• Therapeutic Science for Rehabilitation
• /
• v.9 no.1
• /
• pp.91-99
• /
• 2020

Objective : The purpose of this study was to investigate the effects of the IOPI articulator strength training program on articulator(tongue and lip) muscle strength, numbers of /l, s, ʨ/ articulation accuracy, articulatory numbers, articulation regularity and accuracy in the alternate motion rates, and sequential motion rate changes in patients with spastic dysarthria. Methods : Three cases of patients with spastic dysarthria living in Jeju, Korea, were included in this study. A single subject design was selected to study changes in articulator(tongue and lip) muscle strength, numbers of /ㄹ, ㅅ, ㅈ/ articulation accuracy, articulatory numbers, articulation regularity and accuracy in the alternate motion rates and sequential motion rates. Results : After the articulator strength training program was conducted on patients with spastic dysarthria, there were positive changes in articulator(tongue and lip) muscle strength, numbers of /ㄹ, ㅅ, ㅈ/ articulation accuracy, articulatory numbers, articulation regularity and accuracy on the alternate motion rates and sequential motion rates. Conclusion : Our findings suggest that IOPI articulator strength training program could be very useful for the most representative childeren with cerebral palsy if conducted in various subtypes of dysarthric patients and linked with articulatory function training with IOPI at home.

• Physical Therapy Korea
• /
• v.3 no.3
• /
• pp.44-58
• /
• 1996

The purpose of this study was to compare and evaluate various hand functions in the most common position (chair sitting, standing, floor sitting) used by cerebral palsied children with spastic diplegia. The results, analysed statistically, could be useful in suggesting treatment strategy for the improvement of hand function in such patient. For this study, 27 children mild or moderate spastic diplegia were chosen. They were patients of the Rehabilitation Hospital, Yonsei University Medical Center. Both dominant and nondominant hands were tested by the Box and Block Test. Bilateral hand function was tested by bead striding and card sorting activities. Collected data was analysed using univariate correlation analysis and MANOVA. Results were as follows: 1) In chair sitting there was a significant positive correlation between dominant hand scores in the Bloc and Box Test and chronological age, gestation period, and time of treatment initiation. In bilateral hand function, card sorting scores correlated positively with time of treatment initiation. 2) In standing, there was a significantly positive correlation between dominant hand scores in the Block and Box Test and time of treatment initiation. 3) In floor sitting, there was a significantly positive correlation between the dominance hand scores in the Block and Box Test and the tine of treatment initiation. Bead stringing, a bilateral hand activity, correlated positively with gestation period and birth weight but negatively with the postnatal incubation period. 4) That score of children who walked showed no significant difference in any of the three postures. 5) Highest test scores in children who could nat walk were in the Box and Block Test for nondominant hand in bead stringing for bilateral hand function. There scores occurred with the children in thee chair sitting posture. The results showed that, in order to improve hand function in children with spastic diplegia, it is necessary to maintain a well supported upright trunk posture with variations allowed for relevance to the chosen position of thee improvements hand activity being performed.

• Phonetics and Speech Sciences
• /
• v.12 no.3
• /
• pp.95-103
• /
• 2020

The current study aimed to identify the characteristics of speech rate and pause in children with spastic cerebral palsy (CP) and their relationships with speech intelligibility. In all, 26 children with CP, 4 with no speech motor involvement and age-appropriate language ability (NSMI-LCT), 6 with no speech motor involvement and impaired language ability (NSMI-LCI), 6 with speech motor involvement and age-appropriate language ability (SMI- LCT), and 10 with speech motor involvement and impaired language ability (SMI-LCI) participated in the study. Speech samples for the speech rate and pause analysis were extracted using a sentence repetition task. Acoustic analysis were made in Praat. First, it was found that regardless of the presence of language impairment, significant group differences between the NSMI and SMI groups were found in speech rate and articulation rate. Second, the SMI groups showed a higher ratio of pause time to sentence production time, more frequent pauses, and longer durations of pauses than the NSMI groups. Lastly, there were significant correlations among speech rate, articulation rate, and intelligibility. These findings suggest that slow speech rate is the main feature in SMI groups, and that both speech rate and articulation rate play important roles in the intelligibility of children with spastic CP.

• Phonetics and Speech Sciences
• /
• v.2 no.4
• /
• pp.193-212
• /
• 2010

The purpose of our study was to provide effective speech evaluation items examining the variables of speech that successfully predict the speech intelligibility in CP children. The subjects were 55 children with spastic type cerebral palsy. As for the speech evaluation, we performed a speech subsystem evaluation and a speech intelligibility test. The results of the study are as follows. The evaluation task for the speech subsystems consisted of 48 task items within an observational evaluation stage and three levels of severity. The levels showed correlations with gross motor functions, fine motor functions, and age. Second, the evaluation items for the speech subsystems were rearranged into seven factors. Third, 34 out of 48 task items that positively correlated with the syllable intelligibility rating were as follows. There were four items in the observational evaluation stage. Among the nonverbal articulatory function evaluation items, there were 11 items in level one. There were 12 items in level two. In level three there were eight items. Fourth, there were 23 items among the 48 evaluation tasks that correlated with the sentence intelligibility rating. There was one item in the observational evaluation stage which was in the articulatory structure evaluation task. In level one there were six items. In level two, there were eight items. In level three, there was a total number of eight items. Fifth, there was a total number of 14 items that influenced the syllable intelligibility rating. Sixth, there was a total number of 13 items that influenced the syllable intelligibility rating. According to the results above, the variables that influenced the speech intelligibility of CP children among the articulatory function tasks were in the respiratory function task, phonatory function task, and lip and chin related tasks. We did not find any correlation for the tongue function. The results of our study could be applied to speech evaluation, setting therapy goals, and evaluating the degree of progression in children with CP. We only studied children with the spastic type of cerebral palsy, and there were a small number of severe degree CP children compared to those with a moderate degree of CP. Therefore, when evaluating children with other degrees of severity, we may have to take their characteristics more into account. Further study on speech evaluation variables in relation to the severity of the speech intelligibility and different types of cerebral palsy may be necessary.

• Journal of the Korean Society of Physical Medicine
• /
• v.7 no.3
• /
• pp.293-302
• /
• 2012

Background & Purpose : The purpose of this study is to evaluate the impairment of SVMC(selective voluntary motor control) of the lower extremity by assessing each joints of lower limb and to analyze the motional relationship between each joints of lower limb using SCALE(Selective Control Assessment of the Lower Extremity) during the swing phase of gait cycle in children with spastic diplegia. Method : 11 children with spastic diplegia CP who could walk independently and 10 normal developing children were participated. SCALE(Selective Control Assessment of the Lower Extremity) assessments were conducted for 11 children with CP. Gait analysis were accomplished in all participants. Qualisys motion analysis was used as a statistical tool to assess the motional relationship between hip joint, knee joint and ankle joint in each limb. We used descriptive statistics, cross-tabulation, independent t-test, linear regression to analysis motional relationship between each joints of lower limb using by SPSS ver.17.0. Result : Firstly, there were significant differences in SCALE scores between the cerebal palsy group and the control group in knee joint(p<0.05), but no significant difference in hip and ankle joints during the swing phase of gait cycle. Secondly, the difference of SCALE scores showed no statistical motional difference in knee and ankle joints during the swing phase, and showed significant motional difference in hip joints during the swing phase(p<0.05). Thirdly, there was a liner relationship between the motion of hip and ankle joints during the swing phase. Conclusion : The nature of SVMC(selective voluntary motor control) in each joints of the lower limb may reflect the ability of gait, thus SCALE may be used for assessing and for treating the cerebal palsy patients who are able to walk independently. Also we knew that the impairment of SVMC(selective voluntary motor control) increases from the proximal to the distal joints.

• Journal of Music and Human Behavior
• /
• v.4 no.2
• /
• pp.84-105
• /
• 2007

Cerebral palsy is a collection of motor disorders resulting from damage to the central nervous system that arise in multiple handicaps including cognitive disorders, speech disorders, epilepsy, perception disorders, and emotion disorders. Today spastic cerebral palsy has become more prevalent because intensive care for newborns has resulted in higher survival rates for very small premature babies. Since the children grow the fastest in order for a development during one year after birth, the therapeutic intervention is provided as early as possible to the children with cerebral palsy. After seven year old, there is no effect of intervention. So, the necessity of early intervention to spastic cerebral palsied infants is increasing. The purpose of this study is to develop the music therapy activity program using the techniques of neurological music therapy(NMT), the therapeutic application of music to dysfunctions due to neurologic disease of the human nervous system, for rudimentary movement phase of spastic cerebral palsied infant. This music therapy activity program was developed on the basis of the major developmental tasks of the rudimentary movement phase, the period that children can acquire the most basic movement function at the 0 to 2. Then the developmental characteristics of spastic cerebral palsy were applied to this music therapy activity program. This music therapy activity program was classified to three domains, those are stability, locomotion, and manipulation. This study has been consisted of three steps, those are the development of the activities, the evaluation of the activities by th panels, and the adjustment and complement of the activities. Reviewing literatures and interviews were done for the development of the activities, and the evaluation the activities was done by seven music therapists. In the evaluation steps, the questionnaire was used for estimating the content validity and application efficiency. The adjustment and complement of the activities were evaluated by the panels who were participating in the music therapy for cerebral palsied children in the clinical setting, and the results of the adjustment and complement were confirmed by the panels. The evaluation was presented in a mean value with the comment of the panels. In conclusion, the music therapy activity program for the spastic cerebral palsied infants using the techniques of NMT was developed on the basis of the major developmental tasks of the rudimentary movement phase. The program is comprised of 38 activities, those are 14 activities for developing the stability, 10 activities for developing the locomotion, and 14 activities for developing the manipulation. The programed activities would bring out the answers in the affirmative for the conformance with infants' development phase, the harmony between the objective and the activity, the conformance with the cerebral palsied infants, the properness of the music and the instruments, and the utility in the clinic field. This results mean that this developed music activity program is appropriate to help spastic cerebral palsied infants progress their movement development by stages.

• Dementia and Neurocognitive Disorders
• /
• v.21 no.2
• /
• pp.79-82
• /
• 2022

• Physical Therapy Korea
• /
• v.18 no.3
• /
• pp.16-25
• /
• 2011

This study aimed to evaluate factors related to the ability of ambulatory patients with cerebral palsy (CP) to walk over vertical and horizontal obstacles. Twenty patients with spastic CP who were able to walk independently for at least 10 m with or without walking devices were recruited for the study. Participants were required to walk over small obstacles (1, 4, and 8 cm in height or width; total of 6 conditions). A 'fail' was recorded when either the lower limbs or the walking device contacted the obstacle. Linear regression analyses were used to determine the effects of age, sex, walking devices, eyeglasses, subtype (hemiplegia or diplegia), ankle foot orthoses, functional level, and score of body mass index on the ability of obstacle crossing. Fifteen participants (75%) failed to adequately clear the foot or walking device over obstacles in at least 1 condition. The chance of failure in crossing vertical obstacle was affected by the use of ankle foot orthoses, eyeglasses, gender, and CP subtype (p<.05). The failure rate crossing horizontal obstacle was affected by CP subtype. These findings suggest that rehabilitation procedures should (1) consider the clinical characteristics of patients in order to prepare them to be more independent while performing daily activities, and (2) incorporate environmental conditions that patients encounter at home and in the community.

• The Journal of Internal Korean Medicine
• /
• v.41 no.5
• /
• pp.902-910
• /
• 2020

Medial medullary infarction, with representing symptoms of hemiparesis, lingual palsy, and sensory defect, usually has a bad prognosis. The present case is unusual as the patient had a bilateral infarction, and little information is available for bilateral cases. We treated a patient diagnosed with bilateral medial medullary infarction with the symptoms of quadriplegia, lingual palsy, dyspnea, dysphagia, spastic pain, and loss of proprioception. After 126 days of traditional Korean medicine treatment, the patient showed increased muscle power, sensory recovery, reduced spastic pain, and alleviation of dysphagia and dyspnea. This report indicates that traditional Korean medicine could be an effective treatment of the sequelae of medullary infarctions.

• Journal of the Korean Society of Physical Medicine
• /
• v.6 no.1
• /
• pp.71-79
• /
• 2011

Purpose : The purpose of this study was carried out to investigate the effect of repetitive transcranial magnetic stimulation on increase of H-reflex inhibition and fascilitation of range of motion of spastic ankle joint in chronic stroke patients. Methods : 30 chronic stroke patients were randomly divided into three groups, a control group(placebo rTMS group), 5 Hz rTMS group and manual therapy group. The MAS and ROM of ankle joint and H-reflex inhibition of soleus muscle were evaluated on each group. Results : The rTMS group decreased MAS of ankle joint and increased H-reflex inhibition of soleus muscle, and ROM of ankle joint than manual therapy group. The placebo rTMS group did not affected the change of MAS, ROM of ankle joint and H-reflex inhibition of soleus muscle. Conclusion : The rTMS was a good therapeutic tool to improve the foot drop in the chronic stroke patients.