• 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.

• 대한물리치료과학회지
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• 제19권1호
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• pp.1-7
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• 2012

Purpose : This study aims to examine effects of trunk strengthening exercise in three rigid cerebral palsy adolescents aged between 11 and 13 on their spinal segments and gait. Methods : 2A trunk strengthening program for proprioceptive neuromuscular facilitation was made focusing on improvement in their school life and mental and social activities during their school years, and then trunk strengthening exercise was applied to the three subjects for 30 minutes five times per week for four weeks. With the subjects in a static state, each group's gait analysis was made and maximum anterior flexion, maximum extension, maximum left and right lateral flexion, and cross rotation of the trunk were measured using Sonosens (Germany) prior to and after the intervention. Results : Assessment of spinal segment mobility with the subjects in a static state showed that the trunk muscle strengthening exercise increased their maximum joint movement angles from the right side to the center and rotational abilities of the cervical and lumbar spines. Gait analysis indicated increased movements in the thoracic and lumbar spines and relatively decreased anterior-posterior movement of the cervical spine. Conclusion : Trunk strengthening program is effective in enhancing spinal segment mobility and balance ability of cerebral palsy adolescents and considered able to be used together with diverse treatment interventions.

• 웰빙융합연구
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• 제5권1호
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• pp.1-7
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• 2022

Purpose: This study aimed to investigate spatial and temporal features of motor control in an individual with hemiparesis during the curvilinear gait (CG) and proposed an exercise guideline. Research design, data and methodology: An individual aged 63 with hemiparesis by stroke disease was participated in the study. Autoencoder (AE) was used to extract four motor modules from eight muscle activities of the paretic leg during CG. After extraction, each module of four modules was operationally defined by numbering from M1 to M4 according to spatial and temporal features and compared with results reported in a previous study. Results: As a result, an individual with hemiparesis had motor module problems related to difficulty of weight acceptance (module 1), compensation for the weakness of ankle plantar flexor (module 2), a spastic synergistic pattern (module 3) and difficulty with transition from the swing to stance phase (module 4) in terms of spatial features. Also, a delayed activation timing of temporal motor module (module 2) related to the forward propulsion during CG was observed. Conclusions: Gait rehabilitation for the stroke will need to consider clinical significances in respect of the deterioration of motor module and provide the tailored approaches for each gait phase.

• 대한후두음성언어의학회지
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• 제28권2호
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• pp.100-105
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• 2017

Background and Objectives : Adductor type spasmodic dysphonia (ADSD) is neurogenic disorder and focal laryngeal dystonia, while muscle tension dysphonia (MTD) is caused by functional voice disorder. Both ADSD and MTD may be associated with excessive supraglottic contraction and compensation, resulting in a strained voice quality with spastic voice breaks. The aim of this study was to determine the utility of spectrogram analysis in the differentiation of ADSD from MTD. Materials and Methods : From 2015 through 2017, 17 patients of ADSD and 20 of MTD, underwent acoustic recording and phonatory function studies, were enrolled. Jitter (frequency perturbation), Shimmer (amplitude perturbation) were obtained using MDVP (Multi-dimensional Voice Program) and GRBAS scale was used for perceptual evaluation. The two speech therapist evaluated a wide band (11,250 Hz) spectrogram by blind test using 4 scales (0-3 point) for four spectral findings, abrupt voice breaks, irregular wide spaced vertical striations, well defined formants and high frequency spectral noise. Results : Jitter, Shimmer and GRBAS were not found different between two groups with no significant correlation (p>0.05). Abrupt voice breaks and irregular wide spaced vertical striations of ADSD were significantly higher than those of MTD with strong correlation (p<0.01). High frequency spectral noise of MTD were higher than those of ADSD with strong correlation (p<0.01). Well defined formants were not found different between two groups. Conclusion : The wide band spectrograms provided visual perceptual information can differentiate ADSD from MTD. Spectrogram analysis is a useful diagnostic tool for differentiating ADSD from MTD where perceptual analysis and clinical evaluation alone are insufficient.

• 대한물리의학회지
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• 제11권2호
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• pp.1-11
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• 2016

PURPOSE: This study was conducted to assess the effects of local vibration on ankle plantarflexion spasticity and clonus in patients with spinal cord injury. METHODS: The subjects were 14 inpatients with complete or incomplete spinal cord injury (SCI) whose scores were higher than 1 on the Modified Ashworth Scale (MAS) and Spinal Cord Assessment Tool for Spastic Reflexes (SCATS) scale of paraplegia. A randomized single-blind cross-over design was used. Vibration treatment involved a single application of vibration for 10 min in the sitting position, and placebo treatment involved the patient remaining in the sitting position for 10 min. One day after treatment, vibration and placebo treatments were crossed over. Spasticity was measured by using the MAS, and resistance force, by using a hand-held dynamometer; clonus was gauged by using the SCATS scale and clonus burst duration. Additionally, the burst maximal frequency and voluntary ankle dorsiflexion angle of the triceps surae were measured. RESULTS: The application of vibration treatment in the sitting position significantly reduced the MAS scores and resistance force, but significantly increased the dorsiflexion angle of the ankle joint (p<0.05). Furthermore, the vibration treatment diminished the clonus burst duration and SCATS score significantly (p<0.05). Although it reduced the burst maximal frequency of the lateral gastrocnemius and medial soleus, this was significant only for the lateral gastrocnemius. The placebo treatment did not significantly affect any of the test parameters. CONCLUSION: Vibration treatment in the sitting position was effective in cases of spasticity and clonus caused by SCI.

• 혜화의학회지
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• 제9권1호
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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.

• 재활간호학회지
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• 제7권1호
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• pp.96-104
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• 2004

Purpose: The aim of this study is to evaluate the general status and prevalence of cerebral palsy, the complication and the activity of daily living in patients with cerebral palsy in Holt Ilsan Home. Methods: Cross-sectional study was performed on 113 cerebral palsy patients in Holt Ilsan Home with the medical records review, the physical examination, and the Modified Barthel index for the independency of activities of daily living. Results: The mean age of subjects was $28.1{\pm}12.7$ years and the duration of residence was $22.9{\pm}12.8$ years. The most common type of cerebral palsy according to the muscle tone abnormality was spastic type(53.1%). The most frequent condition in which extremities are involved were quadriplegia in 46.0%. The score of Modified Barthel index was significantly lower in mixed type for $16.9{\pm}24.0$ and quadriplegic type for $14.8{\pm}25.5$ compared with others. Conclusion: This study indicates that cerebral palsy patients in rehabilitation facility have severe medical problems such as musculoskeletal complications, visual and language problems, epilepsy and dependency in activities of daily living. Therefore more medical attention like long-term follow-up study and social supports is needed.

• 한방재활의학과학회지
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• 제31권2호
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• pp.99-108
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• 2021

The study reports the clinical case of a patient with lower extremity weakness and gait disturbance treated with Korean medicine treatments including Chuna therapy. The patient suffered lower extremity weakness and gait disturbance with diagnosis of lumbar disk herniation and spinal stenosis. As a treatment, the doctor applied Chuna therapy, herbal medicine, acupuncture, pharmacopuncture, cupping and moxa. The effect of treatment was evaluated by numeral rating scale (NRS), self-walkable distance, functional independence measure (FIM), Oswestry disability index (ODI) and manual muscle test (MMT). NRS decreased from 6 to 4 at the leg. Self-walkable distance increased from 0 m to 10 m, FIM increased 85 to 96 points while ODI decreased 64% to 54%. MMT of hip flex and knee extension improved from grade 3+, grade 3 to grade 4, respectively. Korean medicine treatment can be effective for patients who suffer lower extremity weakness and gait disturbance due to lumbar disk herniation and spinal stenosis. Further clinical studies are required to verify these findings.

• 한국전문물리치료학회지
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• 제29권2호
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• pp.147-155
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• 2022

Background: Although various conventional approaches have been employed to reduce spasticity in neurological rehabilitation, only a few studies have shown scientific evidence for its effectiveness. Thus, we introduced a different concept (Ueda method) of rehabilitation therapy that can complement the limitations of conventional therapy. Objects: This study aimed to investigate the immediate effects of the application of the Ueda method on patients with spasticity after stroke via an electrophysiological study. Methods: We conducted a randomized double-blind pilot study in two rehabilitation hospitals involving 30 stroke patients who were randomly allocated to the Ueda (n = 15) and convention (n = 15) groups. Electromyographic data of six examined muscles in both upper extremities of all patients were recorded. The A-ApA index and activation ratios of upper extremity muscles were evaluated and compared between the groups to confirm post-intervention changes in upper-extremity flexor spasticity and flexion synergies. Repeated-measures analysis of variance was conducted to confirm the therapeutic effect (2 × 2) as a function of group (Ueda vs. convention) and time (pre-/post-intervention) on all outcome measures (p < 0.05). Results: In the Ueda group, the mean A-ApA index values differed significantly before and after the intervention (p = 0.041), indicating a weak evidence level; however, the effect size was medium (d = -0.503). The interaction effects of the A-ApA index between the Ueda and convention groups and between pre-intervention and post-intervention stages were significant (p = 0.012). The effect size was large (n_p² = 0.220). In the Ueda group, the activation ratios of the anterior deltoid fiber significantly decreased after the intervention in all reaching tasks. Conclusion: The Ueda method reduces upper-extremity flexor spasticity and changes its synergy in stroke patients and should be considered a rehabilitation therapy for spastic stroke patients.