• Annals of Clinical Neurophysiology
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• v.1 no.1
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• pp.19-25
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• 1999

Background & Objectives : In cerebral palsy, spastic paraplegia is one of the most crippling motor manifestations. Reducing the spasticity may improve gait and decrease the incidence of lower-extremity deformities. The spasticity may result from abnormally increased afferent signals via dorsal roots onto interneurons and anterior horn and spreading of reflex activation to other muscle groups. To assess the influence of dorsal rhizotomy to spasticity, the authors analyzed five cerebral palsy patients with spastic paraplegia. Methods : The operation entailed and L1-2 laminectomy, ultrasonographic localization of conus medullaris and identification of lumbosacral dorsal roots. The innervation patterns of each dorsal root were examined by electromyography (EMG) responses to electrical stimulation. Tetanic stimulation was applied to individual rootlets of each root after reflex threshold was determined. the reflex responses were graded and rootlets producing high grade response were selected and cut. Short-term postoperative evaluations were performed. Results : Intraoperative EMG monitoring was satisfactorily performed in all five cases. One month after the operations, all patients showed greatly reduced spasticity which was measured by the instrumental gait analysis. Bilateral knee and ankle jerks were normalized and tip-toe gait with scissoring disappeared in all patients. Conclusion : Intraoperative EMG monitoring seems useful for the selective dorsal rhizotomy to reduce spasticity.

• Journal of Music and Human Behavior
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• v.8 no.1
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• pp.1-16
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• 2011

This study was to investigate the influence of using Therapeutic Instrumental Music Performance (TIMP) in uninvolved hand function for children with spastic cerebral palsy. Participants were recruited from a welfare center for people with cerebral palsy(CP). Ages ranged from 11 to 12, and a total of 15 TIMP sessions were provided for 3 weeks. Hand function tests were used including Jebsen Hand Function Test for hand function, Box and Block Test for dexterity of uninvolved hand, and MIDI (Musical Instrument Digital Interface) evaluation for velocity of fingers. The TIMP program consisted of hand percussion playing and keyboard playing with changes of timbre and tempo. While the scores of Jebsen test and Box and Block test were improved for all participants, outcomes of MIDI analysis showed differences among participants. Overall, hand function improvements were observed after the completion of using the TIMP program, and the results implies that the TIMP program can be applied in upper extremity rehabilitation for children with CP.

• The Journal of Pediatrics of Korean Medicine
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• v.31 no.1
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• pp.82-91
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• 2017

These are three case reports on developmental delay that were treated with Korean medicine more than one year. A child with spastic cerebral palsy was treated only with acupuncture in one case, and in another case, two children with cerebral palsy were treated with both acupuncture and Korean herbal medication: Gami-Dossi-pyengwisan and Gami-Guibiondam-tang. After more than a year of treatment period, all three children showed improvement of general condition and motor function, measured by Gross Motor Function Measure, compare to average of children with cerebral palsy. According to this result, Korean medicine treatment can be helpful in improvement of spasticity and developmental delay due to cerebral palsy. Further studies with more cases and well-designed randomized controlled trials should be performed to establish proper guideline of Korean medicine treatment for cerebral palsy.

• Phonetics and Speech Sciences
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• v.5 no.2
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• pp.3-10
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• 2013

The purpose of this study is to analyze the acoustic characteristics of Korean alveolar sibilant sounds of children with cerebral palsy by acoustic analysis. Thirteen children with spastic cerebral palsy aging from 6 to 10 years old, were selected by an articulation test, and compared with a control group of thirty children. The meaningless monosyllable CV, disyllable VCV(/asa/) and frame sentence including target syllables CV were measured. C was from the /s, s'/, and V was from the set /a, i, u, ${\varepsilon}$, o, ɯ, ʌ/. Multi-Speech was used for data recording and analysis. As a result, the frication duration of lenis-glottalized alveolar sibilant of children with cerebral palsy was significantly shorter than that of the control group in CV, VCV and frame sentence. The vowel duration in the following lenis-glottalized alveolar sibilant of children with cerebral palsy was significantly longer than that of the control group in CV, VCV and frame sentence. The children with cerebral palsy showed frequency and intensity of friction intervals which were significantly lower than in the control group in CV, VCV and frame sentence. In the comparison of the lenis-glottalized alveolar sibilant by the children with cerebral palsy group's phonation types, the frication duration showed a significant difference between the phonation types in CV, VCV and between the phonetic contexts. The glottalized-sibilant was longer than the lenis-sibilant in all the phonetic contexts. The subsequent vowel duration showed a significant difference between the phonation types in VCV and between the phonetic contexts(p<.05). The vowel duration in the following glottalized-sibilant was longer than the vowel duration in the following lenis-sibilant in all the phonetic contexts. In the frequency there was a significant difference between the phonation types in CV, and in the intensity there was a significant difference between the phonation type in CV and VCV. The children with spastic cerebral palsy had difficulty in articulating the alveolar sibilant due to poor control ability in laryngeal, respiration and articulatory movements which require fine motor coordination. This study quantitatively analyzes the acoustic parameters of the alveolar sibilant in various phonetic contexts. Therefore, the results are expected to help provide fundamental data for an intervention of articulation treatment for children with cerebral palsy.

• Journal of the Korean Society of Physical Medicine
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• v.4 no.3
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• pp.149-156
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• 2009

Purpose：The hamstring muscle has an important role in standing, walking and other functions related to daily living. Most people with Cerebral Palsy(CP) have muscle tightness, especially in the hamstring, which may cause abnormal alignment in the lower extremities. To investigate an effective treatment for hamstring muscle tightness by observing the effects of heat pack or Soft tissue mobilization(STM) on hamstring muscles. Methods：Thirteen-two volunteers with CP aged between 9 and 13 years($M\pmSD$: $11\pm1.46$), were recruited and divided into four groups of four: (1) the STM for people with Spastic CP group, (2) the heat pack(HP) for people with Spastic CP group, (3) the STM for people with Mixd CP group, and (4) the heat pack for people with Mixed CP group. All received treatment three times per week for six weeks. A inclinometer was used to measure for hip flexion & knee extension joint range motion(ROM). Results：The ROM of hip flexion & knee extension were improved at the STM and HP for people with Spastic CP groups. The ROM and hip flexion were improved at the STM and HP for people with Mixed CP groups. The amount of increase ROM are differenced by the types of CP. Conculusion：STM and heat pack, both are effective for people with CP especially for Spastic CP.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.4
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• pp.637-645
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• 2013

PURPOSE: The purpose of this study was to examine the effect of using a suspension device for arm reaching activity on trunk stability and gross motor function of children with spastic diplegia cerebral palsy. METHODS: The subject in this study consisted of 11, GMFCS(Gross Motor Function Classification System) III~IV children with spastic diplegia cerebral palsy, all of whom agreed to participate in the study. All subjects were divided into two groups: the experimental group using a suspension device, and the control group using no suspension device. For each group, a thirty-minute intervention was done twice per week during 8 weeks. Before and after intervention, each test was measured using TIS(Trunk Impairment Scale), GMFM (Gross Motor Function Measure) and PRT(Pediatric Reaching Test) to change trunk stability, gross motor function and arm reaching activity. The data were analyzed with the Wilcoxon signed rank test. RESULT: All two groups had a meaningful increase in GMFM-Sit data measured before and after intervention. The experimental group had a significant increase from an average of 78.83 to an average of 84.83 in GMFM-Crawling. For both groups, there was a substantial increase in the change in sitting position and arm reaching. CONCLUSION: According to the results of this study, the arm reaching activity using suspension device had an effect on trunk stability and gross motor function and it changed arm reaching activity.

• Physical Therapy Rehabilitation Science
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• v.6 no.2
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• pp.77-82
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• 2017

Objective: Swimming and water-based exercise (WE) programs can provide vigorous physical activity in a fun and a motivating environment. The properties of water, may make it easier for children with cerebral palsy (CP) to move and to participate in an WE program. The aims of this study was to evaluate the effect of WEs on postural control in children with spastic CP. Design: Quasi-experimental design (one group pretest-posttest design). Methods: Twenty preschoolers with spastic CP participated in this study. Prior to the application, sufficient warm-up training was performed to allow the subjects to adapt to the water. Afterwards, three different types of underwater leg exercises for the flexor, extensor, and adductor/abductor of muscles of the lower limb were performed. The WE program lasted during 8 weeks, with one-40 minute sessions per week (8 training session). The usual care was performed during the training session. The Korean-trunk control measurement scale (K-TCMS) and weight distribution variability (difference of both Fz) were measured before and after training session. Results: According to the results, the K-TCMS scores of the three sub-levels, including static sitting, dynamic sitting, and dynamic reaching, was significantly increased after the training session (p<0.05). Also, the weight distribution variability was significantly decreased after 8 weeks (p<0.05). Conclusions: We suggest that WEs may improve the postural control ability in children with spastic CP. Furthermore, we support the need for additional research on the effect of WE on gait or activity of daily living performance with a control group included.

• The Journal of Korean Physical Therapy
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• v.35 no.2
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• pp.48-52
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• 2023

Purpose: This study was undertaken to determine whether the position of cane use affects the distribution of weight-bearing on both feet of children with hemiplegic cerebral palsy in a standing posture. Methods: Twenty participants with cerebral palsy were recruited as volunteers for this study. Using the Zebris FDM-System, weight-bearing distribution according to the method of using a cane was measured under three conditions in randomized order: (1) standing unaided (no cane); (2) standing with the affected side using the cane; and (3) standing with the non-affected side using the cane. The cane was matched by measuring length-from-floor to the greater trochanter of the subject, and was placed 15 cm outward from the little toe on the supporting side. Results: Evaluating the method of using a cane under the three conditions, we determined that pressure of the foot on the affected side was higher in the order: standing with affected side using cane > standing unaided (no cane) > standing with non-affected side using cane (p<0.05). In the post-hoc analysis, a significant difference was observed between (i) standing unaided (no cane) and standing with the affected side using cane, and (ii) standing with affected side using cane and standing with non-affected side using cane (p<0.05). Conclusion: This study suggests that induced weight-bearing methods using a cane on the affected side could increase the weight-bearing capacity on the affected side in children with spastic hemiplegic cerebral palsy, which will have a positive effect on reducing asymmetry weight support.

• The Journal of Korean Academy of Sensory Integration
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• v.14 no.2
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• pp.1-10
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• 2016

Objective: This study aims investigating the effects of functional electrical stimulation (FES) on hand function of children with spastic cerebral palsy. Methods: The participants of this study are 20 children with spastic cerebral palsy aged between 11 to 16 years old. All the subjects underwent 24 sessions of FES during 8 weeks. Each FES was 20 minutes per session, and 3 sessions of FES were provided in a week. Measurements used to assess hand function are Jebsen Hand Function Test, Modified Ashworth Scale and 3D Motion Analysis. After establishment of the baseline for each client by all the measurements, reevaluations were performed every 2 weeks using Jebsen Hand Function Test and the Modified Ashworth Scale. The 3D Motion Analysis was performed only before- and after the 8 weeks of FES treatment. Results: After the FES, there was significant decrease in completed time for the all 6 subtasks of Jebsen Hand Function Test were (p<.05) and also significant decrease in spasticity score of Modified Ashworth Scale as well (p<.05). 3D Motion Analysis showed that the hand tapping and the finger tapping has been significantly improved (p<.05), and the pronation-supination movement of lower arm has been significantly improved as well. Conclusion: Based on the results of this study, it is evidenced that functional electrical stimulation is effective treatment for hand function of children with cerebral palsy. For future research, it is recommended to examine various protocols of FES including impact of long-term application.

• Phonetics and Speech Sciences
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• v.2 no.4
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• pp.193-212
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• 2010

The purpose of our study was to provide effective speech evaluation items examining the variables of speech that successfully predict the speech intelligibility in CP children. The subjects were 55 children with spastic type cerebral palsy. As for the speech evaluation, we performed a speech subsystem evaluation and a speech intelligibility test. The results of the study are as follows. The evaluation task for the speech subsystems consisted of 48 task items within an observational evaluation stage and three levels of severity. The levels showed correlations with gross motor functions, fine motor functions, and age. Second, the evaluation items for the speech subsystems were rearranged into seven factors. Third, 34 out of 48 task items that positively correlated with the syllable intelligibility rating were as follows. There were four items in the observational evaluation stage. Among the nonverbal articulatory function evaluation items, there were 11 items in level one. There were 12 items in level two. In level three there were eight items. Fourth, there were 23 items among the 48 evaluation tasks that correlated with the sentence intelligibility rating. There was one item in the observational evaluation stage which was in the articulatory structure evaluation task. In level one there were six items. In level two, there were eight items. In level three, there was a total number of eight items. Fifth, there was a total number of 14 items that influenced the syllable intelligibility rating. Sixth, there was a total number of 13 items that influenced the syllable intelligibility rating. According to the results above, the variables that influenced the speech intelligibility of CP children among the articulatory function tasks were in the respiratory function task, phonatory function task, and lip and chin related tasks. We did not find any correlation for the tongue function. The results of our study could be applied to speech evaluation, setting therapy goals, and evaluating the degree of progression in children with CP. We only studied children with the spastic type of cerebral palsy, and there were a small number of severe degree CP children compared to those with a moderate degree of CP. Therefore, when evaluating children with other degrees of severity, we may have to take their characteristics more into account. Further study on speech evaluation variables in relation to the severity of the speech intelligibility and different types of cerebral palsy may be necessary.