• Journal of Korean Neurosurgical Society
• /
• v.41 no.1
• /
• pp.22-26
• /
• 2007

Objective : Cerebral palsy may induce harmful spastic hip adduction. We report the result of microsurgical selective obturator neurotomy, performed on 12 spastic hip adductions of 6 patients, followed clinically for at least 26 months postoperatively. Methods : Microsurgical selective obturator neurotomies, involving microsurgical resection of the anterior obturator nerve branches were performed on 6 patients from January 2000 through June 2003. All patients presented with the inability to sit and 2 patients complained of persistent, intractable pain. We used intraoperative bipolar stimulation to identify selected motor branches. Results : The procedure was performed bilaterally in all patients. In the 3 patients in whom contractures were present, microsurgical selective obturator neurotomies were accompanied by an additional tenotomy of the adductor muscles. Selective tibial neurotomy was performed on three of six patients who originally presented with a spastic ankle. Postoperatively, all spastic hip adductions were corrected more than 60 degrees in passive abduction-adduction amplitude. However, one patient who did not receive active postoperative physiotherapy demonstrated a decreased passive abduction-adduction amplitude upon follow-up. There were no surgical complications. Conclusion : We think microsurgical selective obturator neurotomy may be an effective procedure in the treatment of localized, harmful spastic hip adduction after failure of well conducted conservative treatment. As muscular contractions are often associated with spasticity of the hip adductors, an adjunctive tenotomy may be an option. Comprehensive postoperative physiotherapy is essential to improve long-term results.

• Journal of rehabilitation welfare engineering & assistive technology
• /
• v.10 no.4
• /
• pp.251-257
• /
• 2016

The Pediatric Balance Scale (PBS) was balance measurement equipment for school-age children with mild to moderate motor impairments. The aims of this study are to examine the correlation between PBS and spatiotemporal gait parameter and to identify the walking function with cerebral palsy through balance scale. The PBS consists of 14 items such as sitting of standing, standing to sitting, transfers, standing unsupported, standing on one foot, turning 360 degrees, turing to look behind, etc., and the spatiotemporal parameters include walking speed, stride length, step length, step width, cadence, double-limb support. All subjects were independently ambulatory children with spastic diplegic cerebral palsy, and they were assessed on PBS and spatiotemporal gait parameters by an experienced pediatric physical therapist. Pearson's correlation coefficient was used to assess the correlation between PBS and spatiotemporal gait parameters, and the level of significance was set at ${\alpha}$ = 0.05. Total score of PBS(r=.49~.58), standing to sitting(r=.48~.60), turning to look behind(r=.47~.53), and pick up object(r=.52~.69) were positively correlated with walking speed, stride length, step length, and cadence. Most items of the PBS were negatively correlated with double-limb support(r=-.48~-.92). These findings suggest that the pediatric balance scale can be applied to estimate gait function level for children with spastic diplegic cerebral palsy.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.13 no.9
• /
• pp.4098-4106
• /
• 2012

This study aims to investigate the effect of trunk muscle strengthening exercises on balance performance of sitting posture and muscle tone, targeting the children with spastic diplegic cerebral palsy. 16 children with spastic diplegic cerebral palsy in IV phase of GMFCS were sampled at random and the tests were conducted for 6 weeks, 3 times per week. For experimental groups, only trunk muscle strengthening exercises were conducted and for control groups, only basic physical therapy was conducted. The trunk muscle strengthening exercise consisted of 2 exercises to strengthen abdominal muscles and back muscles. BPM(Balance Performance Monitor) was used to measure balance performance and MMAS(Modified Modified Ashworth Scale) was used to measure muscle tone. As a result, the changes of sitting balance performance in experimental groups and control groups show significant difference in the changes of sway path and sway velocity(p<.05), the comparison of changes in sitting balance performance in between experimental groups and control groups show significant difference in the changes of sway path and sway velocity(p<.05). Knee flexor muscles and hip adductor muscles in both groups show no significant difference in changes of the muscle tone(p>.05). Therefore, the balance performance in both experimental groups and control groups was improved. However, the experimental group had more significant improvement in balance performance and no change in muscle tone was detected in both groups. Thus, these findings show trunk muscle strengthening exercises are effective in improving the balance performance of sitting posture for the children with spastic diplegic cerebral palsy without changing muscle tone.

• Journal of the Korean Society of Physical Medicine
• /
• v.5 no.4
• /
• pp.645-654
• /
• 2010

Purpose : The purpose of this study was to investigate changes in the gross motor function, self-esteem and social ability of children with cerebral palsy from group exercise program for physical and emotional interaction. Methods : Five cerebral palsy children who live in U city were recruited this study. Exercise sessions were held for 1 hour per session, once per week, for 12 consecutive weeks. At pre-treatment and post-treatment, subject were tested gross motor function measure, self-esteem and social ability. Results : After 12 weeks of paticipation in the group exercise program for physical and emotional interaction, there were improvements for gross motor function measure, self-esteem and social ability. Conclusion : Group exercise program for physical and emotional interaction can improve gross motor function, self-esteem and social ability.

• 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.

• Journal of Korean Physical Therapy Science
• /
• v.19 no.1
• /
• pp.1-7
• /
• 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.

• Journal of Music and Human Behavior
• /
• v.4 no.2
• /
• pp.84-105
• /
• 2007

Cerebral palsy is a collection of motor disorders resulting from damage to the central nervous system that arise in multiple handicaps including cognitive disorders, speech disorders, epilepsy, perception disorders, and emotion disorders. Today spastic cerebral palsy has become more prevalent because intensive care for newborns has resulted in higher survival rates for very small premature babies. Since the children grow the fastest in order for a development during one year after birth, the therapeutic intervention is provided as early as possible to the children with cerebral palsy. After seven year old, there is no effect of intervention. So, the necessity of early intervention to spastic cerebral palsied infants is increasing. The purpose of this study is to develop the music therapy activity program using the techniques of neurological music therapy(NMT), the therapeutic application of music to dysfunctions due to neurologic disease of the human nervous system, for rudimentary movement phase of spastic cerebral palsied infant. This music therapy activity program was developed on the basis of the major developmental tasks of the rudimentary movement phase, the period that children can acquire the most basic movement function at the 0 to 2. Then the developmental characteristics of spastic cerebral palsy were applied to this music therapy activity program. This music therapy activity program was classified to three domains, those are stability, locomotion, and manipulation. This study has been consisted of three steps, those are the development of the activities, the evaluation of the activities by th panels, and the adjustment and complement of the activities. Reviewing literatures and interviews were done for the development of the activities, and the evaluation the activities was done by seven music therapists. In the evaluation steps, the questionnaire was used for estimating the content validity and application efficiency. The adjustment and complement of the activities were evaluated by the panels who were participating in the music therapy for cerebral palsied children in the clinical setting, and the results of the adjustment and complement were confirmed by the panels. The evaluation was presented in a mean value with the comment of the panels. In conclusion, the music therapy activity program for the spastic cerebral palsied infants using the techniques of NMT was developed on the basis of the major developmental tasks of the rudimentary movement phase. The program is comprised of 38 activities, those are 14 activities for developing the stability, 10 activities for developing the locomotion, and 14 activities for developing the manipulation. The programed activities would bring out the answers in the affirmative for the conformance with infants' development phase, the harmony between the objective and the activity, the conformance with the cerebral palsied infants, the properness of the music and the instruments, and the utility in the clinic field. This results mean that this developed music activity program is appropriate to help spastic cerebral palsied infants progress their movement development by stages.

• The Journal of the Korea Contents Association
• /
• v.10 no.6
• /
• pp.480-488
• /
• 2010

The aim of this study were to examine the effects of virtual reality program on balance and activities of daily living in children with spastic cerebral palsy (CP) using the Pediatric Balance Scale (PBS) and the Functional Independence Measure for Children (WeeFIM), and to measure relationship between the PBS and the WeeFIM. For this, A total of 20 spastic CP classified as the Gross Motor Function Classification System (GMFCS) I and II were employed. The Participant's were allocated randomly to 2 groups: a virtual reality group (n=10) and the control group (n=10). Both groups received muscle strengthening exercise for 3 sessions, 30 minutes per week over a 12 week period. The virtual reality group practiced additional virtual reality program. The virtual reality group showed significant increases in balance (p<0.05) and activities of daily living (p<0.05). There were a significant correlation between the PBS and the WeeFIM (p<0.05). Application of the virtual reality program to treat the spastic CP will be feasible and suitable. And the PBS was a useful tool to predict activities of daily living in the spastic CP.

• Physical Therapy Korea
• /
• v.24 no.1
• /
• pp.51-60
• /
• 2017

Background: In cerebral palsy (CP), parents' quality of life and rearing attitude are considered possible factors that influence patients' quality of life, function level, and performance in daily activities. Despite these facts, little attention has been given to demonstrate a relation between these factors. Objects: This study aimed to demonstrate the relationship between parents' quality of life, functional level, and performance in daily activities, the quality of life of school-aged children with spastic CP. Methods: This study included 24 parents of school-aged children with spastic CP. The KIDSCREEN-52 and World Health Organization quality of life (WHOQOL)-BREF questionnaires (including physical, psychological, social, and environmental domains) were used as research tools to assess the quality-of-life profiles of the children with spastic CP and those of their parents, respectively. In addition, the function levels and performance in daily activities of the children with CP were assessed by using the gross motor function measure (GMFM) and modified Barthel index (MBI). Correlation and multiple regression analyses were performed to clarify the determinants of the quality of life of the children with CP. Results: The KIDSCREEN-52 score correlated with the total score (r=.735, p<.01) and all domains of the WHOQOL-BREF questionnaire (physical: r=.542, p<.01; psychological: r=.690, p<.01; social: r=.568, p<.01; and environmental: r=.783, p<.01). In addition, significant correlation was found between the KIDSCREEN-52 and MBI scores (r=.411, p<.05), and between the MBI and GMFM scores (r=.427, p<.05). After controlling for age, gender, paralytic type, GMFM, and MBI, the WHOQOL-BREF score ($R^2=.621$), particularly in the environmental domain ($R^2=.699$), remained independently related to the quality of life of the children. Conclusion: These findings suggest that the quality of life of school-aged children with spastic CP can be influenced by the quality of life of their parents. This study provides useful information for future studies to investigate the quality of life of children with CP.

• Clinical and Experimental Pediatrics
• /
• v.45 no.4
• /
• pp.512-518
• /
• 2002

Purpose : Cerebral palsies are the most common and severe motor disabilities in childhood. There is currently increased interest in their occurrence and patterns of likely cause for a variety of reasons. Therefore, a retrospective study was carried out to understand the clinical features of cerebral palsy. Methods : A retrospective chart review was conducted of all children with cerebral palsy who were diagnosed at St. Benedict Hospital between March 1999 and March 2001. Results : Cerebral palsy patients were classified into 6 major groups. Of six groups, spastic diplegia is the most common type of cerebral palsy(55.3%). The risk factors of cerebral palsy were placenta previa(1 case), placenta abruption(1 case), cytomegalovirus infection(1 case), prematurity (53 cases), neonatal asphyxia(12 cases), dystocia(2 cases), breech delivery(1 case), multiple birth(5 cases), head trauma(3 cases), meningitis(2 cases) and unknown(26 cases). Among the 59 in the preterm group, 37 patients showed MR or CT images of periventricular leukomalacia. Among the 44 in the term group, 15 patients showed MR or CT images of atrophy. Among 103 patients, 29 patients(28.2%) had a seizure disorder. Conclusion : It is very importent to understand the clinical features and risk factors of cerebral palsy for physicians to diagnose and manage cerebral palsy patient.