• 디지털융복합연구
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• 제12권5호
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• pp.281-293
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• 2014

본 연구는 만 4-15세까지의 뇌성마비 아동을 대상으로 초기 섭식능력이 조음기관 구조평가와 말 명료도에 영향을 미치는 변인이 무엇인지 파악하고자 하였다. 총 30명의 경직형 뇌성마비 아동을 대상으로 아동의 섭식 능력에 대해 설문하여, 뇌성마비 아동의 조음기관 구조평가와 말 명료도 검사를 실시하였다. 조음기관 구조평가에 영향을 미치는 요인을 분석한 결과 음식삼키기 가능여부와 병원서 섭식에 대한 치료경험여부, 깨물어 씹기 가능여부, 유동식 섭취가능여부, 섭식에 특별한 방법과 도구 사용여부, 식사 중 문제행동여부, 가누기 시작시기에서 조음평가에 긍정적 영향을 미쳤다. 이상의 연구결과에서 보는 바와 같이 경직형 뇌성마비 아동의 초기 섭식능력이 조음기관 구조평가와 말 명료도에 영향을 미치는 것으로 나타났다.

• 디지털융복합연구
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• 제14권7호
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• pp.213-223
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• 2016

본 연구는 경직형 뇌성마비 아동 30명을 대상으로 출생직후 섭식문제를 해결하기 위해 사용되는 비위관이 이후 아동의 섭식발달에 어떠한 영향을 주는지 살펴보았다. 2015년 7월 1일부터 8월 30일까지 뇌성마비 아동을 대상으로 조음능력을 평가하고 주양육자를 통한 섭식능력에 대한 설문조사를 실시하였다. 또한 섭식능력이 조음능력에 미치는 영향에 대해 살펴보았다. 수집된 자료는 SPSS 20.0을 사용하여 분석하였다. 연구결과 비위관의 사용여부는 조음정확도에 유의미한 차이를 보였다. 또한 섭식능력을 평가하는 문항 중 유동식 섭취가능여부, 섭식을 위한 특별한 방법과 도구사용여부, 깨물어 씹기 가능여부는 이후 조음정확도와 관련이 있는 것으로 나타났다. 본 연구 결과 초기 섭식능력의 일부 영역은 이후 조음능력에 영향을 미치는 것으로 보이며 예방적 차원의 접근과 조기개입이 적극적으로 이루어져야 할 것으로 생각된다.

• 대한물리의학회지
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• 제7권3호
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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.

• 대한한의학회지
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• 제40권1호
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• pp.12-23
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• 2019

Objectives: The purpose of this study was to analyze the aspects of the Korean medicine (KM) treatment among children with cerebral palsy (CP) according to the disease characteristics. Methods: In a prospective observational multicenter study for children with CP, we analyzed 78 baseline questionnaires of children having experience of KM treatments such as acupuncture and Korean herbal medicine and 43 follow-up data of children who have received KM during the one observation year. Results: Of all the 182 participants, 38 children were currently getting KM treatment and 40 children have discontinued KM treatment. Children with non-spastic CP and more health problems tended to use KM. The most frequent reason for quitting acupuncture therapy was 'suffering of children' and the highest reason of stopping herbal medicine was 'rejection of children'. Among the 133 participants finished one year follow-up, 43 children have received at least one KM treatment. The average number of acupuncture therapy was twice a week and the average monthly cost of acupuncture therapy and herbal medicine were 65,922 won and 476,003 won, respectively. Children under 32 month old have received significantly more acupuncture and children with non-spastic CP have taken significantly more herbal medicine. Conclusions: Further study will be required to confirm the effectiveness of KM and increase the utilization of KM among the children with CP. More efforts should be made to increase the convenience of acupuncture therapy and herbal medicine and to expand the insurance coverage of KM for children with CP.

• The Journal of Korean Physical Therapy
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• 제27권6호
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• pp.425-429
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• 2015

Purpose: This study was to identify the whether there is any correlation between Gross Motor Function Measures (GMFM) and Functional independence Measurement for children (WeeFIM) in order to identify a relevance of daily life motor with gross motor function of children with cerebral palsy. Methods: Subjects were instructed to evaluated by an occupational therapist using WeeFIM (reliability 0.83-0.99) and by a physical therapist using GMFM (reliability 0.93). 10 male children and 13 female children among 23 children being diagnosed as cerebral palsy were targeted for this study. A correlation between GMFM and WeeFIM was analyzed with Kendall correlation. Results: Participants showed significant correlation between GMFM and WeeFIM in all categories, except in the GMFM's walking running jumping category, standing category of GMFM and self care, sphincter control, communication category of WeeFIM. Lying rolling and sitting and crawling kneeling area of GMFM showed a significant correlation with self care(r=0.35, 0.39, 0.4), sphincter control (r=0.45, 0.43, 0.61), mobility transfer (r=0.44, 0.36, 0.64), locomotion (r=0.41, 0.35, 0.74), communication (r=0.4, 0.44, 0.51), and social cognition (r=0.43, 0.51, 0.64) area of WeeFIM (p<0.05). Standing of GMFM and mobility transfer (r=0.74), locomotion (r=0.47) and social cognition (r=0.4) area of WeeFIM showed a significant correlation (p<0.05). Conclusion: These findings indicated significant correlation between activity of daily living (ADL) and gross motor function of children with cerebral palsy. However, because there are a few results that are not significant, both assessment tools should be used for evaluations so that treatment can be achieved with an accurate assessment and establish a therapeutic plan.

• 말소리와 음성과학
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• 제12권3호
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• pp.95-103
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• 2020

본 연구의 목적은 경직형 뇌성마비 아동의 하위그룹별로 말속도와 쉼에서 차이가 있는지 살펴보고, 말명료도와의 관련성에 대해서 알아보고자 하였다. 연구대상은 경직형 뇌성마비 아동 26명이 참여하였다. 말문제와 언어문제가 없는 NSMI-LCT 4명, 말문제는 없지만 언어문제가 있는 NSMI-LCI 그룹 6명, 말문제가 있지만 언어문제는 없는 SMI-LCT 6명, 말과 언어문제를 모두 동반하는 SMI-LCI 그룹 10명이 참여하였다. 연구과제는 문장 따라말하기였고, Praat을 통해 말속도, 조음속도, 쉼 시간의 비율, 평균 쉼 횟수, 평균 쉼 시간을 측정하였다. 연구결과, 첫째, 말속도와 조음속도는 언어문제의 유무와 관계없이 NSMI와 SMI 그룹 간에 유의한 차이가 나타났다. 둘째, NSMI에 비해 SMI 그룹에서에서 쉼 시간의 비율은 더 높고, 쉼 횟수는 더 빈번하였으며 쉼 시간은 더 길게 나타났다. 셋째, 말속도와 조음속도는 말명료도와 유의한 상관을 나타내었다. 본 연구의 결과는 느린 말속도가 SMI 그룹의 말산출 과정에서 나타나는 주요한 특성이고, 말명료도에 있어서 조음속도와 말속도가 중요한 역할을 함을 시사한다.

• 한국전문물리치료학회지
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• 제17권1호
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• pp.62-68
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• 2010

The purposes of this study were to examine inter-rater reliability of the Manual Ability Classification System (MACS) by children's age and to identify the correlation between the MACS and the Gross Motor Function Classification System (GMFCS) in children with cerebral palsy (CP). Twenty-six children with CP older than two years participated. Children with CP were classified according to the MACS and the GMFCS by two physical therapists. Inter-rater reliability was analyzed using the Intraclass Correlation Coefficients (ICCs). The results showed that the reliability of the MACS for children aged 2~3 years was .88 and for children aged above 4 years was .98 (p<.05). Children with quadriplegia had a higher level of MACS than children with spastic hemiplegia and diplegia. A moderate relationship between the MACS and the GMFCS was found in all children (rater 1, r=.631; rater 2, r=.438). The MACS will be used for classification of children with CP according to the manual abilities. Thus, it offers a reliable method for communicating between therapists about the manual ability of children with CP who are older than 2 years.

• 음성과학
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• 제15권3호
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• pp.103-116
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• 2008

Cerebral palsy children represent abnormal vocalization pattern caused by respiration problem and paralyzed oral motor muscle that are the basics of speech production. Thus, this study examined the effect of respiration and articulator training programs on the basic ability of speech production in CP children. The subjects of this study were 4 children with 3 of spastic CP and 1 of ataxia CP. The respiration and articulator program was conducted in 30 sessions for 30 minutes each. Pre-test was administered twice before the program, ongoing test was administered every 5 session during the period of experiment, and post-test was administered twice. The program included speech production such as respiration training, lips, jaw, cheek, and tongue exercise, and velopharyngeal training, and related articulator training. The following results were obtained. First, all subject children were less than 5 seconds in maximum phonation time before the experiment and 2 were improved by more than 4$\sim$5 seconds during the experiment, but 2 had relatively low rising width. Second, while children with less than 30dB before the experiment became bigger in strength during the experiment, children with more than 35dB before the experiment showed a minor change. Subject child 4 had lower vocal strength in the post-test period. Finally, although each subject had individual difference in syllable diadochokinetic ability, the function was improved and the number of repetition in one respiration was also increased.

• The Korean Journal of Pain
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• 제9권1호
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• pp.232-234
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• 1996

For surgical Treatment of spastic deformities of the foot, selective peripheral neurotomies were introduced. These neurotomies utilize microsurgical techniques and intraoperative electrical stimulation for better identification of the function of the fascicles constituting the nerve. Selectivity is required to supress the excess of spasticity without excessive weakening of motor strength and without producing exaggerated amyotrophy. To achieve this goal, minimum one fourth of the motor fibers must be preserved. Neurotomies may be indicated when spasticity is localized to muscle or muscle groups supplied by a single or a few peripheral nerves that are easily accessible. To help the surgeon decide if neurotomy is appropriate, temporary local anesthetic block of the nerve with bupivacaine can be useful. Such a test can determine if articular limitations result from spasticity, musculotendinous contractures, or articular ankyloses because only spasticity is decreased by the test. In additon, these tests give the patient a chance to appreciate what to expect from the operation.

• 대한물리치료과학회지
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• 제5권3호
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• pp.617-624
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• 1998

A variety of neuromuscular diseases in children cause muscle imbalance. impaired function, and resultant deformity of the lower extremities. Equinovarus, equinos, adductor contracture are common deformity of lower extremities in the children. Generally, the transfer was successful in improving or maintaining range of motion, stability of the joint and gait. Postoperative physical therapy is important. Physical therapy was instituted after cast removal. All children received stretching exercise, range of motion exercise for the joint, proprioceptive neuromuscular fascilitation and gait training was administered. This article describes our experience with the physical therapy for tendon transfered spastic cerebral palsy and discusses the therapeutic protocol.