• Physical Therapy Korea
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• v.5 no.1
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• pp.44-50
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• 1998

The purpose of this case study was to introduce botulinum toxin A injection in cerebral palsy. Spasticity can be managed using a variety of methods. Eliminating aggravating sources, promoting stretching and bracing, and positioning are the least invasive methods of treatment. Botulinum toxin A injection is a relatively recent method of spasticity management in children with cerebral palsy. A 3-year old boy was evaluated for possible botulinum toxin injection to promote left side function. The patient had left hemiparetic cerebral palsy. He walked with bilateral intoning, much worse on the left than on the right and with excessive plantar flexion on the left. Botulinum toxin A was injected into the left medial gastrocnemius, with the goals of improving quality of gait. Finally, botulinum toxin treatment of would improve the motor function and ambulatory status in cerebral palsy by hypertonicity, spasticity, dynamic contracture and athetoid movement.

• Physical Therapy Korea
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• v.4 no.1
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• pp.70-77
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• 1997

An A-B-A-C single subject research design was used to assess the effectiveness of transcutaneous electrical nerve stimulation(TENS) and inhibitive techniques on spasticity in a 10-year-old girl with cerebral palsy. Stimulation electrodes were placed over the sural nerve of the right leg. The standard method of cutaneous stimulation, TENS with impulse frequency of 100 Hz, was applied. Inhibitive techniques including stretch, antagonist contraction, and weight bearing were used. The tonus of the leg muscle was measured by means of a surface-EMG biofeedback unit. Visual analysis of data indicate that the child showed clinically significant reduction of spasticity in passive ankle movement following 30 minutes of TENS and inhibitive techniques application, respectively. The effect of TENS on spasticity inhibition was similar to that of inhibitive techniques. This result suggests that for this child with cerebral palsy, the application of TENS to the sural nerve may induce short-term post-stimulation inhibitory effects on the spasticity of cerebral palsy. Replication of this study with a more complex single-subject design involving more subjects is recommended to confirm this result.

• Korean Journal of Applied Biomechanics
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• v.20 no.3
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• pp.285-292
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• 2010

The purpose of this study was to evaluate the influence of respiratory capacity(forced vital capacity), EMG of rectus abdominal muscle, phonation by respiratory muscle strengthening exercise in children with spasticity cerebral palsy. 24 children with spasticity cerebral palsy was randomized in 2 groups, respiratory muscle strengthening exercise and contro group. In the exprimentral groups, respiratory muscle strengthening exercise for 30minutes duration 3 time per week for 8weeks were respectively preformed, Control group was not performed. Before and after experiments, respiratory capacity(forced vital capacity), EMG of rectus abdominal muscle and phonation was measured in all children. In comparison of difference before and after experiment, the respiratory capacity(forced vital capacity) of respiratory muscle strengthening exercise group was significantly increased than the control group(P<.05), rectus abdominal muscle EMG of the respiratory muscle strengthening exercise group was significantly increased more than the control group(P<.05) and MPT of the respiratory muscle strengthening exercise group was significantly increased more than the control group(P<.05). We found that the respiratory muscle strengthening exercise is useful to improve the respiratory capacity and phonation in children with spasticity cerebral palsy.

• 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.

• The Journal of Korean Physical Therapy
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• v.14 no.3
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• pp.60-73
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• 2002

Spasticity is the most troublesome problems in the management in cerebral palsy. The purpose of this study was to observe the effect of FES to spasticity. 8 cerebral palsy children were selected for this study. Assessment was carried out before treatment for obtain baseline measurement of spasticity and reassessment were carried out at after 10th., 20th. treatment sessions and 24hours after treatment. The results of this study were as following that MAS scores were significantly reduced after 10th and 20th after treatment compared with pre-treatment. MAS scores were significantly reduced after 20th compared with pre-treatment. These results indicated that FES appears to reduce significantly MAS scores and maintained 24hours after treatment compared with pre-treatment.

• The Journal of Korean Physical Therapy
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• v.14 no.2
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• pp.51-64
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• 2002

Spasticity is the most troublesome problems in the management in cerebral palsy. The purpose of this study was to observe the effect of the FES and FIR to spasticity.8 cerebral palsy children were selected for this study. Assessment was carried out before treatment for obtain baseline measurement of spasticity and reassessment were carried out at after 10, 20 treatment sessions and 24hours after treatment. The results of this study were as fellowing : 1. MAS scores were significantly reduced after 10th and 20th after treatment compared with pre-treatment. 2. MAS scores were significantly reduced after 20th and maintained 24hours after treatment compared with pre-treatment These results indicated that FES and Far infrared appears to reduce significantly MAS scores and maintained 24hours after treatment compared with pre-treatment.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.232-234
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• 1996

For surgical Treatment of spastic deformities of the foot, selective peripheral neurotomies were introduced. These neurotomies utilize microsurgical techniques and intraoperative electrical stimulation for better identification of the function of the fascicles constituting the nerve. Selectivity is required to supress the excess of spasticity without excessive weakening of motor strength and without producing exaggerated amyotrophy. To achieve this goal, minimum one fourth of the motor fibers must be preserved. Neurotomies may be indicated when spasticity is localized to muscle or muscle groups supplied by a single or a few peripheral nerves that are easily accessible. To help the surgeon decide if neurotomy is appropriate, temporary local anesthetic block of the nerve with bupivacaine can be useful. Such a test can determine if articular limitations result from spasticity, musculotendinous contractures, or articular ankyloses because only spasticity is decreased by the test. In additon, these tests give the patient a chance to appreciate what to expect from the operation.

• The Journal of the Korea Contents Association
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• v.5 no.3
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• pp.37-44
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• 2005

The purpose of this study was to evaluate the effect of aquatic exercise on body composition, fitness and pulmonary function. Subjects were seven spasticity cerebral palsy(18-20years). The aquatic exercise program consisted of 11 items, and performed for 30-40mins in a bout, 4 times a week at the intensity of HRmax($40-65\%$) for 12 weeks. And the change of body weight, %fat, fat mass, hand grip, sit up, sit and reach, close eyes foot balance and side step have been measured before and post exercise 12 weeks. Paired t-test was performed for data analysis at the 0.051eve1 of significance. The following results as; First, body compositions(body weight, $\%$fat and fat mass) were decreased significantly after 12 weeks(p< .05). Second, muscle endurance, balance and flexibility were increased significantly after 12 weeks(p< .05, p< .01), respectively. Third, vital capacity was increased significantly after 12 weeks(p< .05). These results suggest that the aquatic exercise programs are applicable to the spasticity cerebral palsy with abnormal movement.

• Journal of Korean Physical Therapy Science
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• v.6 no.2
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• pp.989-995
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• 1999

Musclee spasticity of Cerebral Palsy children brings abnormal posture and becomes delayed for Normal Motor Development. The objective of this study is to discover the effects of physical therapy on subject paitient' s posture and Normal Motor Development after Selective Posterior rhizotomy. The subject patients were 280 children who had physical therapy for about 4 to 6 months after Selective Posterior Rhizotomy. The sum of points both pre and post operation by using Locomotion stage of Vojta and Arens's grading of Gross Motor Function were compared and evaluated. Among total of 280 Cerebral Palsy children who had 4 to 6 months of physical therapy ; total of 206 children(197 by grade 1, 9 by grade 2) has increased out of 218 spasticity type children, and totoal of 42 has increased (by gradel) out of 48 Athetoid type, and total of 8 jas increased (by grade 1) out of 14 Mixed type Physical therapy for Cerebral Palsy children after Selective Posterior Rhizotomy has enhanced Normal Motor Development and their posture. The therapy also has shown the results of shortening the therapy period and better treatment results.

• The Journal of Korean Physical Therapy
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• v.30 no.3
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• pp.90-95
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• 2018

Purpose: To investigate the relationship between gross motor capacity and neuromuscular function in children with cerebral palsy (CP) through a short-term intensive intervention. Methods: Twenty-four children younger than 6 years of age (17 boys, 7 girls, mean $age{\pm}standard$ deviation, $42.71{\pm}14.43months$) who were diagnosed with CP underwent short-term intensive treatment for 8 weeks. An evaluation of gross motor function capacity using the gross motor function measure (GMFM-66 and GMFM-88) was performed to measure muscle strength, selective motor control (SMC), and spasticity, factors related to neuromusculoskeletal function. Changes in spasticity, strength, range of motion, selective motor function, and exercise intensity scores were evaluated in terms of the gross motor function classification system (GMFCS) and ages. Results: The GMFM-88 and GMFM-66 scores significantly increased, by $4.32{\pm}4.04$ and $2.41{\pm}1.51%$, respectively, following the 8-week intervention. The change in the GMFM-66 score did not reflect a statistically significant difference in the GMFCS level. However, there was a statistically significant difference in the GMFM-88 score change in individuals at GMFCS Level III, the strength and spasticity of subjects at GMFCS Levels I-II did not significantly differ (p<0.05). The changes in the GMFM-66 scores for strength, SMC, range of motion (ROM), and spasticity significantly differed according to age (p<0.05) in children aged 36 months and older. Overall, there was a statistically significant difference in strength, SMC, and spasticity (p<0.05) before and after intensive short-term treatment. Conclusion: The 8-week short-term intensive care intervention improved the motor function score of study participants, emphasizing the need for early intervention and additional research in this area.