• 제목/요약/키워드: child cerebral palsy

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보이타 치료중재가 뇌성마비아동의 근활성화 및 발성에 미치는 효과 (The Effects of Vojta's Treatment on Respiratory Muscle Activity and Phonation in children with Spastic Cerebral Palsy)

  • 주기찬;이효정
    • 대한통합의학회지
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    • 제1권3호
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    • pp.37-49
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    • 2013
  • Purpose : The purpose of this study was to evaluate the influence of Respiratory Capacity by Vojta's treatment in children with spastic cerebral palsy. Method : The subjects of this study, children diagnosed with spastic cerebral palsy, 12 patients were picked up, who were agreed with this research and were having hospital care for 4weeks at MH and PR medical centers. Result : In comparison of Respiratory muscle activity and Phonation capacity were significant in the group(p<.01) and MPT and Rectus abd(Rt) were significantly correlated in the pre test and SMR and Ex/oblique (Lt) were significantly correlated in the post test. Conclusion : Therefore, the Vojta's treatment is useful to improve the Respiratory muscle activity and Phonation capacity in children with spastic cerebral palsy.

뇌성마비아동 보호자의 삶의 질 측정과 물리치료 서비스의 만족도 조사 (Satisfaction of Utilization of Physical Therapy and Quality of Life for Caregivers of Cerebral Palsy Children)

  • 권미지
    • The Journal of Korean Physical Therapy
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    • 제21권2호
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    • pp.55-63
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    • 2009
  • Purpose: This study evaluated of quality of life (QOL) and physical therapy satisfaction (PTS) in caregivers of cerebral palsy children. Methods: Eighty six caregivers in Gwang-ju were examined. The caregivers' QOL was assessed through self-reports using the WHO Quality of Life-BREF (WHOQOL-BREF), and the data was analyzed separately for each of its 5 domains. Physical therapy satisfaction was assessed using a self-reported questionnaire and the data was analyzed separately for the 2 domains. The results were processed by the mean and standard deviation and then verified by ANOVA and a t-test to determine the significant differences in the QOL and PTS. The factors affecting the QOL were processed by logistic regression. Results: Life environment domain of the QOL across the caregivers factors showed a statistically significant difference in age at natal, monthly income and education. The birth order in the cerebral palsy child factor showed a significant difference in the general, physical and emotional domain of the QOL. The PTS showed a significant difference in the delivery of therapy domain and in the birth order and walking condition of the environment domain. Caregivers education was found to be associated independently with the life environment domain of QOL. Conclusion: Because the QOL of caregivers is an important treatment goal for children with cerebral palsy, early family intervention should be considered.

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뇌성마비아 어머니의 경험 (Lived experience of mothers who have child with cerebral palsy)

  • 이화자;김이순;이지원;권수자;강인순;안혜경
    • Child Health Nursing Research
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    • 제2권1호
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    • pp.93-111
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    • 1996
  • The purpose of the study is to identify the lived experience of mothers who have children with cerebral palsy in order to understand their agony. Moreover, the result of study was to find some nursing intervention for disabled children and their mothers. For this purpose, ten mothers who are willing to cooperate with this research were selected at random from those who have children with the cerebral palsy, currently using the municipal facilities for the handicapped with cerebral malfunction. Data collection was done from October 4, 1994 th December 31, 1994. The data were collected by asking the mothers mentioned above with some unstructured open-ended questions, recorded on the tapes with permission by the interviewee in order to prevent missing of the interviewed contents. These collected data have been substantiated and properly analyzed on the basis of phenomenological approach initiated by Colaizzi's method. The results and validity are proved to be credible by means of the individual checking of the interviewed mothers. The results of this study are as follows : 1. When the mother is first informed of the diagnosis of cerebral palsy on her child, she usually misses the crucial timing needed for proper treatment of the child's disorder because she is notified through the doctor's indifference and his apparently inactive, matter-of-fact attitude. At first she suspects the doctor's diagnosis and tries to attribute it to the unknown cause from a certain genetic problem and then she quickly wants to deny the whole situation that her child is really suffering from the cerebral palsy. The reality is too much for her to accept as it is and she would not believe her child is abnormal. Therefore, she even attempts depend on the power of God for its solution. 2. The mother, who goes thorough this kind of uncommon experiences, is totally devoted to the treatment and care of the child and completely ignores her own life and happiness. At the same time, she feels sorry for her other normal children she believes having not enough care and concern. Also, she feels sorry for the sick child when the child's brothers or sisters show special concern for the patient out of sympathy. It is sorry and not satisfied for her that the child is growing with abnormality and neighbor other around have inappropriate attitudes. Likewise, she is discontent with her husband's lack of concern about the child's treatment. She believes that the health care system in this society isn't fulfilling its due purpose. In the state of her utmost distress and anxiety, she always feels the need of competent consultants, and is angry about that her child is treated as an abnormal being, she is trying to hide the child from other people and to make him or her disappear, if possible. Although she doesn't have harmonious relation with her husband, she id happy when he shows his affection for the child and she feels relieved and thankful when the relatives don't mention about the child's condition Since the child's overall status of health is continuously in unstable conditions, requiring her all-time readiness for an emergency, she feels guilty of her child's illness toward the fEmily members as if it was her own fault to have borne such an abnormal child and she feels responsible for the child morally and financially if necessary Because her life is centered on taking care of the child, she cannot afford to enjoy her own life and happiness. She is a lonely mother, fatigued, with no proper relationship with other people around her. With this sense of guilt and responsibility as a mother of an unusual disease, she has no choice but to grieve her destiny from which she is not allowed to escape. 3. Nevertheless, the mother with the child suffering from the cerebral palsy does not easily give up the hope of getting her child cured and she believes that in the long run, though slower than hoped, her abnormal son or daughter will be eventually cured to become a normal sibling someday. This kind of hope is sustained by the mother's strong faith coming from observing the progress of other similar children getting better. Sometimes she is encouraged to have this faith by other mothers who share the same painful experiences, believing that her child will improve even more rapidly than others with the same palsy. Full of hope, she painstakingly waits for the child's healing. Moreover, she plans to have another child. she thinks that the patient child's brothers and sisters only can truly understand and look after the patients. However, when she notices that the progress of other children under the treatment does not look so hopeful, she is distressed by the thoughts that her child may never get well. Too, she is worried that the patient's brother or sister will be born as the same invalid with the cerebral disease. She is discouraged to have another baby as much as she is encouraged to. She is also troubled by the thought that in case she has another baby, she will have to be forced. to neglect the patient child, especially when she does have an extra hand or some reliable person to help her with taking care of the patient.

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뇌성마비 아동의 대동작 기능에 대한 가정중심치료 효과 : 체계적 고찰 (Effectiveness of home-based therapy on gross motor function in children with cerebral palsy: A systematic review)

  • 김정현
    • 대한물리치료과학회지
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    • 제29권4호
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    • pp.27-42
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    • 2022
  • Background: Although children with cerebral palsy (CP) are able to walk independently, gait imbalance occurs due to abnormal muscle tone, musculoskeletal deformity, loss of balance, and selective motor control impairment. Gait restriction in the community and school is a major problem of rehabilitation in CP. Home-based therapy (HBT) provides a variety of interventions in which the therapist and the parent work together to resolve the activities and problems caused by the child's body structure. Therefore, we investigate the effectiveness of home-centered therapy on gross motor function in CP and try to present the possibility of clinical application. Design: A Systematic Review Methods: Research papers were published from Jan, 2012 to Jan, 2022 and were searched using Medline and PubMed. The search terms are 'family-centered' OR 'home-based' AND 'cerebral palsy'. A total of nine papers were analyzed in this study. The paper presented the quality level based on Physiotherapy Evidence Database (PEDro) scores to assess the quality of randomized clinical trials studies. Results: The results showed that HBT for strengthening exercise in lower extremity has a positive effect on the isokinetic torque and gross motor function. home-based treadmill therapy in CP is effective to perform at least 12 sessions of treadmill HBP in which the therapist determines the treadmill speed every week and the child's own gait pattern is modified. Conclusion: These results suggest that it will be important data for founding evidence on the effectiveness of home-centered therapy on gross motor function in children with cerebral palsy to advance clinical protocols.

혼합치열기 뇌성마비환자의 상악전돌에 대한 교정치료 : 치험례 (ORTHODONTIC APPROACH TO THE CEREBRAL PALSY PATIENT WITH MAXILLARY PROTRUSION IN THE MIXED DENTITION : A CASE)

  • 김종수;조안나;김지연;정태성
    • 대한장애인치과학회지
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    • 제10권1호
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    • pp.43-46
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    • 2014
  • 뇌성마비로 인하여 협조를 얻기가 어려운 일부 혼합치열기 환자의 심미적, 기능적 개선을 위한 구내 고정성 장치의 사용은 대체로 효과적인 것으로 나타났다. 하지만 이와 같은 문제를 보이는 환자의 근본적인 원인인 근육 조절의 불균형을 바로잡는 재활훈련과 함께 이동된 위치에서 치열의 안정적인 적응을 위하여 구강주위 근육훈련이 병행되어야 한다.

뇌성마비아의 부모교육 프로그램 개발에 관한 연구 (A Study on the Development of a Parent Education Program for Cerebral Palsied Child)

  • 신홍철;서규원;강정구
    • 대한물리치료과학회지
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    • 제2권3호
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    • pp.623-631
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    • 1995
  • 1) 뇌성마비아 부모 교육 프로그램에서 집단 교육이 보다 효과적이다. 2) 효과적인 부모교육 프로그램을 위해서 선행되어야 하는 것은, 뇌성마비아의 치료를 담당하는 물리치료사는 물리치료뿐만 아니라 치료 교육적인 측면의 사고와 인식을 갖고 있어야 한다. 또한 집단 교육을 위한 확고한 기준이 확립되어야 하고 감정의 수용이 자유로워야 하며 집단교육의 끝맺음의 시기 정하기, 체계화된 집단 교육의 진행등이 고려되어야 한다. 3) 참여하는 부모들은 자발적인 동기나 자발적인 의지에 의해서 집단교육이 이루어 지도록 해야 한다. 4) 물리치료 과정에서 물리치료사는 부모의 비합리적인 기대의 내용을 잘 파악하여야 하며, 현실적으로 가능한 기대를 가지도록 도와야 한다. 5) 장애에 대한 정보제공의 시기도 중요하다. 6) 물리치료사와 부모가 관계를 맺게 되는 상황과 시기는 매우 중요하며 부모 교육 프로그램에 중요한 단서를 제공해 주고 있다. 7) 부모 교육 프로그램 개발에서 장애아 부모의 태도가 장애요소로 나타날 수 있다. 8) 부모 교육 프로그램 개발에 있어서 대상의 계층을 정하는데 따르는 문제가 있다.

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임파워먼트 프로그램이 뇌성마비 아동 어머니의 부담감에 미치는 효과 (Effects of an Empowerment Program on the Burden of Mothers Having a Child with Cerebral Palsy*)

  • 어용숙
    • 대한간호학회지
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    • 제35권1호
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    • pp.154-164
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    • 2005
  • Purpose: The purpose of this study was to develop an empowerment program as a nursing intervention for mothers who care for a child with cerebral palsy at home and to determine the effects of the program on those mothers' self efficacy, coping behavior and burden. Method: An non-equivalent control group pretest-posttest design was used in this study. An Empowerment program was developed based on Dunst & Trivette's model. Using the program, the study was carried out from Dec. 13, 2003 to Jan. 17, 2004, mothers whose children, aged 1 to 6, were outpatients of the Dept. of Rehabilitation Medicine, at P University Hospital or registered at educational institutions for early disabled children. The experimental group of subjects were included in the new empowerment program which was held for two and half hours every week for 6 times. Results: After treatment with the Empowerment Program, the experimental group was found to be significantly increased in score for self efficacy(t=4.55, p<.01), coping behavior(t=5.54, p<.001), objective burden(t=-3.96, p<.01) and subjective burden(t=-5.05, <.01), in comparison to the control group. Conclusion: The Empowerment Program is very effective in increasing self efficacy and coping behavior of mothers having a child with cerebral palsy and decreasing their burden. Finally, this study would recommend that an empowerment program should be extended to community facilities such as public health offices and welfare centers.

Factors affecting the health-related quality of life of children with cerebral palsy in Indonesia: a cross-sectional study

  • Ade Febrina Lestari;Mei Neni Sitaresmi;Retno Sutomo;Firda Ridhayani
    • Child Health Nursing Research
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    • 제30권1호
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    • pp.7-16
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    • 2024
  • Purpose: Children with cerebral palsy (CP) and their parents experience various problems that can affect their quality of life. This study examined factors affecting the quality of life of children with CP. Methods: A cross-sectional study was conducted in Yogyakarta, Indonesia, from January to August 2019. The participants were consecutively recruited children with CP aged 2 to 18 years and their parents. Ninety-eight children with CP and their parents, specifically their mothers, were recruited. Children's health-related quality of life (HRQoL) was measured using the Pediatrics Quality of Life Cerebral Palsy. Parental HRQoL and stress were measured using the WHOQOL-BREF and Parenting Stress Index (PSI). Results: Functional level V was the most common category for both Gross Motor Function Classification System (GMFCS) and Bimanual Fine Motor Function (BFMF) (35% and 28%, respectively). Children's mean HRQoL was medium (49.81±20.35). The mean total PSI score was high (94.93±17.02), and 64% of parents experienced severe stress. Bivariate analysis showed that GMFCS, BFMF, number of comorbidities, presence of pain, and parental stress were significantly correlated with the total score for children's HRQoL (p<.05). Multiple linear regression analysis (p<.05) demonstrated that more severe GMFCS and parental stress were associated with lower mean HRQoL scores in children. Conclusion: Factors including the level of GMFCS and parental stress affected the HRQoL of children with CP. Parental stress management should be included in the comprehensive management of these children.

뇌성마비 환아의 자해 방지를 위한 변형된 마우스가드의 적용 (APPLICATION OF THE MODIFIED-MOUTHGUARD TO PREVENT SELF-INJURIOUS BEHAVIORS IN A CHILD WITH CEREBRAL PALSY : A CASE REPORT)

  • 박은경;김광철;최성철;박재홍
    • 대한소아치과학회지
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    • 제35권2호
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    • pp.351-356
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    • 2008
  • 뇌성마비(cerebral palsy)는 비진행성의 정신, 운동 장애를 총칭하는 용어로, 소아 장애의 흔한 원인이 된다. 자해 행위란(self-injurious behavior) 자살 의도없이 자신의 신체 일부를 고의적으로 손상시키는 것으로, 종종 반복적인 행동으로 나타난다. 소아에서의 이러한 자해 습관은 정상적인 어린이에서는 드물며, 증후군, 유전질환, 정신지체 어린이 등에서 그 발생률이 높게 보고된다. 구강 내 자해 행위의 가장 흔한 유형은 혀나 입술 혹은 구강 점막을 물어뜯는 것이다. 이러한 자해 행위를 조절하기 위하여 행동 수정법, 약물 치료, 신체 속박술, 치과적 장치의 적용, 외과적 수술 또는 치아 발치술 등의 다양한 방법들이 제시되었다. 이 중 마우스가드 등의 치과적 장치를 이용한 방법은 구강 내 자해 행위의 감소와 조직의 보호를 위해 가장 보존적이며 적합한 방법이라고 사료된다. 본 증례에서는 자해 습관에 의해 하순과 협점막에 궤양성 병소를 가진 뇌성마비 환아에 있어서, 변형된 마우스가드를 이용하여 자해에 의한 손상을 방지하고 만족할 만한 치유 양상을 보였기에 이를 보고하는 바이다.

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체간 조절을 통한 앉기 자세 교정이 경직형 뇌성마비 아동들의 호흡근과 음향학적 측정치들의 변화에 미치는 효과 (The Effects of Changing the Respiratory Muscles and Acoustic Parameters on the Children With Spastic Cerebral Palsy)

  • 김선희;안종복;서혜정;권도하
    • 한국전문물리치료학회지
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    • 제16권2호
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    • pp.16-23
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    • 2009
  • The purpose of this study was to investigate the effects postural changes on respiratory muscles and acoustic parameters of the children with spastic cerebral palsy. Nine children with spastic cerebral palsy who required assistance when walking were selected. The ages of the children ranged from 6 to 9 years old. The phonation of the sustained vowel /a/ and the voice qualities of each child such as fundamental frequency($F_0$; Hz), pitch variation (Jitter; %), amplitude variation (Shimmer; %) and noise to harmonic ratio (NHR) were analyzed by Multi-Dimensional Voice Program (MDVP). The muscle activity of three major respiratory muscles: pectoralis major muscle, upper trapezius muscle and rectus abdorminalis muscle, were measured by examining the root mean square (RMS) of the surface EMG to investigate the impact of changes in the adjusted sitting posture of each subject. However, the RMS of pectoralis major muscle showed a significant differences (p<.05). Secondly, there were no significant differences in $F_0$, Jitter and Shimmer between pre and post posture change, but there was a significant difference in NHR (p<.05). The data were collected in each individual; once prior and once after the sitting posture change. The data were analyzed by Wilcoxon signed ranks-test using SPSS version 14.0 for Windows. The findings of this study were as follows; Firstly, the RMS of upper trapezius and rectus abdorminalis muscle were not significant different between pre and post sitting posture changes. From the result, it is concluded that changes in the adjusted sitting posture decreases the abnormal respiratory patterns in the children with spastic cerebral palsy which is characterized by the hyperactivity of the respiratory muscles in breathing. Also, there is increased on the voice qualities in children with spastic cerebral palsy.

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