• 한국콘텐츠학회논문지
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• 제10권5호
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• pp.268-284
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• 2010

이 연구의 목적은 뇌성마비 아동의 대동작 운동기능에 대한 승마시뮬레이션 훈련의 치료적 효과를 알아보는 것이었다. 뇌성마비진단을 받은 24명의 아동을 무작위 추출하여 두 그룹으로 나누었다. 실험은 12주간, 주 3회로 두 그룹 모두 30분간 운동치료를 시행하였고, 실험군만 승마시뮬레이션 훈련을 15분간 부가적으로 시행하였다. 치료의 전후 변화를 평가하기 위해 대동작 운동기능 측정(GMFM)을 사용하였다. GMFM 점수로 두 군간 맨- 휘트니 검정을 하였고, 통계적 유의성은 <.05로 하였다. 결과는 다음과 같다. 첫째, 각각의 실험군과 대조군의 실험 전과 후를 비교하면, 대조군에서 GMFM A, B 영역은 유의한 차이를 보였고, 실험군은 모든 영역에서 유의한 차이를 보였다. 둘째, 대조군과 비교해서 실험군은 GMFM C,D 와 E영역에서 유의한 차이를 보였다. 결과적으로, 승마시뮬레이션 훈련은 뇌성마비 아동의 기능향상을 위해 치료적 방법으로 고려 될 만하다.

• 대한물리의학회지
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• 제7권3호
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• pp.357-365
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• 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
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• 제14권4호
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• pp.45-53
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• 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.

• The Journal of Korean Physical Therapy
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• 제30권4호
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• pp.123-128
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• 2018

Purpose: This study examined the effects of neuromuscular electrical stimulation (NMES) and horseback riding using a robotic device on the trunk muscle activity and gross motor function in children with spastic diplegia. Methods: Children with spastic diplegia were divided into two groups: an experimental group (NMES and horseback riding using a robotic device [n=10]) and a control group (placebo NMES and horseback riding using a robotic device [n=10]). Each group received general physical therapy and occupational therapy. Each intervention involved the administration of NMES for 15 minutes and horseback riding using robotic device therapy for 15 minutes three times a week for 4 weeks. The evaluation included both the rectus abdominis muscles (RA), external oblique muscles (EO), thoracic paraspinal muscles (TP), and lumbar paraspinal muscles (LP) activity and GMFM. Results: The RA, EO, TP, and LP muscle activity, GMFM C, D, and E were increased significantly in the experimental and control groups. A significant increase in both the TP muscle activity and GMFM D was observed in the experimental group compared to the control group. Conclusion: This study showed that horseback riding using a robotic device is an effective intervention for trunk muscle activity and GMFM in children with spastic diplegia. However, if NMES is added to the back muscles, it is possible to further increase the thoracic paraspinal muscle activity and standing ability.

• 대한물리의학회지
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• 제16권3호
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• pp.123-130
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• 2021

PURPOSE: Robotic gait training is being used increasingly to improve the gross motor performance and gait speed. The present study examined the effectiveness of a novel end-effector type of robotic gait training (RGT) system on standing, walking, running, and jumping functions, as well as the gait speed in children with spastic cerebral palsy. METHODS: Eleven children with spastic cerebral palsy Gross Motor Function Classification System (GMFCS) levels I-III (6 males; age range, 15.09 ± 1.44 years) were examined. They underwent 24 sessions (30 minutes/sessions, one time/day, three days/week for eight consecutive weeks) of RGT. The Gross Motor Function Measure-88 D domain (GMFM D), and GMFM E were assessed with a pretest and posttest of RGT. The setting was a one-group pretest-posttest design. RESULTS: A comparison of the pre-test and post-test show that the outcomes in post-test of GMFM D (p < .01), GMFM E (p < .05), and 10MWT were improved significantly after RGT intervention. CONCLUSION: The present study provided the first evidence on the effects of an eight-weeks RGT intervention in participants with spastic CP. The outcomes of this clinical study showed that standing performance, locomotion function, and gait speed increased in after 24 sessions of the end-effector RGT system in children with spastic cerebral palsy.

• 대한물리의학회지
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• 제18권4호
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• pp.29-35
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• 2023

PURPOSE: High-intensity physical therapy may help improve some gross motor developmental delays through an increased treatment frequency. This study describes an increase in physical therapy frequency and intensity over an eight-week time frame for a child with a rare genetic neurodevelopmental disorder. METHODS: A single-subject research was performed. The subject was a nine-year-old boy with MECP2 Duplication Syndrome. The outcome measure consisted of one time before and after the intervention. An intensive physical therapy program was applied to this subject. The treatments included reciprocal crawling, high kneeling, tailor sitting, weight-bearing and shifting training to facilitate ankle balance strategies and training to walk without assistance. RESULTS: After the eight-week follow-up, the child achieved a gradual improvement in the gross motor function measures, and the mother reported that the child frequently engaged in tailor sitting and independently walking. CONCLUSION: This case study highlights that intensive physical therapy improved the overall motor function of a child with MECP2 duplication syndrome.

• 대한감각통합치료학회지
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• 제10권1호
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• pp.11-20
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• 2012

목적 : 본 연구는 뇌성마비아동을 대상으로 일상생활활동수행 능력을 평가하기 위한 측정 도구인 수정바델지수(Modified Barthel Index: MBI)와 사물조작 기능 분류체계(Manual Ability Classification System: MACS)와 대동작 기능 분류체계(Gross Motor Function Classification System: GMFCS)와의 상관관계를 통하여 장애판정 지표인 MBI를 유용하게 활용할 수 있는 정보를 제공하고자 한다. 연구 방법 : 연구대상자는 전문재활병원에서 작업치료와 물리치료를 받고 있는 뇌성마비 아동 82명을 대상으로 MBI, MACS, GMFCS를 사용하여 평가하였으며, 일상생활활동 수행능력과 사물조작기능, 그리고 대동작기능과의 관계를 알아보기 위하여 상관분석을 사용하여 분석하였다. 결과 : 본 연구 결과는 MBI와 MACS간의 상관계수가 -.765(p<0.001)로 높은 음의 상관을 나타냈고, MBI와 GMFCS 는 상관계수가 -.851(p<0.001)로 높은 음의 상관관계가 있었다. MACS와 GMFCS의 상관계수 또한 .615(p<0.001)로 높은 상관관계를 보였다. 결론 : 뇌성마비 유형에 따른 MBI의 각 항목과 MACS, GMFCS와의 상관관계에 대한 결과는 모든 뇌성마비 유형과 관련하여 MBI의 항목과 MACS와 GMFCS은 유의미한 상관관계를 나타냈다. 뇌병변 장애등급 판정 기준으로 사용하는 MBI와 MACS, GMFCS와의 높은 상관관계는 장애판정 지표인 MBI를 뇌성마비 장애 아동들을 대상으로 유용하게 활용할 수 있을 것이다.

• 대한물리치료과학회지
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• 제6권2호
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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.

• 한국주거학회논문집
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• 제23권1호
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• pp.89-96
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• 2012

The purpose of this study is to find out the characteristics of activity areas according to the age difference and provide the alternatives for space planning of activity areas in classroom of childcare centers. This study used the content analysis method for field survey data collected from 36 classrooms of 9 childcare centers in the Daejeon area. Floor plans were converted to Autocad drawings to analyze the characteristics of activity areas. The results of this study were as follows; 1) In case of 0 to 2-year-old classrooms, they had 6 activity areas such as gross-motor area, role play, block building, language, creative expression, exploration/manipulation area. The activity area with the most low frequency was gross-motor area. 2) In case of 0 to 2-year-old classrooms, the size of activity area was in order of gross-motor area > role play > block building > language > creative expression > exploration/manipulation area. In case of 3 to 5-year-old classrooms, the size of activity area was in order of language > art > role play > math > block building > science > tone and rhythmic area. 3) The central areas with easy access in 0 to 2-year-old classrooms were Large-motor and Imaginary Play Areas. Also, more isolated areas were Manupulatives and Block Areas. The central areas with easy access in 3 to 5-year-old classrooms were Arts, Numbers and Manupulatives. While more isolated areas were Music, Movement and Science Areas.

• 한국전문물리치료학회지
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• 제12권4호
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• pp.20-25
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• 2005

The Gross Motor Function Measure (GMFM) is an internationally widely used outcome measure. The aim of this study was to evaluate the structural properties of the Korean version of GMFM using the Rasch Model, with regard to scoring within rehabilitation centers in Korea. GMFM data for 206 children with cerebral palsy were collected from 11 outpatient rehabilitation facilities by 29 pediatric therapists. The Winsteps software was used to refine the rating scale. This study suggests that the scoring categories of the Korean version of the GMFM should be collapsed from 0 (subject does not initiate task), 1 (subject initiates task), 2 (subject partially completes task), 3 (subject completes task) to 0 (subject does not initiate task), 1 (subject initiates or partially completes task), 2 (subject completes task) for better accuracy in estimating the gross motor function of children with cerebral palsy.