• The Journal of Korean Academy of Sensory Integration
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• v.4 no.1
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• pp.47-55
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• 2006

Objective : The purpose of this study was to evaluate the correlation between visual perception ability and activities of daily living(ADL) in the children with spastic diplegia who were treated at developmental disabilities children salutary institute. Method : The subject were consisted of 8 children with spastic diplegia(mean age, 10). The visual perception ability was measured by the Developmental Test of Visual Perception(DTVP) and by the Functional Independence Measure for Children(WeeFIM) to evaluate activities of daily living. Collected data analysis were completed by using correlation analysis. Results : Visual perception ability of children with spastic diplegia is the highest in Position in Space(PS) score, and is the lowest in Visual-Motor coordination(VM) score. Average visual perception performance of children with spastic diplegia is the highest in SR(Spatial relationship) score, and is the lowest in VM score. In activities of daily living, eating component were significantly correlated with Visual-Motor coordination. Conclusions : Therefore, accurate evaluation of visual perception ability and visual perception training for children with spastic diplegia will be important to improve patient's activities of daily living skill.

• PNF and Movement
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• v.19 no.2
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• pp.163-172
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• 2021

Purpose: This study investigated the correlation between physical function and forward head posture in spastic diplegia. Methods: The subjects of this study were 10 spastic diplegia patients. We took pictures of the subjects' craniovertebral angle with a digital camera to determine the degree of forward head posture and then analyzed them using the NIH image J program. The physical function test used the TCMS, the BBT, and a spirometer. The data in this study were measured using SPSS version 23.0, and the statistical significance level α was 0.05. A Pearson correlation coefficient analysis was performed to identify the correlation between the degree of the subject's head forward position and physical function. Results: When we performed the BBT and spirometer tests, the subjects' forward head postures were not correlated (p < 0.05). However, with the TCMS, there was a strong correlation between the forward position of the head and balance, with balance decreasing as the head position increased (p < 0.05). Conclusion: Spastic diplegia patients with severe forward head posture showed problems with static balance, dynamic balance, and equilibrium reaction when sitting. Intervention on the right posture and preventive activities will be needed to improve the health of spastic diplegia patients and prevent future problems with physical function.

• Journal of the Korean Society of Physical Medicine
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• v.16 no.3
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• pp.123-130
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• 2021

PURPOSE: Robotic gait training is being used increasingly to improve the gross motor performance and gait speed. The present study examined the effectiveness of a novel end-effector type of robotic gait training (RGT) system on standing, walking, running, and jumping functions, as well as the gait speed in children with spastic cerebral palsy. METHODS: Eleven children with spastic cerebral palsy Gross Motor Function Classification System (GMFCS) levels I-III (6 males; age range, 15.09 ± 1.44 years) were examined. They underwent 24 sessions (30 minutes/sessions, one time/day, three days/week for eight consecutive weeks) of RGT. The Gross Motor Function Measure-88 D domain (GMFM D), and GMFM E were assessed with a pretest and posttest of RGT. The setting was a one-group pretest-posttest design. RESULTS: A comparison of the pre-test and post-test show that the outcomes in post-test of GMFM D (p < .01), GMFM E (p < .05), and 10MWT were improved significantly after RGT intervention. CONCLUSION: The present study provided the first evidence on the effects of an eight-weeks RGT intervention in participants with spastic CP. The outcomes of this clinical study showed that standing performance, locomotion function, and gait speed increased in after 24 sessions of the end-effector RGT system in children with spastic cerebral palsy.

• PNF and Movement
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• v.21 no.2
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• pp.265-272
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• 2023

Purpose: The purpose of this study was to investigate tactile sense perception of the lower extremities according to physical function in children with spastic cerebral palsy. Methods: This study was conducted on 15 children diagnosed with spastic cerebral palsy. Physical function measurement items included dynamic balance ability, gross motor function level, and lower extremity ankle spasticity. The lower extremity tactile sensation uses a monofilament to measure the sole of the first metatarsal head, the sole of the fifth metatarsal head, the heel, the anterior part of the shin midway between the patella and the ankle joint, the kneecap, the upper anterior iliac spine, and the knee. A total of six measurements were taken in the mid-femoral region of the bone. Spearman correlation analysis was performed to determine the degree of body function and lower extremity tactile perception. Results: As the physical function of children with spastic cerebral palsy deteriorated, there was a decrease in tactile sensation in the thigh area corresponding to the proximal lower extremity. (p <.05). Conclusion: Children with spastic cerebral palsy and poor physical function have sensory loss not only in the distal part but also in the proximal part, so a treatment approach that recognizes and improves it is necessary.

• The Journal of Korean Physical Therapy
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• v.30 no.4
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• pp.123-128
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• 2018

Purpose: This study examined the effects of neuromuscular electrical stimulation (NMES) and horseback riding using a robotic device on the trunk muscle activity and gross motor function in children with spastic diplegia. Methods: Children with spastic diplegia were divided into two groups: an experimental group (NMES and horseback riding using a robotic device [n=10]) and a control group (placebo NMES and horseback riding using a robotic device [n=10]). Each group received general physical therapy and occupational therapy. Each intervention involved the administration of NMES for 15 minutes and horseback riding using robotic device therapy for 15 minutes three times a week for 4 weeks. The evaluation included both the rectus abdominis muscles (RA), external oblique muscles (EO), thoracic paraspinal muscles (TP), and lumbar paraspinal muscles (LP) activity and GMFM. Results: The RA, EO, TP, and LP muscle activity, GMFM C, D, and E were increased significantly in the experimental and control groups. A significant increase in both the TP muscle activity and GMFM D was observed in the experimental group compared to the control group. Conclusion: This study showed that horseback riding using a robotic device is an effective intervention for trunk muscle activity and GMFM in children with spastic diplegia. However, if NMES is added to the back muscles, it is possible to further increase the thoracic paraspinal muscle activity and standing ability.

• Physical Therapy Korea
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• v.19 no.3
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• pp.81-90
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• 2012

The aim of the current study was to assess the effectiveness of backward gait training on the treadmill in patients with spastic diplegic cerebral palsy (CP). Twelve patients with spastic diplegic CP participated in the study. An 8-week course of backward gait training was administered to the subjects for 3 days per week. Pre-intervention and post-intervention assessments of temporal-spatial gait parameters, the symmetry of the bilateral lower extremity weight bearing, and gross motor function were analyzed using motion analysis system, force plate, and Gross Motor Function Measurement (GMFM). There were significant improvements (p<.05) in the measures of both step length and right stance phase time. Joint kinematics showed increase in right hip abduction in initial contact and terminal swing, right hip external rotation and knee flexion in mid-swing, left ankle dorsiflexion in initial contact and terminal swing (p<.05). The symmetry of the bilateral lower extremity weight bearing and GMFM also significantly increased (p<.05). These findings indicate that backward gait training using a treadmill is beneficial for patients with spastic diplegic CP.

• Journal of the Korean Society of Physical Medicine
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• v.7 no.2
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• pp.213-221
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• 2012

Purpose : The purpose of this study was to investigate the effect of Vojta therapy on Gross Motor Function Measurement(GMFM) and Selective Voluntary Motor Control (SVMC) in children with Spastic diplegia. Methods : During this experiment, the subject of four children diagnosed with spastic diplegia was tested using ABA design for Single-subject Experimental Research Design. The procedure consisted of baseline, intervention and follow-up phase which was held thirty minutes each for three times a week for a total of 24 times. Gross motor function was measured using GMFM and selective voluntary motor control was measured using SCALE. Results : According to this study, the gross motor function and selective voluntary motor control of all subjects were improved from their intervention phase to their baseline phase. During the follow phase which the intervention was removed, the ability that was enhanced during the prior phases was still either maintained or only reduced slightly. Conclusion : The Vojta therapy used on children diagnosed with spastic diplegia was effective on both GMFM and SVMC. In other words, the therapy was effective on coordination. However, this study is difficult to be generalized due to the insufficient number of subject. In further studies, it will be necessary to increase the number of trials with a control group in order to generalize the effectiveness of Vojta therapy.

• Physical Therapy Korea
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• v.19 no.4
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• pp.16-23
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• 2012

This study examined the effects of custom-made foot orthotics on the temporal-spatial gait parameters in children with cerebral palsy. Twenty spastic bilateral cerebral palsy (spastic CP) children (11 boys and 9 girls) participated in this study. GAITRite was used to examine the velocity, cadence, step length differential, step length, stride length, stance time, single support time, double support time, base of support, and toe angle while walking with and without foot orthotics. The differences in temporal-spatial parameters were analyzed using paired t-test. The significance level was set at .05. The velocity, cadence, both step lengths, both stride lengths, both bases of support and right toe angle significantly increased when the children with spastic CP with foot orthotics compared to without foot orthotics (p<.05). The step length differential between the two extremities, left stance time and left single support time, significantly decreased with foot orthotics (p<.05). Right stance time, right single support time, both double support times and left toe angle showed little change (p>.05). This study demonstrated that foot orthotics were beneficial for children with spastic CP as a gait assistance tool.

• Journal of the Korean Society for Precision Engineering
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• v.23 no.7 s.184
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• pp.152-158
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• 2006

The objective of this work is to develop the knee joint model for representing various pendulum motions and quantifying the spasticity. Knee joint model included the extension and flexion muscles. The joint moment consists of both the active moment from the stretch reflex and the passive moment from the viscoelastic joint properties. The stretch reflex was modeled as nonlinear feedback of muscle length and the muscle lengthening velocity, which is Physiologically-feasible. Moreover, we modeled the spastic reflex as having dynamic threshold to account far the various pendulum trajectories of spastic patients. We determined the model parameters of three patients who showed different pendulum trajectories through minimization of error between experimental and simulated trajectories. The simulated joint trajectories closely matched with the experimental ones, which show the proposed model can predict pendulum motions of patients with different spastic severities. The predicted muscle force from spastic reflex appeared more frequently in the severe spastic patient, which indicates the dynamic threshold relaxes slowly in this patient as is manifested by the variation coefficient of dynamic threshold. The proposed method provides prediction of muscle force and intuitive and objective evaluation of spasticity and it is expected to be useful in quantitative assessment of spasticity.

• Journal of the Korean Society of Physical Medicine
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• v.12 no.2
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• pp.103-111
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• 2017

PURPOSE: This study was aimed to investigate the effects of pelvic movements-based training on trunk stability and balance during sitting in children with spastic cerebral palsy. METHODS: Ten children with spastic cerebral palsy were matched to an intervention (n=5) or control group (n=5). The intervention consisted of two weeks of pelvic movements-based training, five times a week. All participants were evaluated before, during, and after pelvic movements-based training using a trunk impairment scale (TIS) for trunk stability and a modified functional reaching test for balance during sitting. The collected data were analyzed using Repeated Measures ANOVA and the Mann-Whitney U test. RESULTS: The results of this study were as follows: 1) Significant increases in the TIS score (only dynamic balance) and forward reaching were observed in the experimental group, compared with the control group, after training (P<.05). 2) There were statistically significant time-factor increases within and between the subject' effects, in the TIS score (dynamic balance and total), dominant side, non-dominant side, and forward reaching (P<.05). CONCLUSION: In conclusion, this study showed that for children with spastic cerebral palsy, pelvic movements-based training improves trunk stability and balance during sitting. Further studies will be required to determine the long-term effects of pelvic movements-based training.