• Title/Summary/Keyword: Spastic

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Effects of Contralateral Seventh Cervical Nerve Transfer on Upper Extremity Motor Function in the Patients with Spastic Hemiplegia after Stroke: a Retrospective Cohort Study

  • Wonjae Choi
    • Physical Therapy Rehabilitation Science
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    • v.11 no.4
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    • pp.502-508
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    • 2022
  • Objective: Contralateral seventh cervical nerve transfer (contralateral C7 transfer) is a newly attempted method to restore upper extremity motor function in the patients with spastic arm paralysis. The aim of this study was to investigate the effects of contralateral C7 transfer on upper extremity motor function in the patients with spastic hemiplegia after stroke. Design: A retrospective cohort study. Methods: Thirty-four patients with spastic hemiplegia after stroke was investigated. All patients registered between January 2020 and February 2021. The subjects were assessed on upper extremity motor function, cognition, and spasticity before and after contralateral C7 transfer. The upper extremity motor function was measured using the Fugl-Meyer upper extremity scale and box & block test. The cognition and spasticity were assessed by Korean version mini mental state examination (K-MMSE) and modified Ashworth scale from baseline to 8 weeks after the surgery. Results: The Fugl-Meyer upper extremity scale and modified Ashworth scale were significantly improved after contralateral C7 transfer (p<0.05). However, box & block test and K-MMSE were no significant changes after the surgery (p>0.05). Conclusions: This study suggested that the contralateral C7 transfer was a feasible and practical approach to improve upper extremity motor function in the patients with spastic hemiplegia after stroke, but further study is required to identify the long-term effects after the contralateral C7 transfer.

Assessment of Hand Function in Spastic and Athetoid Cerebral Palsied Children by Jebsen Hand Function Test (경련성과 무정위성 뇌성마비 아동의 Jebsen Hand Function Test에 의한 손기능 평가)

  • Lee, Cu-Rie;Lee, Mi-Ja
    • Journal of Korean Physical Therapy Science
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    • v.3 no.2
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    • pp.981-987
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    • 1996
  • Hand function evaluations are an important element of the assessment process in physical rehabilitation settings. The purpose of this study was to investigate hand function evaluation. Subjects consisted of 20 with spastic cerebral palsy(mean age = 9.8, SD = 1.6) and 20 with athetoid cerebral palsy(mean age = 9.6, SD = 2.3). Two groups of subjects were tested twice(pretest and posttest) by the JHFT to measure evaluations of hand function. These findings suggest that on four subtests - writing, card turning, large heavy objects and Stacking Checker-the spastic cerebral palsy perform significantly faster than athetoid cerebral palsy. But there were no significant differences between the pretest and posttest in spastic and athetoid cerebral palsy. To see the statistical differences in the experimental results was done using origin V. 3.0.

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The Comparison of Different of Normal Development Walking and Walking Characteristics of Children with Spastic Cerebral Palsy (보행의 정상발달 및 요소와 경직형 뇌성마비 아동의 보행 특성의 비교 연구)

  • Oh Tae-young
    • The Journal of Korean Physical Therapy
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    • v.9 no.1
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    • pp.195-204
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    • 1997
  • The Purpose of this study was to compare the different of normal development and walking characteristics of children with spastic cerebral palsy, and to guide theraputic approach for improve on walking. Key contributions from normal development of standing and walking, abnormol walking pattern of children with spastic cerebral palsy are studies. Spastic cerebral palsy includes an increased factors of problem in standing, walking : These are deformity of lowerextremities, arm used for balancing, asymmetic walking, abnormal walking patterns, build .up Treatment goal is to normal walking patterns. and to prevent secondary deformity. In this study, normal walking is very important factors in daily activities, then to recovery function of children with cerebral palsy, its need more adapted several method.

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The Effects of Vojta's Treatment on Respiratory Muscle Activity and Phonation in children with Spastic Cerebral Palsy (보이타 치료중재가 뇌성마비아동의 근활성화 및 발성에 미치는 효과)

  • Joo, Jichan;Lee, Hyojeong
    • Journal of The Korean Society of Integrative Medicine
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    • v.1 no.3
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    • pp.37-49
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    • 2013
  • Purpose : The purpose of this study was to evaluate the influence of Respiratory Capacity by Vojta's treatment in children with spastic cerebral palsy. Method : The subjects of this study, children diagnosed with spastic cerebral palsy, 12 patients were picked up, who were agreed with this research and were having hospital care for 4weeks at MH and PR medical centers. Result : In comparison of Respiratory muscle activity and Phonation capacity were significant in the group(p<.01) and MPT and Rectus abd(Rt) were significantly correlated in the pre test and SMR and Ex/oblique (Lt) were significantly correlated in the post test. Conclusion : Therefore, the Vojta's treatment is useful to improve the Respiratory muscle activity and Phonation capacity in children with spastic cerebral palsy.

One Family with Hereditary Spastic Paraplegia due to SPG4 Gene Mutation (SPG4 유전자 변이에 의한 유전경직하반신마비를 보인 가족 1예)

  • Cho, Jeong-Seon;Kim, Doo-Eung;Kim, Jung-Mee;Han, Young-Su;Ha, Sang-Won;Park, Sang-Eun;Han, Jeong-Ho;Cho, Eun-Kyoung
    • Annals of Clinical Neurophysiology
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    • v.7 no.2
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    • pp.138-140
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    • 2005
  • Strumpell, in 1880, was the first to describe familial case of spastic paraplegia characterized by progressive weakness and spasticity of the lower limbs with little or no involvement of the upper extremities. This syndrome is heterogeneous in inheritance, age of onset, severity and associated signs. We present one family with autosomal dominant hereditary spastic paraplegia (HSP) due to SPG4 (spastin) gene mutation which is confirmed by genomic DNA isolated from peripheral blood.

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The Characteristics of Nasalance in Speakers with Spastic Cerebral Palsy according to the Types of Sentence used for Nasalance Test (비성도 검사 문형에 따른 경직형 뇌성마비 화자의 비성도 특성)

  • Nam, Hyun-Wook;Yoo, Jae-Yeon
    • Phonetics and Speech Sciences
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    • v.2 no.1
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    • pp.121-125
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    • 2010
  • The purpose of this study was to compare the characteristics of nasalance in speakers with spastic cerebral palsy (CP) according to the types of sentence used for nasalance test. Twenty-eight speakers with spastic CP participated in this study. The experiment was conducted by analyzing nasalance of prolonged vowel utterance using the Sea sentence, the Zoo sentence, and the Mother sentence. The three sentences differ in the ratio of nasal consonants. The results show significant differences among the types of sentence for nasalance test.

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Microsurgical Selective Obturator Neurotomy for Spastic Hip Adduction

  • Park, Yeul-Bum;Kim, Seong-Ho;Kim, Sang-Woo;Chang, Chul-Hoon;Cho, Soo-Ho;Jang, Sung-Ho
    • Journal of Korean Neurosurgical Society
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    • v.41 no.1
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    • pp.22-26
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    • 2007
  • Objective : Cerebral palsy may induce harmful spastic hip adduction. We report the result of microsurgical selective obturator neurotomy, performed on 12 spastic hip adductions of 6 patients, followed clinically for at least 26 months postoperatively. Methods : Microsurgical selective obturator neurotomies, involving microsurgical resection of the anterior obturator nerve branches were performed on 6 patients from January 2000 through June 2003. All patients presented with the inability to sit and 2 patients complained of persistent, intractable pain. We used intraoperative bipolar stimulation to identify selected motor branches. Results : The procedure was performed bilaterally in all patients. In the 3 patients in whom contractures were present, microsurgical selective obturator neurotomies were accompanied by an additional tenotomy of the adductor muscles. Selective tibial neurotomy was performed on three of six patients who originally presented with a spastic ankle. Postoperatively, all spastic hip adductions were corrected more than 60 degrees in passive abduction-adduction amplitude. However, one patient who did not receive active postoperative physiotherapy demonstrated a decreased passive abduction-adduction amplitude upon follow-up. There were no surgical complications. Conclusion : We think microsurgical selective obturator neurotomy may be an effective procedure in the treatment of localized, harmful spastic hip adduction after failure of well conducted conservative treatment. As muscular contractions are often associated with spasticity of the hip adductors, an adjunctive tenotomy may be an option. Comprehensive postoperative physiotherapy is essential to improve long-term results.

The Effects of Trunk Muscle Strength Training on Sitting Balance of Children with Spastic Cerebral Palsy (체간 근력 강화 훈련이 경직성 뇌성마비아의 앉은 자세 균형에 미치는 효과)

  • Oh Jung-Lim
    • The Journal of Korean Physical Therapy
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    • v.15 no.4
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    • pp.255-298
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    • 2003
  • The purpose of study was to evaluate effects of a trunk muscle strength training on sitting balance of children with spastic cerebral palsy. Five individuals with spastic cerebral palsy(three females. two males; mean aged 6.6) participated three times a week over 6 weeks. Five individuals with spastic cerebral palsy(three females. two males; mean aged 7.0) who did not receive strength training served as control. BPM(Balance Performance Moniter) was used to measured sitting balance and EMG(electromyograph, NORAXON, USA) was used to measured activities of abdominal and erector spine muscle. The obtain result are as follows. 1. The result of this study were following that maximum perturbation area and perturbation velocity were significantly reduced strength training group compared with control group(p<.05). 2. The result of this study were following that maximum perturbation area and perturbation velocity were significantly reduced after strength training compared with pre strength training in strength training group(p<.05). 3. The result of this study were following that maximum perturbation area and perturbation velocity were not significantly reduced at interval of six week in control group(p<.05). 4. The result of this study were following that abdominal muscle activity was significantly increased strength training group compared with control group(p<.05). 5. The result of this study were following that erector spine muscle activity was significantly increased strength training group compared with control group(p<.05). 6. The result of this study were following that abdominal muscle activity and erector spine muscle were significantly increased after strength training compared with pre strength training in strength training group(p<.05). 7. The result of this study were following that abdominal muscle activity and erector spine muscle were not significantly increased at interval of six week in control group(p<.05). In conclusion, the result of this study suggest that improved sitting balance and increased activities of trunk muscle by trunk strength training in spastic cerebral palsy. The result was proposed that therapeutic approach of spastic cerebral palsy with impaired sitting balance should use trunk strength training.

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Long-Term Results of Microsurgical Selective Tibial Neurotomy for Spastic Foot : Comparison of Adult and Child

  • Kim, Jong-Hoon;Lee, Jae-Il;Kim, Min-Su;Kim, Seong-Ho
    • Journal of Korean Neurosurgical Society
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    • v.47 no.4
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    • pp.247-251
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    • 2010
  • Objective : Selective neurotomy is generally a safe, effective, and long-lasting treatment for patients with spastic equinovarus foot deformity. We retrospectively analyzed the results of microsurgical selective tibial neurotomy (STN) for spastic feet in adults and children. Methods : A neurosurgeon selected 32 patients with 45 spastic feet (adults : 13, children : 32) to undergo microsurgical STN between October 1998 and September 2007. A physician of rehabilitation assessed spasticity pre- and postoperatively, that was based on the Ashworth scale, ankle clonus, and the amplitude of ankle dorsiflexion. The mean postoperative follow-up period was 36.7 months in adults and 42.5 months in children. Results : Spastic components of the feet were corrected immediately after surgery in both the adult and child groups. The mean Ashworth's grade changed from $3.6{\pm}0.40$ to $1.6{\pm}0.70$ in adults and from $3.7{\pm}0.69$ to $1.4{\pm}0.49$ in children. Mean ankle clonus decreased markedly, from $1.6{\pm}0.79$ to $0.3{\pm}0.42$ in adults and from $1.7{\pm}0.65$ to $0.3{\pm}0.56$ in children. The mean amplitude of ankle dorsiflexion was improved, but eight (adults: 4, children: 4) contracted feet needed complementary orthopedic correction for acceptable results. Conclusion : STN can be effective in the long-term for improving lower limb function and reduction of equinovarus deformity. Our results demonstrate that STN might be an effective procedure for treating localized harmful spastic feet in adults and children.

The Effects of Changing the Respiratory Muscles and Acoustic Parameters on the Children With Spastic Cerebral Palsy (체간 조절을 통한 앉기 자세 교정이 경직형 뇌성마비 아동들의 호흡근과 음향학적 측정치들의 변화에 미치는 효과)

  • Kim, Sun-Hee;Ahn, Jong-Bok;Seo, Hye-Jung;Kwon, Do-Ha
    • Physical Therapy Korea
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    • v.16 no.2
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    • pp.16-23
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    • 2009
  • The purpose of this study was to investigate the effects postural changes on respiratory muscles and acoustic parameters of the children with spastic cerebral palsy. Nine children with spastic cerebral palsy who required assistance when walking were selected. The ages of the children ranged from 6 to 9 years old. The phonation of the sustained vowel /a/ and the voice qualities of each child such as fundamental frequency($F_0$; Hz), pitch variation (Jitter; %), amplitude variation (Shimmer; %) and noise to harmonic ratio (NHR) were analyzed by Multi-Dimensional Voice Program (MDVP). The muscle activity of three major respiratory muscles: pectoralis major muscle, upper trapezius muscle and rectus abdorminalis muscle, were measured by examining the root mean square (RMS) of the surface EMG to investigate the impact of changes in the adjusted sitting posture of each subject. However, the RMS of pectoralis major muscle showed a significant differences (p<.05). Secondly, there were no significant differences in $F_0$, Jitter and Shimmer between pre and post posture change, but there was a significant difference in NHR (p<.05). The data were collected in each individual; once prior and once after the sitting posture change. The data were analyzed by Wilcoxon signed ranks-test using SPSS version 14.0 for Windows. The findings of this study were as follows; Firstly, the RMS of upper trapezius and rectus abdorminalis muscle were not significant different between pre and post sitting posture changes. From the result, it is concluded that changes in the adjusted sitting posture decreases the abnormal respiratory patterns in the children with spastic cerebral palsy which is characterized by the hyperactivity of the respiratory muscles in breathing. Also, there is increased on the voice qualities in children with spastic cerebral palsy.

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