• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.9
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• pp.4098-4106
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• 2012

This study aims to investigate the effect of trunk muscle strengthening exercises on balance performance of sitting posture and muscle tone, targeting the children with spastic diplegic cerebral palsy. 16 children with spastic diplegic cerebral palsy in IV phase of GMFCS were sampled at random and the tests were conducted for 6 weeks, 3 times per week. For experimental groups, only trunk muscle strengthening exercises were conducted and for control groups, only basic physical therapy was conducted. The trunk muscle strengthening exercise consisted of 2 exercises to strengthen abdominal muscles and back muscles. BPM(Balance Performance Monitor) was used to measure balance performance and MMAS(Modified Modified Ashworth Scale) was used to measure muscle tone. As a result, the changes of sitting balance performance in experimental groups and control groups show significant difference in the changes of sway path and sway velocity(p<.05), the comparison of changes in sitting balance performance in between experimental groups and control groups show significant difference in the changes of sway path and sway velocity(p<.05). Knee flexor muscles and hip adductor muscles in both groups show no significant difference in changes of the muscle tone(p>.05). Therefore, the balance performance in both experimental groups and control groups was improved. However, the experimental group had more significant improvement in balance performance and no change in muscle tone was detected in both groups. Thus, these findings show trunk muscle strengthening exercises are effective in improving the balance performance of sitting posture for the children with spastic diplegic cerebral palsy without changing muscle tone.

• The Journal of Korean Physical Therapy
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• v.16 no.4
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• pp.59-79
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• 2004

The purpose of this study was to determined the effects of reciprocal inhibition on spatial-temporal gait parameters in spastic hemiplegic patients through GaitRite system. The subjects were consisted 45 patients who had spastic hemiplegia due to stroke. All subjects randomly assigned to 3 group : manual reciprocal inhibition program group(manual group), neuromuscular electrical stimulation group(NMES group) and control group. The manual group received voluntary isometric contraction of pre-tibia muscle. The NMES group received neuromuscular electrical stimulation on tibialis anterior. The control group was not recieved any therapeutic intervention. Before and after experiments, spatial-temporal gait parameters and functional ambulatory profile was measure in all patients. The data of 30 patients who complete experimental course were statistically analysed. The results of this study were as following : 1. The percentage of change of functional ambulatory profile were markedly increased in manual group but statistically non significant(p>.01). 2. The percentage of change of gait velocity and cadence were markedly increased in manual group but statistically non significant(p>.01). 3. Asymmetry ratio of gait elements were more improved in manual group but statistically non significant(p>.01). 4. There were no statistical difference between pre-test and post-test with functional ambulatory profile, gait velocity, cadence and asymmetry ratios in NMES group(p>.01). 5. There were no statistical difference between pre-test and post-test with unctional ambulatory profile, gait velocity, cadence and asymmetry ratios in control group(p>.01). In conclusion, the present results revealed that reciprocal inhibition which produced by voluntary isometric contraction of pre-tibia muscle can be improved spatial-temporal gait parameters including functional ambulatory profile in hemiplegic patients. Therefore, reciprocal inhibition is useful to improve functional activities in hemiplegic patient. Further study should be done to analyze the effects of intervention duration of reciprocal inhibition, appropriate muscle contraction, optimal time to apply the reciprocal inhibition in more long period.

• The Journal of Korean Academy of Sensory Integration
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• v.17 no.1
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• pp.9-18
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• 2019

Objective : This study investigated the effect of intensive weight shift training (IWST) on the ability to balance in a sitting posture of children with spastic cerebral palsy (SCP). Methods : One child with spastic diplegia participated in this study for a total of 8 weeks using the ABA experimental design. For the pre-intervention period (A1), general physical therapy (GPT) for children with SCP was performed. The intervention period (B1 and B2), GPT and IWST were conducted for children with SCP, and GPT was conducted again for the post-intervention period (A'1 and A'2). Trunk control capacity was measured using the Korean Trunk Control Measurement Scale (TCMS-K) and Biorescue (RM Ingenierie, France). Results : All TCMS-K variables increased from A1 to B2, and decreased from B2 to A'2. The total area with limit of stability (LOS) increased from A1 to B2, and decreased from B2 to A'2. The ratio of the left/right (Lt/Rt) and anterior/posterior (Ant/Post) LOS area was closer to 1, meaning symmetry, in B2 than in A1. The ratio of the Lt/Rt LOS area decreased further from 1 in A'2 than in B2. The ratio of the Ant/Post LOS area was closer to 1 in A'2 than in B2. Conclusion : IWST had a positive effect on the improvement of balance in the sitting posture of a child with SCP. The results suggest that IWST might help to improve the balance abilities of children with SCP for independent sitting, postural control, and activities of daily living.

• Journal of Korean Physical Therapy Science
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• v.8 no.2
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• pp.1099-1104
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• 2001

The purpose of this single subject case study was to evaluate the effectiveness of a swedish knee cage worn to prevent genu recurvatum in right spastic hemiplegic with cerebral palsy. The subject was a 6-year-old female who had right side hemiparesis with genu recurvatum on affected side for the 18 month from January 1998 to June 1999. As a result, genu recurvatum of the patient was reduced the 7 degree after the putting on the swedish knee cage.

• Journal of Korean Neurosurgical Society
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• v.50 no.2
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• pp.95-98
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• 2011

Objective : This study aimed to evaluate the surgical outcomes of selective median neurotomy (SMN) for spastic wrist and fingers. Methods : We studied 22 patients with wrist and finger spasticity refractory to optimal oral medication and physical therapy. The authors evaluated spasticity of the wrist and finger muscles by comparing preoperative states with postoperative states using the modified Ashworth scale (MAS). We checked patients for changes in pain according to the visual analog scale (VAS) and degree of satisfaction based on the VAS. Results : The preoperative mean MAS score was $3.27{\pm}0.46$ ($mean{\pm}SD$), and mean MAS scores at 3, 6, and 12 months after surgery were $1.82{\pm}0.5$, $1.73{\pm}0.7$, and $1.77{\pm}0.81$ ($mean{\pm}SD$), respectively. On the last follow-up visit, the mean MAS score measured $1.64{\pm}0.9$ ($mean{\pm}SD$). Wrist and finger spasticity was significantly decreased at 3, 6, and 12 months after the operation (p<0.01). The preoperative mean pain VAS score was $5.85{\pm}1.07$ ($mean{\pm}SD$), and the mean pain VAS score on the last follow-up visit after surgery was $2.28{\pm}1.8$ ($mean{\pm}SD$). Compared with the preoperative mean pain VAS score, postoperative mean pain VAS score was decreased significantly (p<0.01). On the basis of a VAS ranging from 0 to 100, the mean degree of patient satisfaction was $64.09{\pm}15.93$ ($mean{\pm}SD$, range 30-90). Conclusion : The authors propose SMN as a possible effective procedure in achieving useful, long-lasting tone and in gaining voluntary movements in spastic wrists and fingers with low morbidity rates.

• Clinical and Experimental Pediatrics
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• v.48 no.9
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• pp.1004-1008
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• 2005

Hemangiomas are the most common benign tumors of infancy. Fifteen to 30% of these patients have multiple hemangiomas. Diffuse neonatal hemangiomatosis (DNH) is a disease that often has a fatal outcome if left untreated, and is characterized by multiple cutaneous and visceral hemangiomas. Corticosteroids are the commonly accepted first line treatment, but if no effect is seen, further treatment is required such as interferon, surgical excision, embolization and radiotherapy. Interferon is effective, but the neurologic sequela including spastic diplegia can be a complication. We experienced a case of DHN in a neonate. In this case, the baby presented with multiple cutaneous and visceral hemangiomas with Kasabach-Merritt syndrome (KMS) that included thrombocytopenia and consumptive coagulophthy. The baby was successfully treated with vincristine after the failure of steroid therapy.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.11 no.1
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• pp.88-98
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• 2011

Lesch-Nyhan syndrome is a X-linked recessive disorder caused by a deficiency of the enzyme hypoxanthine-guanidine phosphoribosyltransferase (HPRT), enzyme to recycle purines. Case history: born induced vaginal delivery at 40 weeks complicated by premature membrane ruputure, body weight 2.820 gm. He showed failure to thrive showing severe protein aversion like milk products and pink daper. Developmental delay revealing rolling over at 10.5 month, followed by regression. Seizure at 2 months, His poor oral feeding was lifelong problem. Weak crying, spastic, choreoathetoid movement. Self mutilating behavior noted and diagnosed at age 3 years. No family history of consanguinity and neurological disorders. Method: Laboratory test, physical exam, imaging study and molecular. Clinical follow up Treat ment with allopurinol. Result: uric acid 10.5 mg/dL (N 3.5-7.9), APRT 151.1uM/ min/ml pro(25.7-101), HPRT 7.6 (N 233.5-701) and c.151C>T hemizygote (p,Arg51X). Abdominal sonogram showed staghorn calculi in both kidneys, brain MRI brain atrophy. Clinical follow up showed, seizure at 2 mo, developmental delay (head control and, rolling over at at 11mo, pointing body part at 2 yr 7 mo, eye hand coordination at 2 y 11mo,creeping at 3 y 7 mo, speaking words at 6 y 6 mo ),and developmental regression at 3 yr of age. Sleeping problem including insomnia and severe constipation. Self mutilating behavior (lip bite) started at 2.5 yr, neurologic sx including intermittent upward gaze accompanied by swallowing difficulty at 3 y 7 mo grand mal seizure at 4.5 yr and spastic extremity and trunchal hypotonia and choleoathetoid movement and ataxia at 6.5 yr. Scoliosis with severe spasticity at 9 yr 9 mo. Acute life threatening episode with irregular breathing at 9 yr and 9 mo, Emaciation and nephrolithiasis and recurrent pneumonia. Died suddenly at 10 yr 3 mo. Conclusion: life long feeding problem, chronic gut motility dysfunction, sleeping difficulty and progressing neurologic deterioration and nephrolithiasis despite normal serum uric acid maintence by allopurinol treatment.

• Journal of Digital Convergence
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• v.12 no.5
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• pp.281-293
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• 2014

This study is to help fine some factors of how the Initial food consumption ability affects articulation production and intelligibility in children at aged 4-15 with cerebral palsy. According to the factor analysis of articulation production, here are some positive articulation productions; the ability of mumbling and swallowing food, biting and swallowing and liquid diet, the experience of food consumption therapy, the use of specific methods or tools for food consumption, the behavior-problem during a meal and the beginning of the neck control. Therefore, the study finds that the Initial food consumption ability in children with spastic cerebral palsy may affect articulation production and intelligibility.

• Journal of Digital Convergence
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• v.14 no.7
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• pp.213-223
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• 2016

The research mainly focused on how the nasagastric tube used to solve feeding troubles developed by 30 children with CP(Cerebral Palsy) affects the post-childhood feeding development right after their birth. It tested an articulation skill of the children and surveyed their feeding ability with their care-givers from 1st in July to 30th in August, 2015. This study conducted an investigation of the way a feeding ability affects an articulation skill. It suggested that an articulation accuracy significantly depends on whether or not the nasagastric tube is used. Also, the findings showed that the post-articulation accuracy is quite related with the problems for the liquid intake, the use of special feeding methods and tools, and biting and chewing among the evaluating problems for the childhood feeding ability. The research concluded that some areas in the early childhood feeding ability have an apparent influence on the post-articulation skill for children with CP.

• Journal of the Korean Society of Physical Medicine
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• v.7 no.3
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• pp.357-365
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• 2012

Purpose : The present study has been performed to find the effects on gross motor function and balance ability of applying a balance exercise program consisting of motions able to stimulate balance-related sensory systems on various support surfaces along with goal-oriented upper extremity tasks to enhance the balance ability. Methods : 10children diagnosed as having spastic diplegia were selected as the subject for this study, of whom 5children were randomly assigned to a control group (CG) and the remainder to a balance exercise group (BEG) to perform the upper extremity task on various support surfaces. Each intervention was executed 30minutes per session with 2sessions a week for 12weeks. To make comparisons before and after intervention, gross motor function measure; standing; demention D(GMFM;D), walking/running/jumping ;demention E (GMFM;E) and pediatric balance scale (PBS) were evaluated. Results : The CG showed a significant difference (p<.05) in GMFM;E. BEG showed a significant difference (p<.05) in GMFM;D as well as GMFM;E and in PBS before and after intervention. BEG showed a significant improvement (p<.05) in GMFM;D and the PBS compared with the CG whereas it did not indicate any statistically significant difference in GMFM;E. Conclusion : According to the results of this study, it has been shown that a balance exercise accompanied by upper extremity task on various support surfaces had an effect on improvement in the gross motor function and the balance ability of children with spastic diplegic cerebral palsy.