• 대한물리의학회지
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• 제15권4호
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• pp.75-85
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• 2020

PURPOSE: Cerebral palsy is a common cause of disability in children, requiring constant rehabilitation. Improving balance in children with cerebral palsy helps to alleviate daily movement and the quality of life. This study examines a program that combines Resistance Exercise and Group Exercise, and investigates the effect on trunk control ability, balance ability, maximum grip strength, and quality of life of children with cerebral palsy. METHODS: Totally, 9 children with cerebral palsy participated in this study. Resistance exercise was performed for 8 weeks, 40 minutes every day. Group Exercise was conducted for 8 weeks, 40 minutes each Sunday. All participants were evaluated by the Korean version of the trunk control measurement scale, pediatric reach test, grip strength test, and KIDSCREEN-52. RESULTS: The trunk control ability was significantly improved in all subcategories (p < .05). In the pediatric reach test, the left and right directions were significantly improved (p < .05). Maximum grip strength was significantly improved in both hands (p < .05). The quality of life significantly improved in total score, physical well-being, general moods, self-perception, autonomy, relationship with parents, and home life (p < .05). CONCLUSION: Considering the encouraging results, we propose to use Resistance Exercise and Group Exercise as programs other than rehabilitation treatment in hospitals, to improve motor function and quality of life of children with cerebral palsy.

• 재활복지공학회논문지
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• 제8권3호
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• pp.161-168
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• 2014

본 연구에서는 Pneumatic air fitting system을 적용한 기립보조기 제품을 뇌병변 소아환자를 대상으로 기립보조기의 신체 고정용 폼패드(foam pad)와 에어패드(air pad) 사용 시, 뇌병변 장애아동들의 체간 및 하지근육의 수축 양상을 비교 분석하였다. 연구결과, 패드(foam pad vs. air pad) 유형에 따른 근육별 근력 활성도는 차이가 있었다. 이러한 차이는 큰 동작(식사동작)에서 크게 나타나고, 작은 동작(쓰기동작, 읽기동작)이 작게 나타났다. 이는 Pneumatic air fitting system을 적용한 기립보조기 제품 사용 시, 기존 폼패드에 비해 사용자에게 좀 더 편안함을 제공하는 것으로 나타났다.

• International Journal of Advanced Culture Technology
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• 제7권1호
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• pp.231-236
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• 2019

Background/Objectives: This paper proposes a dual mode feedback-controlled cycling system for children with spastic cerebral palsy to rehabilitate upper extremities. Repetitive upper limb exercise in this therapy aims to both reduce and analyze the abnormal torque patterns of arm movements in three- dimensional space. Methods/Statistical analysis: We designed an exercycle robot which consists of a BLDC motor, a torque sensor, a bevel gear and bearings. Mechanical structures are customized for children of age between 7~13 years old and induces reaching and pulling task in a symmetric circulation. The shafts and external frames were designed and printed using 3D printer. While the child performs active/passive exercise, angular position, angular velocity, and relative torque of the pedal shaft are measured and displayed in real time. Findings: Experiment was designed to observe the features of a cerebral palsy child's exercise. Two children with bilateral spastic cerebral palsy participated in the experiment and conducted an active exercise at normal speed for 3 sets, 15 seconds for each. As the pedal reached 90 degrees and 270 degrees, the subject showed minimum torque, in which the child showed difficulty in the pulling task of the cycle. The passive exercise assisted the child to maintain a relatively constant torque while visually observing the movement patterns. Using two types of exercise enabled the child to overcome the abnormal torque measured in the active data by performing the passive exercise. Thus, this system has advantage not only in allowing the child to perform the difficult task, which may contribute in improving the muscle strength and endurance and reducing the spasticity but also provide customizable system according to the child's motion characteristic. Improvements/Applications: Further study is needed to observe how passive exercise influences the movement characteristics of an active motion and how customized experiment settings can optimize the effect of pediatric rehabilitation for spastic cerebral palsy.

• 대한물리의학회지
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• 제9권3호
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• pp.293-299
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• 2014

PURPOSE: The purpose of this study was to investigate the effect of functional training using a sliding rehabilitation machine (SRM) on the mobility of the ankle joint and balance in children with cerebral palsy (CP). METHODS: The subjects consisted of 11 children who were diagnosed with spastic CP. They carried out the functional training using the SRM for 30 minutes, three times a week, for 8 weeks. Before and after all of the training sessions, the subjects were tested using the Pediatric Balance Scale (PBS) and Gross Motor Function Measurement (GMFM), range of motion (ROM) in the ankle joint, the pennation angle of the gastrocnemius muscle and the fascicle length of gastrocnemius muscle were measured to determine the mobility of the ankle joint and balance ability. RESULTS: There were significant differences between the pre-test and post-test in the PBS and GMFM. The ROM of the ankle joint was significantly increased after the functional training using the SRM. Moreover, the fascicle length was increased and the pennation angle was decreased after the functional training using the SRM, but the difference was not significant. CONCLUSION: These results suggest that functional training using the SRM may have some effect on the mobility of ankle joint and balance in children with CP. According to the results, this study could present an approach to the rehabilitation or treatment of children with CP.

• 척추신경추나의학회지
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• 제16권2호
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• pp.29-38
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• 2021

Objectives This study was aimed to evaluate the effects of Chuna manual therapy (CMT) for the treatment of cerebral palsy. Methods The randomized controlled trials (RCTs) on the treatment of CMT for cerebral palsy in children were selected among the literature published until January 2021 in seven databases. The quality of the literature was evaluated using the Cochrane's risk of bias tool, and RevMan 5.3 was used for the synthesis of results. Results Total 801 pediatric patient with cerebral palsy incontinence were finally selected from twelve RCTs. The total effective rate of the combined treatment general rehabilitation and CMT is statistically significantly higher (P<0.0001) than that of general rehabilitation alone. Conclusions This study suggests that general rehabilitation combined with CMT for cerebral palsy in children might be more effective in improving symptoms than general rehabilitation alone. As the number and quality of the literature included in the meta-analysis was insufficient, high-quality clinical studies on CMT for cerebral palsy would be required.

• 대한지역사회작업치료학회지
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• 제9권2호
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• pp.33-42
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• 2019

목적 : 이 연구는 국내 소아재활 분야에 종사하는 재활의학과의사 및 치료사를 대상으로 강제유도운동치료(constraint-induced movement therapy, CIMT)에 대한 지식과 임상적용 현황에 대해 조사하고자 하였다. 연구방법 : 대한소아재활발달의학회에 등록된 510명 (재활의학과의사 204명, 치료사 306명)을 대상으로 전자우편을 이용한 설문조사를 시행하였다. 결과 : 총 510명 중 179명이 설문에 응답하여 응답률은 35.1%였다. 응답한 179명 중 재활의학과 의사 39명, 물리치료사 89명, 작업치료사 48명, 언어치료사 3명이었다. 응답자 중 45.9%(82명)는 소아재활분야의 경험이 6년 이상인 전문가로 구성되어 있었고, 58.1%(104명)가 강제유도운동치료에 대한 경험이 있었다. 임상 진료에서 강제유도운동치료를 적용하는 경우는 환자의 순응도가 좋을 때 73.1%(76명), 보호자의 순응도가 좋을 때 48.1%(50명), 양손훈련(bimanual training)의 효과가 제한적이라고 판단될 때 39.4%(41명) 순으로 조사되었다. 임상적용에서 제한점으로 작용하는 요인은 치료인력 부족이나 가정내 환경 부적합 등과 같은 환경제한 35.1%(61명), 인식부족 19.5%(34명), 건측 제한으로 인한 건측 기능발달 저해에 대한 우려 13.8%(24명)으로 조사되었다. 강제유도운동치료를 중단한 이유로는 환자의 비협조 77.6%(76명), 인지/행동요인 42.9%(42명), 보호자의 비협조 25.5%(25명), 효과가 없다고 판단될 때(non-effectiveness) 11.2%(11명) 순으로 조사되었다. 결론 : 강제유도운동치료의 의학적 근거가 높게 보고되고 있지만 이 연구에서는 많은 수의 재활의학과 의사와 치료가사 실제 임상치료에서 적용하지 못하고 있음을 확인하였다. 국내 현황에서 제한점을 개선하여 향후 임상적용 확대를 위한 노력이 필요하겠다.

• The Journal of Korean Physical Therapy
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• 제11권2호
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• pp.21-28
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• 1999

The purpose of this study were to describe the performance 67 kindergartener who aged from 4 to 7 years on the Pediatric Clinical Test of Sensory Interaction for Balance(P-CTSIB) and to determine difference with foot position and age. All Subjects were performance with different foot position that were feet-together, heel-toes. the starting position was that subject placed their hands on the hips, The results of this study were as follows 1. There were significiant difference in all instances by age whoa subjects were foot together(p<0.05). 2. There were singificiant difference in all instances by age excepts condition V awhen subjects were heel toes(p<0.05). 3. Duration of balance performance, of 4-year-olds were shortest and duration of balance performance of 7-year-olds were longest.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제24권2호
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• pp.238-243
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• 2021

Caudal regression syndrome (CRS) is a rare neural tube defect that affects the terminal spinal segment, manifesting as neurological deficits and structural anomalies in the lower body. We report a case of a 31-month-old boy presenting with constipation who had long been considered to have functional constipation but was finally confirmed to have CRS. Small, flat buttocks with bilateral buttock dimples and a short intergluteal cleft were identified on close examination. Plain radiographs of the abdomen, retrospectively reviewed, revealed the absence of the distal sacrum and the coccyx. During the 5-year follow-up period, we could find his long-term clinical course showing bowel and bladder dysfunction without progressive neurologic deficits. We present this case to highlight the fact that a precise physical examination, along with a close evaluation of plain radiographs encompassing the sacrum, is necessary with a strong suspicion of spinal dysraphism when confronting a child with chronic constipation despite the absence of neurologic deficits or gross structural anomalies.

• Journal of Dental Anesthesia and Pain Medicine
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• 제22권5호
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• pp.357-367
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• 2022

Background: Low-dose dexmedetomidine may be a suitable alternative to opioids for pediatric ambulatory procedures under general anesthesia (GA). However, the recovery profile remains unclear. Herein, we aimed to evaluate the effects of low-dose dexmedetomidine on the recovery profile of children. Methods: Seventy-two children undergoing ambulatory oral rehabilitation under GA were randomly and equally distributed into two groups (D and F). Group D received an infusion of dexmedetomidine 0.25 ㎍/kg for 4 min for induction, followed by maintenance of 0.4 ㎍/kg/h. Group F received an infusion of fentanyl 1 ㎍/kg over 4 min for induction, followed by maintenance at 1 ㎍/kg/h. The primary outcome was the extubation time. The secondary outcomes were awakening time, end-tidal sevoflurane (ET-Sevo) requirement, change in hemodynamic parameters, Richmond Agitation-Sedation Scale (RASS), Children's Hospital of Eastern Ontario pain scale (CHEOPS) score, length of PACU stay, and incidence of adverse events. Results: Statistically significant differences were observed in the recovery profile between the groups: the median time for extubation was 3.65 (3.44-6.2) vs. 6.25 (4.21-7) minutes in groups D vs. F (P=0.001), respectively, while the corresponding awakening times were 19 (18.75-21) and 22.5 (22-24) minutes, respectively (P < 0.001). The mean ET-Sevo was low in group D (1.1 vs. 1.2; P < 0.001). The heart rate was significantly low across all time points in group D, without resulting in bradycardia. The median RASS and CHEOPS scores were also significantly lower in group D. No significant differences were observed in the mean arterial pressure, incidence of adverse events, or length of PACU stay. Conclusion: Low-dose dexmedetomidine was more effective than fentanyl as an opioid substitute at providing a better recovery profile in pediatric ambulatory oral rehabilitation under GA. Dexmedetomidine also significantly reduced sevoflurane consumption without causing adverse events or prolonging hospital stay.

• 대한물리의학회지
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• 제5권2호
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• pp.281-288
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• 2010

Purpose : The purpose of this study was to examine the correlation between Pediatric Balance Scale(PBS) and Gross Motor Function Measurement(GMFM) with cerebral palsy(CP) children. Methods : 31 ambulatory children with CP were recruited for this study. PBS is a modified version of the Berg’s Balance Scale to access the children with motor impairments. To access the motor functions that directly influence to the functional independence of the ambulatory CP children, total scores of standing category and walking/running/jumping category of GMFM were selectively compared with PBS score by Spearman correlation coefficient analysis. Results : The results revealed high correlation between PBS and GMFM scores both in standing and walking/running/jumping categories(r=.9). Conclusions : Therefore, this study indicates that PBS can be applied not only as a tool to access balance, but also as a measurement to predict and access the level of standing and ambulatory related functions of children with CP.