• Journal of the Korean Society of Physical Medicine
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• v.7 no.4
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• pp.471-480
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• 2012

PURPOSE: The object of the present study is to investigate the effects of the insole supporting medial longitudinal arch while walking in spastic cerebral palsy with pes planus. METHODS: Ten spastic bilateral cerebral palsy children with pes planus participated in this study. The insole were custom-made for the individual child. Muscle activity was measured by surface EMGs attached on tibialis anterior (TA), gastrocnemius (GA), vastus medialis oblique (VMO), biceps femoris long head (BF). temporal-spatial parameters such as velocity, step length, stride length, stance time, toe angle were collected while the subjects walked on the GAITRite system. RESULTS: The results of the present study were summarized as follows: 1. Muscle activities in mean EMGs while walking: Left VMO, Right TA, Left BF and GA revealed significant reductions after applying insole. 2. Muscle activities in peak EMGs while walking: Left TA and BF demonstrated reductions significantly after applying insole. 3. There were improvements in temporal-spatial gait parameters with insole: velocity, both step length, Right stride length and Right toe angle were increased(p<.05). CONCLUSION: Therefore the current study demonstrated that insole supporting the medial longitudinal arch would be effective on gait of the spastic cerebral palsy with pes planus.

• The Journal of Korean Physical Therapy
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• v.26 no.4
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• pp.274-279
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• 2014

Purpose: The aim of this study was to determine the change of static and dynamic foot pressure on trunk stabilization exercise in children with spastic diplegic cerebral palsy. Methods: This study examined five male children participants ages 10~14 years old with spastic diplegic cerebral palsy. All subjects participated in a 6-week sling exercise program for trunk stabilization; the exercise was performed three times per week and each session lasted 50 minutes. The subjects were measured for static and dynamic foot pressure and bilateral symmetry of both feet before and after the trunk stabilization exercise. Results: The static foot pressure increased significantly before and after the trunk stabilization exercise (left foot: before $0.41{\pm}0.02%BW/cm^2$ after $0.79{\pm}0.02%BW/cm^2$, right foot: before $0.14{\pm}0.03%BW/cm^2$, after $0.43{\pm}0.44%BW/cm^2$) (p<0.05) and bilateral symmetry of both feet increased (before $0.27{\pm}0.18%BW/cm^2$, after $0.37{\pm}0.05%BW/cm^2$) with more weight shift on left foot than right foot, but was not statistically significant (p>0.05). The dynamic foot pressure increased (left foot: before $2.58{\pm}0.44%BW/cm^2$, after $3.40{\pm}0.31%BW/cm^2$, right foot: before $2.75{\pm}0.19%BW/cm^2$, after $3.26{\pm}0.18%BW/cm^2$) with more weight shift on right foot than left foot, but was not statistically significant (p>0.05), and bilateral symmetry of both feet decreased (before $0.31{\pm}0.36%BW/cm^2$, after $0.13{\pm}0.20%BW/cm^2$) (p<0.05). Conclusion: The findings of this study indicated that the trunk stabilization exercise has a positive impact on static and dynamic foot pressure in children with spastic diplegic cerebral palsy.

• Journal of Korean Physical Therapy Science
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• v.19 no.3
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• pp.23-30
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• 2012

The purpose of this study was to apply treadmill training through motor learning to cerebral palsy children and examine its effects on their Gross Motor Functions. The subjects of this study were 13 spastic diplegia children who had difficulty in independent gait, and GMFCS level III, IV. We performed treadmill gait training using the principle of weight bearing, based on 4times a week for 30 minutes before and after each session physical therapy we gave weight bearing treadmill training 5 to 10 minutes, during 7 weeks(April 9, 2012~May 26, 2012) fittingly for the children's gait characteristics. In order to test how the weight bearing treadmill training affects spastic diplegia children's gross motor functions, we measured body mobility with Gross Motor Function Measure (GMFM). These data were collected before and after the experiment and analyzed through comparison. Data collected from the 13 spastic diplegia children the results were as follows. For evaluating with regard to change in body mobility, significant difference was observed between before and after the experiment in measured gross motor functions, which were crawling, kneeling, standing, walking, jumping and running(p<0.05). According to the results of this study, when gait training through motor learning was applied to spastic cerebral palsy children, it made significant changes in their body mobility. Accordingly, for the effective application of gait training through motor learning to cerebral palsy children, it is considered necessary to make research from different angle on how such training affects children's mobility, activity of muscles in the lower limbs, and gait characteristics.

• Journal of the Korean Society of Physical Medicine
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• v.7 no.3
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• pp.339-348
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• 2012

Purpose : The purpose of this study is to compare muscle activations of neck, trunk and leg in cerebral palsy of spastic diplegia with genu recurvatum and knee flexion contracture, when using anterior and posterior walkers. Methods : We selected 21 cerebral palsy and received the written consent to participate in this study. The inclusion criteria for participation required patients to have spastic diplegic CP; to be between 3~6 years of age, to have a GMFCS III grade, to have no botulinum toxin injection and orthopedics surgery within before six months starting the study. Measurements of muscle activities (sternocleidomastoid, splenius capitis, rectus abdominis, erector spinea, gluteus maximus, rectus femoris, medial hamstring and calf muscles) were evaluated anterior and posterior walker ambulations. Statistical evaluation of these data were accomplished by utilizing the paired t-test and independent t-test by SPSS 20.0 program. Significance level was set at p<.05. Results : The following results were obtained. There was significant difference on muscle activation of neck, trunk and legs(soleus except) in anterior and posterior walkers. There was no significant difference in muscle activation of neck but significant difference in muscle activation of trunk, legs between genu recurvatum and knee flexion contracture(rectus abdominis, medial hamstring when using anterior walker, rectus abdominis, erector spinea, gluteus maximus, medial hamstring when using posterior walker). Conclusion : The conclusion of this study is the different knee joint forms would have different effect on muscle activation of trunk and legs while cerebral palsy of spastic diplegic ambulated with anterior walker and posterior walker.

• PNF and Movement
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• v.17 no.2
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• pp.237-243
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• 2019

Purpose: The purpose of the present study was to investigate the effects of toe wedges on the gait ability of adolescents with spastic diplegic cerebral palsy. Methods: Six adolescents with spastic diplegic cerebral palsy participated in this study. During the participants walked with- and without toe wedges, the gait ability was analyzed using the electronic walkway system. Gait parameters, including velocity, cadence, step length, stride length, single support time, and double support time, were collected and analyzed. Results: When the participants walked with toe wedges, there were significant improvements in gait velocity, cadence, and double support time compared to those without toe wedges (p<0.05). However, there were no significant differences in step length, stride length, and single support time. Conclusion: Toe wedges may have a positive effect on the gait ability of adolescents with spastic diplegic cerebral palsy. However, it is necessary to conduct high-quality studies to identify the effects of toe wedges.

• Therapeutic Science for Rehabilitation
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• v.9 no.1
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• pp.79-90
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• 2020

Objective : The purpose of this study was to investigate the age, motor function, and characteristics of feeding and articulation in children with spastic cerebral palsy. Methods : This study included 34 boys and 27 girls who lived in Seoul, Gyeonggi, Daegu, Daejeon, or Busan, and were diagnosed with cerebral palsy by rehabilitation doctors. A total of 61 children with cerebral palsy were identified as dependent variables for verbal intelligibility, diadochokinesis speed and intelligibility. Multiple regression analysis was performed. Results : Verbal intelligibility among the articulating abilities of children with spastic cerebral palsy was significantly associated with the non-speech mechanisms of cup drinking, and spoon feeding. Diadochokinesis speed was significantly associated with the speech mechanism of porridge feeding, the non-speech mechanism of cup drinking, and motor function. Diadochokinesis intelligibility also showed significant results with regards to the speech mechanism of porridge feeding and the non-speech mechanism of cup drinking. Conclusion : It is useful to evaluate and treat eating function by considering speech and non-speech mechanisms and motor function, according to eating function, among the variables related to articulation ability in children with spastic cerebral palsy. In addition, it would be very useful to study the improvement of articulation abilities after developing and applying a feeding program for children with cerebral palsy.

• Physical Therapy Rehabilitation Science
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• v.5 no.4
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• pp.205-209
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• 2016

Objective: Children with spastic diplegic cerebral palsy show weakness especially in the lower-extremity rather than upper-extremity muscles and display characteristics such as asymmetric alignment, deficits in postural control or balance ability, and slow walking speed. Various therapeutic interventions are applied to children with cerebral palsy, of which taping is widely used in the field of rehabilitation, however, there are few studies of the effects of kinesio taping on gait patterns of children with cerebral palsy. The present study investigated the effects of kinesio taping on gait parameters of children with cerebral palsy. Design: Cross-sectional study. Methods: Four children with spastic diplegia participated in this study. The participants' gait parameters while walking 10 m with and without kinesio taping (tibialis anterior, quadriceps femoris, and gluteus maximus) were recorded. Gait parameters including gait velocity, cadence, step length, stride length, single support time, and double support time were evaluated using the GAITRite. Mean values were obtained after having the subjects walk three times in each condition with a 5-minute rest period between each condition. The order of each condition was assigned randomly. Results: There were significant improvements in gait velocity, step length, stride length, and single support time of the right leg with kinesio taping condition compared to the without kinesio taping condition taping (p<0.05). However, there were no significant differences in cadence, single support time of the left leg, or double support time. Conclusions: The results show that kinesio taping may have a positive effect for improving gait parameters of children with spastic diplegia. However, its usefulness in the rehabilitation of children with cerebral palsy needs to be further investigated.

• The Journal of Korean Physical Therapy
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• v.32 no.6
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• pp.341-347
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• 2020

Purpose: The purpose of this study is to introduce a tool for evaluating eye movement and analyze the reliability of measurement based on 10 cases of evaluating the oculomotor function of children with spastic cerebral palsy Methods: The participants were selected by 6 medical and welfare institutions in Busan as GMFCS grade 1-3 among spastic diplegia and hemiplegia. Seven examiners evaluated 3 children for the evaluation of inter-rater agreement of Ocular Motor Score (OMS) and evaluated the condition of the ocular motor of 10 children using OMS, a re-examination was performed at six weeks after the initial examination. SPSS ver.25.0 was used to calculate the interclass correlation coefficient and Wilcoxon's signed-rank test, Mann Whitney-U test. Results: The inter-rater agreement of OMS was 0.89. Second mean values were decreased compared first examination in motility/ductions/version, saccades and smooth pursuit, but there was no significant difference. Children under 6 years old had a high mean value of saccades in first examination and the motility/ductions/version, fixation, saccades in second examination, but there was no significant difference. Spastic diplegia children's mean values were higher in head posture, fixation in 8 gaze directions than hemiplegia children in both first and second examination, but there were no significant differences. Conclusion: Ocular motor function in 10 children of spastic children who participated in the study and could see that the scores was differed depending on age, type, grade of cerebral palsy. OMS may be available for this purpose.

• The Journal of Korean Physical Therapy
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• v.20 no.2
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• pp.49-55
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• 2008

Purpose: The purpose of this study is to find the effect of grip strength of the grasping reflex skill training of 4 case children with spastic cerebral palsy. Smedley hand dynamometer(JAMAR, USA) was used for measuring grip strength. Methods: Smedley hand dynamometer(JAMAR, USA) was used for measuring grip strength. Cases were chosen mild, moderate and severe spastic cerebral palsy with sitting balance and perception. To achieve that purpose, this training program was carried out 5 times a week for 4 weeks with 4 children. The performance of grasping reflex skill training and grip strength was evaluated each other. Results: Both hands were investigated with grasping reflex skill test and grip strength in two week intervals. In the dominant or nondominant hand, the more improvement of grasping reflex skill test is high, the more that of grip strength is high. Conclusion: The result were as follows that. The grasping reflex skill training was effective in grip strength.

• 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.