• Physical Therapy Korea
• /
• v.8 no.1
• /
• pp.51-58
• /
• 2001

In children with cerebral palsy, bone density is decreased by disturbance of bone remodelling due to lack of normal weight bearing and muscle contraction through physical activity. Loss of bone density cause fracture, delays treatment with immobilization, and leads to functional limitation. The purpose of this study was to investigate bone mineral density of lumbar spine in children with spastic quadriplegia and diplegia. Six spastic quadriplegia and 14 spastic diplegia were evaluated in this study. QDR 4500 X-ray densitometer was used to measure bone density at lumbar spine (L1~L4). Children with cerebral palsy showed lower bone density than that of normal children. Bone density in children with spastic quadriplegia and diplegia was $-1.812{\pm}.962$, $-1.519{\pm}.935$, respectively. However, there was no significant differences in bone density between children with spastic quadriplegia and diplegia. There was no significant difference in bone density relation to motor development level, height, and weight. Further study is needed to find the appropriate interventions for preventing loss of bone density in children with cerebral palsy.

• Journal of the Korean Society of Physical Medicine
• /
• v.14 no.4
• /
• 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.

• The Journal of Internal Korean Medicine
• /
• v.41 no.5
• /
• pp.902-910
• /
• 2020

Medial medullary infarction, with representing symptoms of hemiparesis, lingual palsy, and sensory defect, usually has a bad prognosis. The present case is unusual as the patient had a bilateral infarction, and little information is available for bilateral cases. We treated a patient diagnosed with bilateral medial medullary infarction with the symptoms of quadriplegia, lingual palsy, dyspnea, dysphagia, spastic pain, and loss of proprioception. After 126 days of traditional Korean medicine treatment, the patient showed increased muscle power, sensory recovery, reduced spastic pain, and alleviation of dysphagia and dyspnea. This report indicates that traditional Korean medicine could be an effective treatment of the sequelae of medullary infarctions.

• Journal of the Korean Society of Physical Medicine
• /
• v.14 no.4
• /
• pp.45-53
• /
• 2019

PURPOSE: This study examined the differences in the trunk impairment scores according to the levels of the gross motor classification system by evaluating trunk control in children with spastic cerebral palsy using the index of trunk impairment. In addition, the characteristics of trunk control disabilities were investigated according to the cerebral palsy type. METHODS: The subjects were 49 children (mean age 8.57±1.83 years, 11 with hemiplegia, 26 with diplegia, and 12 with quadriplegia) with spastic cerebral palsy levels I to IV under the gross motor function classification system (GMFCS). The coordination and balance of the children with cerebral palsy were evaluated using the index for trunk impairment. Statistical analyses were performed using a Kruskal-Wallis test, and Bonferroni analyses were used as a post-hoc comparison for any significant results. RESULTS: The median of the total scores of trunk impairment was 13 (range, 9-17), which was 56% of the maximum score. The total score of trunk impairment and subscales differed significantly according to the disease severity and type of motor disability. The scores for children with quadriplegia were the lowest compared to children with hemiplegia and diplegia. CONCLUSION: Trunk control function in children with spastic cerebral palsy was reduced, and varied according to the disease severity and types of motor disabilities. The degree of trunk impairment differed from the trunk control ability according to the degree of motor disability of children with cerebral palsy.

• Journal of the Korean Academy of Clinical Electrophysiology
• /
• v.2 no.1
• /
• pp.9-17
• /
• 2004

The purpose of this study are to determine the proper radiographic measurements for hip deformity in spastic cerebral palsy patients, and the correlation of hip deformity with neurological involvement, ability of ambulation. Thirty children with cerebral palsy(22 males, 8 females) were evaluated by measurement of the migration index, acetabular index, center edge angle from bilateral hip APs(anterior posterior view). The result are as follows; 1. The incidence of hip dislocation, among the thirty children fifteen children were found to be dislocated, and more significantly high in non-walking group than in walking group(p<0.05) and in quadriplegia than in diplegia(p<0.05). 2. When compared to normal hip and dislocation hip, the migration index was significantly higher(p<0.01) and the center edge angle was lower in the dislocation hip than in the normal hip. 3. Correlation of radiological findings in right and left hip, the migration index and the center edge angle were highly correlated(p<0.01). We recommand regular intervals X-ray study for early diagnosis and management of hip dislocation in spastic cerebral palsy.

• The Journal of the Korea Contents Association
• /
• v.9 no.11
• /
• pp.231-239
• /
• 2009

The purpose of this study was to investigate changes in balance and upper extremity (UE) function associated with reaching training for children with quadriplegic cerebral palsy based on Biomechanical Frame of Reference. The baseline (phase A) lasted one week. The therapeutic protocol consisted of three reaching training (Phase B) for 40 minutes three times a week. Intervention phases lasted 4 weeks. The CMS-70P (Zebris Medizintechnik Gmbh, Germany) was used to evaluate the qualitative changes in UE function and Pediathc Berg Balance Scale was used to test the balance. The observed performance changes seem to be associated with the presence of intervention and suggest that biomechanical training can be a useful intervention to improve not only manual function but also balance.

• Physical Therapy Korea
• /
• v.17 no.1
• /
• pp.62-68
• /
• 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.

• Clinical and Experimental Pediatrics
• /
• v.59 no.6
• /
• pp.276-279
• /
• 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.

• Journal of Haehwa Medicine
• /
• v.9 no.1
• /
• pp.469-501
• /
• 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.

• The Korean Journal of Rehabilitation Nursing
• /
• v.7 no.1
• /
• pp.96-104
• /
• 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.