• Title/Summary/Keyword: Spastic diplegia

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The Changes of Respiratory Functions Following Postures in Cerebral Palsy : Spastic Diplegia (뇌성마비의 유형별 자세에 따른 호흡기능의 변화 : 경직성 양하지마비)

  • Song Ju-Young
    • The Journal of Korean Physical Therapy
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    • v.16 no.4
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    • pp.115-128
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    • 2004
  • The purpose of this study was to evaluate respiratory functions in relation to the gross motor functions(total value of GMFM), the difference of chest girth, and the changing position in spastic children. The respiratory functions(FVC, FEV1, $FEV1\%$, and PEF) were measured in the supine, the $45^{\circ}$semi-sitting, and the $45^{\circ}$sitting in 9 subjects. In the supine position, the mean difference of chest girth was $1.56{\pm}0.80cm$, the total value of GMFM was $45.41{\pm}17.79\%$. In the supine position, there was significant positive relationship in FVC-FEV1, FVC-PEF, and FEV1-PEF, but there was no significant relationship in GMFM and all respiratory functions. In the $45^{\circ}$semi-sitting, there was significant positive relationship in GMFM-FVC, FVC-FEV1, FVC-PEF, FEV1-PEF, and $FEV1\%-PEF$. In the $90^{\circ}$sitting, there was significant positive relationship in GMFM-FEV1, $GMFM-FEV1\%$, FVC-FEV1, FVC-PEF, and FEV1-PEF. In results of measured respiratory functions according to the postures, the supine position had highest value in all respiratory functions, but there were no significant (p<0.05).

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Changes in the Gross Motor Function, Self-esteem and Social Ability of Children with Spastic diplegia from Group Exercise : Case Study (그룹운동프로그램에 의한 뇌성마비 아동의 대동작 기능, 자아존중감 및 사회성의 변화 : 사례연구)

  • Lee, Eun-Jung;Song, Ju-Min
    • Journal of the Korean Society of Physical Medicine
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    • v.5 no.4
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    • pp.645-654
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    • 2010
  • Purpose : The purpose of this study was to investigate changes in the gross motor function, self-esteem and social ability of children with cerebral palsy from group exercise program for physical and emotional interaction. Methods : Five cerebral palsy children who live in U city were recruited this study. Exercise sessions were held for 1 hour per session, once per week, for 12 consecutive weeks. At pre-treatment and post-treatment, subject were tested gross motor function measure, self-esteem and social ability. Results : After 12 weeks of paticipation in the group exercise program for physical and emotional interaction, there were improvements for gross motor function measure, self-esteem and social ability. Conclusion : Group exercise program for physical and emotional interaction can improve gross motor function, self-esteem and social ability.

The Effects of Weighted Vest During Task-Oriented Training on Gross Motor Performance and Balance Abilities of Children With Spastic Diplegia : A Randomized Clinical Trial Study (경직형 양마비 아동의 과제지향훈련 시 무게조끼 적용이 대동작 수행력과 균형 능력에 미치는 영향: 무작위배정 위약비교 연구)

  • Kwon, Hae-Yeon
    • The Journal of Korean Academy of Sensory Integration
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    • v.15 no.2
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    • pp.46-65
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    • 2017
  • Objective : The purpose of this research is to find clinical effects of application of weighted vest during task-oriented training focused on gross motor performance and balance abilities of children with spastic diplegia. Methods : 34 subjects were divided by simple random sampling into two groups; experimental group (male : 9, female : 8, average age : 8.12) and placebo group (male : 9, female : 9, average age : 7.53). Both two groups underwent to 40 minute intervention, twice a week for 12 weeks. The intervention was task-oriented training focused on facilitating closed kinematic chain and multi-joint functional movement pattern. During the training, the experimental group received loaded-resistance weighted vest and placebo group also received weighted vest but without loaded-resistance. Participants in both groups underwent 8 to 10 reps of the task-oriented training and there were 3 minutes break time between tasks. There were pre-test of gross motor performance and balance abilities, and two times of post-tests were performed upon 6 weeks and 12 weeks after the intervention completed. And in final, an additional follow-up test was performed 12 weeks after the evaluation was finished in order to find any difference between the two groups over time. Results : There was significant difference in Gross Motor Performance Measure (GMPM) between two groups. It is found that average score of the experimental group increased more than the placebo group after 6 weeks and 12 weeks intervention (p<.05). There was significant difference in Pediatric Berg's Balance Scale (PBS) between two groups. It is found that average score of the experimental group increased more than the placebo group after 6 weeks and 12 weeks intervention (p<.05). Conclusion : Based on the results in this study, it is proposed that application of weighted vest into task-oriented training to facilitating closed kinematic chain and multi-joint movement can improve gross motor performance and balance abilities of children with cerebral palsy.

The Effect of Balance Exercise on Various Support Surfaces on the Gross Motor Function and Balance Ability of Children with Cerebral Palsy (다양한 지지면에서 균형운동이 경직성 뇌성마비 양하지마비 아동의 대동작기능 및 균형능력에 미치는 효과)

  • Lee, Eun-Jung;Song, Ju-Min
    • Journal of the Korean Society of Physical Medicine
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    • v.7 no.3
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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.

Reliability of the Manual Ability Classification System for Children With Cerebral Palsy (뇌성마비 아동에서 손 기능분류체계의 신뢰도)

  • Park, Eun-Young;Lee, Young-Jung;Kim, Won-Ho
    • Physical Therapy Korea
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    • v.17 no.1
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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.

A rare case of Sjogren-Larsson syndrome with recurrent pneumonia and asthma

  • Tavasoli, Azita;Sayyahfar, Shirin;Behnam, Babak
    • Clinical and Experimental Pediatrics
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    • v.59 no.6
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    • pp.276-279
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    • 2016
  • Sjogren-Larsson syndrome (SLS) is a rare autosomal recessive neurocutaneous disorder with worldwide incidence of 0.4 per 100,000 people. It is characterized by the triad of congenital ichthyosis, spastic diplegia or quadriplegia, and mental retardation. Herein we report a 2-year-old male child with SLS, asthma, and recurrent pneumonia. SLS was confirmed by a molecular genetics study that revealed a deletion mutation in the ALDH3A2 gene. An ALDH3A2 gene mutation results in dysfunction of the microsomal enzyme fatty aldehyde dehydrogenase and impaired metabolism and accumulation of leukotriene B4, which is a key molecule and a pro-inflammatory mediator in developing allergic diseases, especially asthma. An increased level of leukotriene B4 has been reported in SLS patients. As far as we are aware, this is the first report of SLS associated with asthma and recurrent pneumonia. In conclusion, pediatricians should be aware of and evaluate patients with SLS for possible associated asthma and allergic disorders.

The Effect of Intensive Weight Shift Training on Seated Postural Balance in Children With Spastic Cerebral Palsy: A Case Study (집중체중 이동훈련이 뇌성마비 아동의 체간조절 능력에 미치는 영향: 사례연구)

  • Ryu, Hyun-Nam;Han, Jin-Tae
    • The Journal of Korean Academy of Sensory Integration
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    • v.17 no.1
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    • pp.9-18
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    • 2019
  • Objective : This study investigated the effect of intensive weight shift training (IWST) on the ability to balance in a sitting posture of children with spastic cerebral palsy (SCP). Methods : One child with spastic diplegia participated in this study for a total of 8 weeks using the ABA experimental design. For the pre-intervention period (A1), general physical therapy (GPT) for children with SCP was performed. The intervention period (B1 and B2), GPT and IWST were conducted for children with SCP, and GPT was conducted again for the post-intervention period (A'1 and A'2). Trunk control capacity was measured using the Korean Trunk Control Measurement Scale (TCMS-K) and Biorescue (RM Ingenierie, France). Results : All TCMS-K variables increased from A1 to B2, and decreased from B2 to A'2. The total area with limit of stability (LOS) increased from A1 to B2, and decreased from B2 to A'2. The ratio of the left/right (Lt/Rt) and anterior/posterior (Ant/Post) LOS area was closer to 1, meaning symmetry, in B2 than in A1. The ratio of the Lt/Rt LOS area decreased further from 1 in A'2 than in B2. The ratio of the Ant/Post LOS area was closer to 1 in A'2 than in B2. Conclusion : IWST had a positive effect on the improvement of balance in the sitting posture of a child with SCP. The results suggest that IWST might help to improve the balance abilities of children with SCP for independent sitting, postural control, and activities of daily living.

Effect of Sensorimotor Training Using a Flexi-bar on Postural Balance and Gait Performance for Children With Cerebral Palsy: A Preliminary Study

  • Ga, Hyun-you;Sim, Yon-ju;Moon, Il-young;Yun, Sung-joon;Yi, Chung-hwi
    • Physical Therapy Korea
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    • v.24 no.2
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    • pp.58-65
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    • 2017
  • Background: Children with cerebral palsy (CP) have impaired postural control, but critically require the control of stability. Consequently, therapeutic interventions for enhancing postural control in children with CP have undergone extensive research. One intervention is sensorimotor training (SMT) using a Flexi-bar, but this has not previously been studied with respect to targeting trunk control in children with CP. Objects: This study was conducted to determine the effect of SMT using a Flexi-bar on postural balance and gait performance in children with CP. Methods: Three children with ambulatory spastic diplegia (SD) participated in the SMT program by using a Flexi-bar for forty minutes per day, three times a week, for six weeks. Outcome variables included the pediatric balance scale (PBS), trunk control movement scale (TCMS), 10 meter walking test (10MWT), and 3-dimensional movement coordination measurement. Results: The SMT provided no statistically significant improvement in PBS, TCMS, 10MWT, or 3-dimensional movement coordination measurement. However, positive changes were observed in individual outcomes, as balance and trunk control movement were improved. Conclusion: SMT using a Flexi-bar may be considered by clinicians as a potential intervention for increasing postural balance and performance in children with SD. Future studies are necessary to confirm the efficacy of Flexi-bar exercise in improving the functional activity of subjects with SD.

The literature study on the cerebral palsy (뇌성마비(腦性麻痺)의 동(東)·서의학적(西醫學的) 문헌고찰(文獻考察))

  • You, Ho-Sang;Oh, Min-Seok;Song, Tae-Won
    • Journal of Haehwa Medicine
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    • v.9 no.1
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    • pp.469-501
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    • 2000
  • In the literature study on the cerebral palsy, the results were as follows : 1. Cerebral palsy is defined as a disorder of movement and posture due to a defect or lesion of the immature brain. For practical purposes it is useful to exclude from cerebral palsy those disorders of posture and movement which are of short duration, due to a progressive disease due solely to mental deficiency. 2. Cerebral Palsy is classified with quadriplegia, diplegia, hemi plegia, triplegia, and monoplegia or spastic CP, athetoid CP, ataxic CP, and combined classifications 3. Causes of Cerebral Palsy is any damage to the developing brain, whether caused by genetic or developmental disorders. And it is classified with prenatal.natal and postnatal causes. 4. Management consists of helping the child achieve maximum potential in growth and development. This should be started as early as possible with identification of the very young child who may have a developmental disorder. Certain medications, surgery, and braces may be used to improve nerve and muscle coordination and prevent dysfunction. 5. The aim of treatment is to encourage children and adults to learn to be as independent as possible. Some children and adults who have mild cerebral palsy will have no problems in achieving independence 6. Oji(五遲), Oyeon(五軟) and Okyeong(五硬) have the simmiar concepts with the cerebral palsy. 7. Oji(五遲) Oyeon(五軟) and Okyeong(五硬) are caused by seoncheon-pumbu-bujok(先天稟賦不足) and related with gan(肝), bi(脾) and sin(腎). 8. The treatment is achieved by the method of bogansin(補肝腎), ganggeungol(强筋骨) and boiungikki(補中益氣). And jihwanghwan(地黃丸) has been used most frequently.

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Clinical Studies of Cerebral Palsy (뇌성마비의 임상적 고찰)

  • Kang, Won Sik;Cheon, Kyong Whoon;Son, Byeong Hee;Kim, Sung Won
    • Clinical and Experimental Pediatrics
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    • v.45 no.4
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    • pp.512-518
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    • 2002
  • Purpose : Cerebral palsies are the most common and severe motor disabilities in childhood. There is currently increased interest in their occurrence and patterns of likely cause for a variety of reasons. Therefore, a retrospective study was carried out to understand the clinical features of cerebral palsy. Methods : A retrospective chart review was conducted of all children with cerebral palsy who were diagnosed at St. Benedict Hospital between March 1999 and March 2001. Results : Cerebral palsy patients were classified into 6 major groups. Of six groups, spastic diplegia is the most common type of cerebral palsy(55.3%). The risk factors of cerebral palsy were placenta previa(1 case), placenta abruption(1 case), cytomegalovirus infection(1 case), prematurity (53 cases), neonatal asphyxia(12 cases), dystocia(2 cases), breech delivery(1 case), multiple birth(5 cases), head trauma(3 cases), meningitis(2 cases) and unknown(26 cases). Among the 59 in the preterm group, 37 patients showed MR or CT images of periventricular leukomalacia. Among the 44 in the term group, 15 patients showed MR or CT images of atrophy. Among 103 patients, 29 patients(28.2%) had a seizure disorder. Conclusion : It is very importent to understand the clinical features and risk factors of cerebral palsy for physicians to diagnose and manage cerebral palsy patient.