• 제목/요약/키워드: Pediatric physical therapy assessment

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소아 청소년 물리치료 실태 조사: 서울 경기 지역 소아 청소년 재활병원을 중심으로 (Survey About Current Status of Pediatric and Adolescent Physical Therapy: Focus on Pediatric and Adolescent Rehabilitation Hospitals in Seoul and Gyeonggi Province)

  • 김정수;민경철
    • 재활치료과학
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    • 제12권4호
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    • pp.67-80
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    • 2023
  • 목적 : 본 연구는 장애 소아 청소년을 치료 중인 물리치료사를 대상으로 소아 청소년 물리치료 실태, 만족도, 수가 체계, 대상, 시행, 평가 활용에 대해 알아보기 위해 진행되었다. 연구방법 : 서울 경기 지역 소아 청소년 물리치료사 60명을 대상으로 설문지를 활용하여 소아 청소년 물리치료 실태, 대상자, 만족도, 치료 시행 및 평가 활용 등을 조사하였다. 실태, 대상자, 만족도 등은 빈도 및 기초 통계 분석을 활용하여 분석하였으며, 물리치료 참여도-난이도, 소아 청소년 물리치료 주요 요소의 중요도-본인의 능력, 주요 치료 목표-사용 빈도 차이는 대응 표본 T 검정을 통하여 그 차이를 확인하였다. 결과 : 소아 청소년 물리치료 실태는 대부분 독립된 공간(95.0%)에서 하루 11~15건(66.7%), 1대 1 치료(95.0%)로 진행되는 것으로 조사되었다. 대상자의 주요 연령은 학령기, 학령전기, 진단은 뇌병변, 발달지연이 많았으며 20대 이상까지 치료하였다. 소아 청소년 물리치료 만족도는 높았으나(70.0%) 업무강도 역시 높았다(71.7%). 주요 치료법으로는 신경발달치료, 보행치료, 목표지향적 재활이 있으며, 평가는 대동작기능검사 88과 66, 대동작기능분류검사 사용이 많았다. 현 수가 체계는 부적합하다고 하였으며(66.1%), 적정 수가 체계가 필요하다고 하였다. 결론 : 본 연구를 통하여 소아 청소년 물리치료와 관련된 광범위한 내용과 요소를 확인하였다. 현 실태조사연구를 바탕으로 소아 청소년 물리치료사의 전문성 및 지속성 향상, 최신 치료법 적용을 위한 노력이 필요할 것이다.

발달지연 아동 및 뇌성마비 아동의 평가실태와 물리치료사들의 평가에 대한 인식도 조사 (Physical Therapist's Understanding and the Usage of Assessment Tools for Children With Delayed Development and Cerebral Palsy)

  • 박혜정;이충휘;조상현;권혁철
    • 한국전문물리치료학회지
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    • 제7권1호
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    • pp.1-21
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    • 2000
  • The purposes of this study were to research the current state of evaluation of children with delayed development and cerebral palsy and determine pediatric physical therapists' knowledge of assessment tools and their use. The subjects were 130 pediatric physical therapists (general hospitals, university-related hospitals, rehabilitation centers, etc.). Data was obtained from August 24, 1999 to October 18, 1999 by means of a survey questionnaire. The results were as follows: 1. The current state of pediatric physical therapist evaluation of children with delayed development and cerebral palsy. 1) Tools used to assess functional areas of children with cerebral palsy were: subjective description format-128 (47.1%); the GMFM-58 (21.3%); facility-generated tool-51 (18.8%); and DDST-15 (5.5%). 2) Tools used to assess developmentally delayed children were: subjective description format-121 (50.6%); the GMFM-43 (18.0%); facility-generated tool-41 (17.2%); and DDS T-14 (5.9%). 3) After their college or university study, therapists who had attended lectures on evaluation were 113 (86.9%); 13 (10.0%) therapists had not attended any lectures on evaluation 2. Test scores of physical therapists' professional knowledge of evaluation procedures: high (more than 36 points)-74 (56.9%); moderate (18~35 points)-39 (30.0%); and low (below 17 points)-none. 1) For therapists treating cerebral palsied children, 73 (65.2%) were in the high range, 39 (34.8%) were in the moderate range and none were in the low range. 2) For therapists treating children with delayed development, 71 (65.7%) were in the high range, 37 (34.3%) were in the moderate range and none were in the low range. Although the general degree of professional knowledge of evaluation was quite high, there was a lack of variety in the assessment tools used With a large number of therapists depending on subjective description. Possible reasons for the low rate of objective asses sment tool use: 1) Poor clinical environment: too many clients and lirnited treatment time. 2) Lack of any medical insurance fee category for specific assessment tools. 3) Lack of continuing education opportunities in pediatric evaluation skills during or after either college-based (3 year) or university-based (4 year) education programs. Based on the study results, provision of more extended educational opportunities would promote the use of a greater variety of objective assessment tools by pediatric physical therapists.

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국내 아동 작업치료사의 평가도구 사용 동향 (Current Trend in Use of Occupational Therapy Assessment Tool by Pediatric Occupational Therapist)

  • 이선희;홍초롱;박혜연
    • 대한감각통합치료학회지
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    • 제16권3호
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    • pp.23-33
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    • 2018
  • 목적 : 본 연구는 국내 아동 작업치료사들이 사용하고 있는 평가도구를 영역별로 구체화하여, 평가도구의 사용 동향을 파악하고자 하였다. 연구방법 : 본 연구는 아동 작업치료사를 대상으로 평가도구 사용에 대한 설문을 실시하였다. 평가도구의 하위영역은 작업수행, 일상생활활동, 교육, 놀이, 감각-지각, 운동 및 실행, 인지, 사회적 상호작용 기술, 발달, 이학적 검사로 구성하였다. 설문에 응답한 105명의 자료를 대상으로 기술통계 및 빈도분석을 사용하여 분석하였다. 결과 : 본 연구 결과는 초기 평가 시 소요되는 시간은 30~60분(41.9%)이 가장 많았으며, 재평가 주기는 3~6개월(41.0%)로 가장 많이 실시하는 것으로 나타났다. 영역 별 평가도구를 살펴보면, 작업 수행은 Canadian Occupation Performance Measure(55.2%)을, 일상생활활동은 Wee Functional Independence Measure(57.1%)을, 교육은 School Function Assessment(2.5%)를, 놀이 평가도구는 Revised Knox Preschool Play Scale(28.6%)을, 감각-지각은 Developmental Test of Visual Perception(94.3%)을, 운동 및 실행 평가도구는 Bruininks-Oseretsky Test of Motor Proficiency-2(42.9%)를, 인지 평가도구는 Lowenstein Occupational Therapy Cognitive Assessment(11.4%)를, 사회적 상호작용 기술은 Evaluation of Social Interaction(6.1%)을, 발달은 Denver Developmental Screening Test-II(92.4%)를, 이학적 검사는 임상관찰(89.5%)을 주로 사용하는 것으로 나타났다. 결론 : 본 연구를 통하여 국내 아동작업치료사들이 사용하고 있는 평가도구를 영역별로 구체적으로 파악할 수 있었으며, 이를 통해 추후 평가 교육 및 개발을 위한 기초적인 근거자료가 될 것으로 기대된다.

뇌성마비 아동의 대동작 수행평가(GMPM)와 아동용 균형척도(PBS) 사이의 상관성 연구 (The study on Correlation between Gross Motor Performance Measure and Pediatric Balance Scale in Children with Cerebral palsy)

  • 김효원;안소윤
    • 대한물리치료과학회지
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    • 제22권2호
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    • pp.1-10
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    • 2015
  • Background : This study verified a correlation between gross motor performance measure (GMPM) and pediatric balance scale (PBS) for children, which are most widely used for assessment of children with cerebral palsy. Methods : The study subjects are 20 children aged between five and 13 who were diagnosed with cerebral palsy. Their mean age was $8.15{\pm}2.96years$ and consists of 15 males and 5 females. The subjects were divided into three groups according to muscle tone and motility disorders and then GMPM and PBS were assessed. In the assessment items in the GMPM, alignment, coordination, dissociated movement, stability, and weight shift were measured. The PBS consists of sitting to standing, standing to sitting, moving between chairs, standing without using hands, standing with one foot, turning 360 degrees, turning to look behind, retrieving object from floor, and reaching forward with outstretched arm while standing. A correlation of the collected data was analyzed using SPSS 18.0 for windows. Results : From Significant correlations were shown between items of GMPM and PBS as well as total scores of GMPM and PBS. Among them, coordination and weight transfer in the GMPM items had a high correlation with the PBS. In addition, the higher the GMPM total score was, the higher the PBS score was. Conclusion : This study result showed a significant correlation between GMPM and PBS, and this relation can be used to pediatric physical examination.

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물리치료과 학생들을 대상으로 아동균형척도의 항목별 측정자 신뢰도에 관한 연구 (The Study on the Rater Reliabilities of Physical Therapy Students Pediatric Balance Scales items)

  • 황룡;김기원
    • 대한물리의학회지
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    • 제8권1호
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    • pp.137-145
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    • 2013
  • PURPOSE: The purpose of this study is to examine assessment of test-retest reliability for 13 items of pediatric balance scales, then the intrarater reliability among the raters. METHODS: Study participants included 6 children with spastic cerebral palsy who could walk. Raters were consist of seventy-four, 2nd year physical therapy major students. The children's ability to achieve physical balance was wideotaped for PBS items. The raters watched the tapes and evlauated each child twice. Test-retest reliability was analyzed using the Spearman correlation, and interrater reliability was analyzed using the Kendall's coefficient of concordance for ranks. RESULTS: The total PBS scores averaged 49.22 and 50.06 for first and second tests. Test-retest reliability of PBS individual items were between low and high. The low itmes were 3 items, and high were 4 itmes. Interrater reliability were low agreement. CONCLUSION: Based on the study, the pediatric balance scale is an effective evaluating tool for measuring functional balance of school age child. However, the agreement of students or beginner's interpretation is necessary in conjunction to this study results. On top of that, it is important to provide detailed explanation and repetitive training, which improves the analysis reliability. Also, each category subscores level for the pediatric balance scale must be examined carefully in conjunction to performing test, only after improving match quality via preceding practice.

The Reliability of the Pediatric Functional Muscle Testing in Children with Developmental Delay

  • Seo, Hye-Jung;Kim, Joong-Hwi
    • The Journal of Korean Physical Therapy
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    • 제27권4호
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    • pp.183-189
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    • 2015
  • Purpose: The aim of this study was to examine the test-retest and inter-rater reliability of the pediatric functional muscle testing (PFMT) when applied to children with developmental delay. Methods: Sixteen children with developmental delay (seven females, nine males) participated in this study. For the inter-rater reliability, each was scored on the PMFT by two pediatric physical therapists with more than 8 years of clinical experience on the same day. For assessment of the test-retest reliability, one therapist tested the children again within 10 days. The second measurement was performed by taking a first measurement in video. Intraclass correlation coefficient (ICC) was calculated to determine the test-retest and inter-rater reliability of the PFMT, and Chronbach's alpha was used to measure internal consistency. Results: The results of this study were as follows: 1) The test-retest ICC of the score of the infant action month and the right side of the PFMT was from 0.53 to 1.00 and from 0.63 to 0.99, respectively. 2) The inter-rater ICC of the score of the infant action month and the right side of the PFMT was from 0.66 to 1.00 and from 0.64 to 1.00, respectively. 3) Chronbach's alpha was 0.93. The internal consistency indicated excellent. Conclusion: In conclusion, this study showed that the test-retest and inter-rater reliability of the PFMT was relatively high, except for a few items. Therefore, it can be suggested that the PFMT will be a useful tool for measurement of muscle strength for children with developmental delay if it be some modifications.

A Survey on the Current Status of Neonatal Physical Therapy in South Korea

  • Kim, Sung Tae;Lee, Joon-Hee
    • The Journal of Korean Physical Therapy
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    • 제32권3호
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    • pp.168-175
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    • 2020
  • Purpose: This study aimed to investigate and report the current status of physical therapy (PT) performed in Korean neonatal intensive care units (NICU) to present foundational data that promotes the advances in neonatal PT in Korea. Methods: Based on the Health Insurance Review and Assessment (HIRA) data, we administered a questionnaire survey to 74 hospitals (39 tertiary and 35 general hospitals) in Korea equipped with a NICU and pediatric PT unit. We developed a 32-item questionnaire with reference to previous Korean studies. The questionnaires were distributed and retrieved via regular mail and an online system. Results: Of the 74 hospitals, 58 (78%) practiced neonatal PT and the duration of each session significantly differed according to the hospital rating. PT was given, depending on clinical symptoms, to infants who were preterm and low birth-weight (96.5%), had brain and spinal cord diseases (84.5%), had pathological tonus (94.8%), with respiratory problems (65.5%), for range of motion exercises (82.8%), for neurodevelopment approaches (72.4%), and for positioning (70.7%). Interdisciplinary meetings were held to share clinical decisionmaking in 17.2% of the hospitals surveyed and parent-participating education to ensure a family-centered approach was offered in 63.8% of the hospitals. The barriers of neonatal PT included low insurance fees, insufficient awareness of colleagues, and the severity of the patient. Conclusion: This study is the first report of the current status of neonatal PT in Korea. The findings of this study will serve as foundational data to review the current neonatal PT practice and promote further advances.

Comprehensive Physiotherapy Approaches for Children With Cerebral Palsy: Overview and Contemporary Trends

  • Changho Kim
    • 한국전문물리치료학회지
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    • 제30권4호
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    • pp.253-260
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    • 2023
  • Cerebral palsy (CP) is a prevalent neurodevelopmental disorder characterized by motor and postural impairments caused by central nervous system dysfunction. It significantly impacts children's daily functioning and quality of life. Physical therapy is a crucial intervention for children with CP that aims to improve motor skills and functional abilities. This study aimed to provide a comprehensive overview of holistic physical therapy approaches methods specifically designed for children with CP and examine recent research trends and their implications for optimizing outcomes in this population. This study employed a narrative review approach, conducting a comprehensive examination of the current literature pertaining to physical therapy methods for children with CP. The review encompassed studies exploring assessment techniques, evidence-based interventions, and innovative approaches in the field. It was discerned that encompassing physical therapy strategies, which encompass individualized treatment plans, evidence-based interventions, and the integration of innovative techniques, yield a favorable influence on the motor skills and functional capacities of children with CP. This review synthesizes the current knowledge on effective physical therapeutic strategies for children with CP. Furthermore, this review highlights the need for continued research and innovation in the field of pediatric physical therapy for CP.

Functions (Mobility, Self-care, Social Ability) and Health-related Quality of Life in Children with Cerebral Palsy

  • Ko, Joo-Yeon;Lee, Suk-Min
    • 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.

The Effect of Weight-support Treadmill Training on the Balance and Activity of Daily Living of Children with Spastic Diplegia

  • Choi, Hyun-Jin;Nam, Ki-Won
    • The Journal of Korean Physical Therapy
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    • 제24권6호
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    • pp.398-404
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    • 2012
  • Purpose: This is designed to study the effect of weight-support walking training through motor learning on motor functions of children with cerebral palsy, in particular their activity of daily living and balance. Methods: Thirteen children with spastic cerebral palsy, at gross motor function classification system (GMFCS) levels III~IV, underwent treadmill walking training. It used principles of weight support, 4 times a week for 7 weeks, 10 minutes at a time, before and after neurodevelopmental physical therapy. Everyday functions were measured using Functional Independence Measure for Children (Wee-FIM). The ability to keep their balance was measured using electronic measuring equipment from good balance system and the assessment was made before and after the experiment. Results: There were significant differences (p<0.05) between pre and post experiment levels of functional independence in everyday life, in self-care activities, mobility, locomotion and social cognition. With regard to changes in standing balance, there were significant differences before and after the experiment (p<0.05) in GMFCS level III. There was a reduction in the agitation velocity in the x- and y-axes which measures the left-to-right shaking; in GMFCS level IV, velocity moment was reduced. Conclusion: Walking training using a treadmill can help improve the everyday activity and balance in children with spastic cerebral palsy. It can also be served as a useful purpose as a method of intervention in pediatric care.