• 대한물리의학회지
• /
• 제7권3호
• /
• pp.339-348
• /
• 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.

• 대한물리의학회지
• /
• 제14권4호
• /
• pp.37-44
• /
• 2019

PURPOSE: The purpose of this study was to compare sitting balance and coordination spastic cerebral palsy in children using the Korean version of Trunk Impairment Scale (K-TIS) as well as to provide basic data about effective postural control treatment for clinicians handling these two types. METHODS: The K-TIS was measured in 29 children diagnosed with diplegic and quadriplegic cerebral palsy (18 with diplegia and 11 with quadriplegia). The average and standard scores of the children's K-TIS subscales and items of the two groups were measured. The two groups' subscales and items were analyzed by using the Mann-Whitney U test. RESULTS: Static sitting balance, dynamic sitting balance, coordination, and total score for children with diplegia were statistically high (p<.05). For all items under static sitting balance, the score for children with diplegia was higher. The first differences in the repeated items of dynamic sitting balance and coordination area that rotates between the upper and lower body were presented. CONCLUSION: The difference in balance and coordination in sitting positions is exhibited in children with diplegia and quadriplegia. For children with spastic quadriplegia, treatments should focus on static sitting balance and coordination, together with a focus on dynamic sitting balance and coordination.

• Physical Therapy Rehabilitation Science
• /
• 제5권4호
• /
• pp.205-209
• /
• 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.

• 재활복지공학회논문지
• /
• 제10권4호
• /
• pp.251-257
• /
• 2016

소아균형검사(Pediatric Balance Scale)는 경증이나 중증의 운동손상을 지닌 학령기 아동에게 사용할 수 있는 균형검사도구이다. 본 연구의 목적은 경직성 양하지 뇌성마비 아동을 대상으로 소아균형검사와 시공간적 보행변수간의 상관관계를 알아보고자 하였다. 소아균형검사는 앉은 자세에서 일어나기, 선 자세에서 앉기, 의자에서 의자로 이동하기, 잡지 않고 서 있기, 한 다리로 서 있기, 제자리에서 $360^{\circ}$ 회전하기, 뒤돌아보기 등 총 14개 항목으로 구성하고, 시공간적 보행변수는 보행속도 및 보폭, 보거리, 보격, 분속수, 양하지 지지 시간을 포함한다. 모든 대상자들은 독립적으로 보행이 가능한 경직성 양하지 뇌성마비 아동이며, 숙련된 소아물리치료사에 의해 소아균형검사와 시공간적 보행변수를 측정하였다. 소아균형검사와 시공간적 보행변수 간의 상관관계를 분석하기 위해 피어슨 상관분석을 사용하였고, 통계학적 유의수준은 0.05로 설정하였다. 소아균형검사의 총점(r=.49~.58)과 세부항목 중 선 자세에서 앉기(r=.48~.60)와 선 자세에서 왼쪽/오른쪽 어깨 뒤로 돌아보기(r=.47~.53), 선 자세에서 바닥에 물건 집어 들기(r=.52~.69)는 보행속도와 보폭, 보거리, 분속수의 각 변수 사이에 모두 유의한 양의 상관관계를 보였으며, 소아균형검사의 대부분 항목이 양하지 지지 시간 간의 매우 높은 음의 상관관계(r=-.48~-.92)를 보여주고 있다. 이는 소아균형검사와 시공간적 보행변수는 높은 상관관계를 가진 것을 관찰 할 수 있었으며, 소아균형검사를 통해 뇌성마비 아동의 보행수준을 예견하는데 유용하게 적용될 것이다.

• 한국산학기술학회논문지
• /
• 제13권9호
• /
• pp.4098-4106
• /
• 2012

본 연구는 경직성 양하지 뇌성마비 아동을 대상으로 하여 체간 근력 강화 운동이 앉은 자세 균형 수행력과 근 긴장도 변화에 어떠한 영향을 미치는지 알아보고자 하였다. 대상자는 대운동 분류 시스템 제 IV단계의 경직성 양하지 뇌성마비 아동 16명을 무작위로 배분하여 주 3회 6주 동안 실시하였고, 실험군은 체간 근력 강화 운동을 대조군은 기본 물리치료만 실시하였다. 체간 근력 강화 운동은 복부근과 배부근 강화를 위한 2가지 운동으로 구성하였다. 대상자들의 균형 수행력 측정은 BPM(Balance Performance Monitor)를 사용하였고 근 긴장도 측정은 MMAS(Modified Modified Ashworth Scale)를 사용하였다. 연구 결과, 앉은 자세 균형수행력 변화에서 실험군과 대조군의 동요거리, 동요속도에서 유의한 차이가 있었고(p<.05), 앉은 자세 균형 수행력 변화 비교에서 실험군과 대조군 사이에 동요속도, 동요거리에서 유의한 차이가 있었다(p<.05). 또한 근긴장도 측정 결과 실험군과 대조군의 무릎관절 굽힘근, 엉덩관절 모음근에서 유의한 차이가 나타나지 않았다(p>.05). 따라서 실험군과 대조군 모두에서 균형 수행력 향상이 나타났지만 실험군에서 조금 더 유의하게 향상되었고, 근 긴장도의 변화는 두 군에서 나타나지 않았다. 경직성 양하지 뇌성마비 아동에게 체간 근력 강화 운동은 근 긴장도의 변화 없이 앉은 자세 균형 수행력을 향상시키는데 효과적임을 알 수 있었다.

• The Journal of Korean Physical Therapy
• /
• 제27권2호
• /
• pp.106-111
• /
• 2015

Purpose: Impaired reaching movement is commonly observed in children with cerebral palsy. The purpose of this study was to determine whether the inclination of seat surface can influence the reaching movement in children with spastic diplegic cerebral palsy (CP). Methods: The subjects were 31 children, 16 children with spastic bilateral CP and 15 typically developing (TD) children. The children performed static sitting and forward reaching under three conditions: a horizontal seat surface (Horizontal $0^{\circ}$), a seat surface inclined anterior 15 degrees (Ant $15^{\circ}$), and a seat surface inclined posterior 15 degrees (Post $15^{\circ}$). A 3-axis accelerometer ('ZSTAR3') was used for analysis of the reaching movement. A 3-axis accelerometer was attached on the manubrium of the sternum, lateral epicondyle of the humerus, and styloid process of the ulna. We measured the reaction time, movement time, and data amount during reaching the 8 cm target with an index finger on the three inclined seat surfaces. Results: Reaction time and movement time for CPs showed significant delay; comparing the TD's and CP's amount was significantly greater than the TD's during reaching task (p<0.05). In particular, CP's reaction time and movement time on a seat surface inclined Ant $15^{\circ}$ was significantly more delayed compared with the other seat surfaces (p<0.05). Conclusion: Our results suggest that seat-inclination intervention may provide an ergonomic approach for children with spastic cerebral palsy.

• 대한물리의학회지
• /
• 제7권3호
• /
• pp.357-365
• /
• 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.

• 대한물리의학회지
• /
• 제8권4호
• /
• pp.583-592
• /
• 2013

PURPOSE: This study aimed to investigate muscles activation relate to core stability during 5 therapeutic exercise in children with spastic diplegia. METHODS: The subjects of this study were 8 children with typical development and 12 children with spastic diplegia who have been treated in Bobath children's hospital, all of whom agreed to participate in the study. All subjects were measured to see their muscles activation of rectus abdominalis, external oblique abdominalis, elector spinae, gluteus maximus, rectus femoris, and semitendinosus with surface EMG. RESULTS: The results of this study were as follows : 1) There were statistically significant difference in the root mean square(RMS) of all muscles according to 5 therapeutic exercise in children with spastic diplegia. 2) There were statistically significant difference in the RMS of all muscles according to 5 therapeutic exercise in children with typical development. 3) Significant differences of the RMS between diplegic children and normal children were found in elector spinae and rectus femoris only curl-up exercise. CONCLUSION: As the above results, we suggest that 5 therapeutic exercises could be used for a core stability or core strengthening program. Depending on the individual needs of children with cerebral palsy, some of exercises may be more beneficial than others for achieving strength.

• 한국전문물리치료학회지
• /
• 제10권4호
• /
• pp.77-83
• /
• 2003

본 연구는 발가락 벌림 보조기(toe spreader)가 긴장성 발가락 굽힘 반사(Tonic Toe Flexion Reflex: TTFR)가 있는 양하지 뇌성마비 아동의 보행에 미치는 영향을 알아보고자 하였다. 12명의 TTFR이 있는 양하지 뇌성마비 아동을 대상으로 같은 날에 맨발과 발가락 벌림 보조기를 착용한 상태에서 보행분석을 실시하였다. 시간 거리 보행변수로 활보장(step length), 보장(step length), 보폭(step width), 발가락 외전각도(toe out angle), 활보시간(stride), 입각기(stance phase), 유각기(swing phase), 분속수(cadence), 보행속도(speed)를 측정하였다. 발가락 벌림 보조기 착용 시 시간 거리 보행변수는 통계적으로는 유의한 차이가 없었다(p>.05). 양하지 뇌성마비 아동에서 TTFR을 억제하기 위한 발가락 벌림 보조기의 즉시적인 효과는 유의하지 않다고 볼 수 있으며, 추후연구로 장기간 일상생활에서의 지속적인 착용을 통한 연구가 필요하다고 본다.