritional status.

• 대한예방한의학회지
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• 제23권2호
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• pp.25-42
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• 2019

Objectives : The purpose of this study was to identify factors that affect the utilization of Korean medicine (KM) among children with cerebral palsy (CP) and explore a processing model of decision-making by their parents. Methods : We conducted an individual in-depth interview with 21 mothers of children with CP who were recruited during the observational study. A grounded theory of Strauss and Corbin was used for qualitative analysis. Thus, collected data were classified into open coding including 121 concepts, 27 sub-categories and 7 categories. Results : The central phenomenon of the process of using KM for children with CP is 'KM as an optional treatment not essential'. Therefore there are many obstacles to starting KM treatment and it is easily interrupted for various reasons, unlike general rehabilitation treatment. However, if the patient experiences the therapeutic effect, the parents want to continue KM treatment. They try to provide treatment as much as possible if they can afford it. The parents give priority to general rehabilitation treatment and value the information and experience provided by the caregivers in similar situation as well as expert opinions. Conclusions : To expand and generalize KM treatment for children with CP, efforts to change interventional conditions such as treatment effect, treatment cost, treatment compliance, and convenience of treatment based on the understanding of the strategy used by the parents in KM utilization.

• The Journal of Korean Physical Therapy
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• 제28권6호
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• pp.385-392
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• 2016

Purpose: This study aimed to evaluate the relationships among quality of life, caregiver depression levels, and disease severity, especially motor function, in children with cerebral palsy. Methods: Data were collected through questionnaires using survey and interview from 80 caregivers of children with cerebral palsy. The caregivers' quality of life was measured using medical outcomes study 36-item short form health survey, and level of depression was scored using the beck depression inventory. In addition, children's motor function was evaluated using gross motor function measure-88 and functional independence measure scores. Results: Among 8 domains of medical outcomes study 36-item short form health survey, "physical functioning," "physical role functioning," "mental health," and "bodily pain" domains were significantly correlated to "total" percentage scores of gross motor function measure-88. In addition, "mental health" and "bodily pain" domains were correlated to each sub-dimension, including "lying and rolling," "sitting," "crawling and kneeling," "standing," and "walking, running, and jumping." Similarly, the "running" and "jumping" dimensions including motor function measures correlated with "transfer," "locomotion," and "motor subtotal" of functional independence measure scores. The beck depression inventory scores were negatively correlated to "lying and rolling," "sitting," "crawling and kneeling," and the "total" percentage scores of gross motor function measure-88. The beck depression inventory scores were negatively correlated to "sphincter control," "communication," "social cognition," "cognitive subtotal," and "total" functional independence measure scores. Conclusion: It is necessary to consider the quality of life and emotional problems of caregivers of CP children and support them both physically and psychologically with comprehensive rehabilitation.

• Journal of Acupuncture Research
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• 제19권4호
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• pp.89-100
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• 2002

Objective : We want to have a correct understanding and the distance about the Oriental Medical therapy on the CP(cerebral palsy) children. Methods : We made up a question of parents of CP children and analyzed it. Conclusion : 19 patients were taken physical treatment and 12 patients were taken occupational treatment in company with physical treatment(In our OPD CP patient) Parents complained about poor surroundings of our hospital for children and deficiency of physical treatment. The most satisfactory thing is acupuncture treatment, then the next thing is aroma therapy. On the satisfaction degree about the Oriental Medical therapy, very good is 27.3%, good 45.5%, ordinary 27.3% and unsatisfaction is none. The place Oriental medical therapy before our hospital was taken is local Oriental medical clinic, 9 cases out of 22.

• 대한통합의학회지
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• 제7권1호
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• pp.99-112
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• 2019

Purpose : The purpose of this study was to analyze Korean qualitative research studies on cerebral palsy and provide a basis for future direction of research. Methods : Twenty-six articles were selected by searching 4 Korean databases (NDSL, DBpia, KISS, and RISS) and reviewing the list of additional references. All the articles were analyzed and assessed using the Consolidated criteria for Reporting Qualitative research (COREQ). Results : Seventeen qualitative studies and 9 mixed quantitative and qualitative studies were selected, and methodologies such as case study (42.3 %), constant comparative method (23.1 %) and phenomenology (23.1 %) were used. The studies investigated the effects of interventions (38.5 %), support programs (30.8 %), and life experiences (26.9 %). Among the participants, 50.0 % were persons with disabilities only, 19.2 % were parents only, and 30.8 % were combination of persons with disabilities, parents, teachers, and therapists. The number of participants in most studies was 2-9 (57.7 %). The COREQ evaluation of the selected articles revealed many shortcomings in the studies. Interview guidelines were used only in 26.9 % of the studies. In particular, many articles did not describe in detail the characteristics of researchers and the relationship between researchers and the participants. Conclusion : In future, various research methodologies and research checklists must be used to stimulate high-quality qualitative research with on cerebral palsy.

• 재활복지
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• 제22권2호
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• pp.175-212
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• 2018

본 연구의 목적은 뇌성마비아동 보호자들의 재활치료 선택과 중단에 영향을 미치는 요인을 확인하고, 요인들의 상호작용에 의한 재활치료 선택과 중단 과정모형을 제시하는 것이다. Strauss와 Corbin(1994)의 근거이론을 사용하였다. 분석결과, 개방코딩에서 140개의 개념과 29개의 하위범주, 8개의 범주가 도출되었으며, 축 코딩의 패러다임에 의한 범주 분석 결과 중심현상은 '시행착오 속 최적화된 치료 찾기'였다. 재활치료 시작부터 현재까지의 과정분석결과 뇌성마비 아동 보호자들은 '당황', '혼란', '극대화', '방황', '전략', '균형' 등 6단계를 경험하는 것으로 나타났다. 재활치료 선택과정의 핵심범주는 '시행착오 속 재활과 일상생활의 균형 잡기'로 도출하였다. 뇌성마비아동 보호자들의 재활치료 선택에 영향을 미치는 요인들의 상호작용에 의한 재활치료 선택과 중단 과정모형을 설명하고, 재활과 일상생활의 균형 잡기를 제안하였다.

• Journal of Preventive Medicine and Public Health
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• 제20권2호
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• pp.312-321
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• 1987

뇌성마비아의 조기 발견에 관련된 모자인자를 조사하기 위하여 1987년 2월부터 1987년 4월까지 대구 장애자 복지관, 대구대학교 부설재활원, 성바오로 어린이집, 그리고 부산 뇌성마비아복지회에 통원 또는 입원치료를 받고 있는 어린이 110명중 1980년 1월 1일 이후 출생자 74명 전원의 어머니를 대상으로 면담조사 하였다. 아버지의 학력과 이상 발견시기와는 아무런 상관관계가 없었으나 어머니의 학력이 대학졸업이상 일때가 고졸이하에 비해 어린이의 이상을 일찍 발견했고, 또 아버지의 직업이 전문직 또는 관리직일 때가 그 이외의 직업에 비해, 그리고 아버지의 월수입이 610,000원이상 일때가 600,000원 이하보다 더 일찍 발견하는 경향이었다. 첫째아이가 둘째아이 보다 그리고 부모의 나이가 34세 이하인 경우가 35세 이상인 경우에 비해 좀더 일찍 이상을 발견하는 경향을 보였다. 남아에서 여아에 비해 더 일찍 이상이 발견되었고 육아상담을 정기적으로 받은 어린이에서 정기적으로 받지 않은 어린이보다 더 일찍 이상이 발견되었는데 5% 유의수준에는 약간 못미쳤다. 연구대상아를 임신했을 때 산전관리를 7회이상 받았던 경우가 6회이하 받았던 경우에 비해 통계적으로 유의하게 일찍 어린이의 이상이 발견되었다. 처음으로 이상을 발견한 사람은 부모가 85.1%, 육아 상담을 정기적으로 받은 여부와는 관계없이 의사가 발견한 것은 2.7%였고 부모가 어린이의 이상을 발견하고 의사의 진단을 받았을때 36.5%에서 뇌성마비 진단을 받았고 나머지는관찰, 정상등으로 진단이 확실하지 않았다. 부모가 어린이의 이상을 발견하고 $2{\sim}3$개월 뒤에 의사의 진단을 받았고 진단후 전문적 치료를 시작할 때까지 방치했거나 물리치료, 한약, 침술 등을 받았다. 뇌성마비아의 조기 발견을 위해 의학교육과 임상수련과정에서 어린이의 발달을 평가하는 방법의 교육과 수련이 강화되어야 할 것이며 진단을 위한 전문인력의 양성이 필요한 것으로 생각된다. 또 부모들의 뇌성마비를 비롯한 각종 장애의 진단과 치료에 대한 인식을 높이기 위한 계몽교육이 필요하다.

• The Journal of Korean Physical Therapy
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• 제22권3호
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• pp.37-44
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• 2010

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.

• 대한장애인치과학회지
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• 제9권2호
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• pp.122-126
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• 2013

14세 남환이 정기검진을 위해 내원하여 임상 구강검사 결과 상악 전치의 돌출과 상악궁 협착이 관찰되었다. 환아는 뇌성마비를 가지고 있었으나 간단한 설명을 이해하고 쉬운 지시를 수행할 수 있었으므로 가철성 장치를 이용한 교정치료를 시도하였다. 단계적이고 주의 깊은 접근을 통해 상악궁 협착 해소 및 상악 전치의 돌출을 완화할 수 있었다. 뇌성마비 환아의 경우 특징적으로 상악 전치의 돌출이 흔히 나타나는데, 이는외상의 위험에 쉽게 노출된다. 하지만 뇌성마비 환아에서 나타나는 특징적인 반사, 침 흘리기 습관, 행동조절의 어려움 등을 이유로 많은 임상의들이 교정 치료를 포기하게 된다. 적절한 환자 선정과 수행 가능한 치료목표를 세운다면, 뇌성마비 환아에서도 단계적이고 반복적인 행동조절과 약물을 이용하여 치료가 가능하다. 교정 치료를 통해 얻어진 상악 전치의 돌출 완화는 외상의 위험성을 줄이고 더 나은 심미성을 제공하는 긍정적인 효과를 가져오게 된다. 따라서 임상의들은 뇌성마비 환아의 치료에 대한 인식 변화 및 개선을 위한 적극적인 노력이 필요할 것이며, 뇌성마비 환아들은 더 나은 구강 건강을 영위할 수 있을 것이다.