• Journal of Korean Physical Therapy Science
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• v.26 no.2
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• pp.61-73
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• 2019

Purpose: This study was to evaluate the effect of cranio-cervical flexion based trunk stabilization exercise on gross motor function and posture alignment change in children with spastic cerebral palsy. Design: Randomized Controlled Trial. Methods: Twenty-six children participated in this study. All subjects were randomly assigned to either the Cranio-Cervical Flexion Based Trunk Stabilization Exercise (CCFTS) group (n=13) or the Trunk Stabilization Exercise (TS) group (n=13). In both groups were trained general physical therapy for 10 minutes, in the CCFTS group was trained cranio-cervical flexion based trunk stabilization exercise for 20 minutes and in the TS group was trained trunk stabilization exercise for 20 minutes. The training was provided 2 times a week during 8 weeks. All subjects were measured with the Gross Motor Function Measure (GMFM) and Cranio-Vertebral Angle (CVA) before and after intervention. Results: The results showed that the CCFTS have increased significantly in GMFM (B, C, D and E-dimension) and CVA, and the TS group have increased significantly in GMFM (B, C D and E-dimension). In particular, the CCFTS group improved significantly than TS group in GMFM (B, C and D-dimension) and CVA. Therefore, the cranio-cervical flexion based trunk stabilization exercise improved gross motor function and posture alignment in children with spastic cerebral palsy. Conclusion: These results suggest that cranio-cervical flexion based trunk stabilization exercise is feasible and suitable for individuals with a spastic cerebral palsy and can be used in addition to conventional physical therapy.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.3
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• pp.71-83
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• 2019

Purpose: This meta-analysis aimed to analyze to the effects of aquatic exercise programs in children with cerebral palsy and identify directions for future research. Methods: A systematic search based on the PRISMA guidelines was undertaken for studies conducted between 2006 and 2018 on aquatic exercise programs in children with cerebral palsy. A total of 10 studies were selected according to the inclusion criteria. The methodological quality was assessed using the Risk of Bias Tool for Randomized Controlled Trials (RoB) and Risk-of-Bias Assessment Tool for Non-randomized Studies (RoBANS). A meta-analysis software (CMA 3.0) was used to calculate the mean effect size, effect size by intervention (Halliwick and Watsu Aquatic methods), and effect size by outcome. Results: The mean effect size was 0.457. The effect size by intervention was largest for the Halliwick method, followed by the Watsu method. The effect size by outcome was largest for range of motion, followed by the gross motor function measure, the Pediatric Berg Balance Scale, and the Modified Ashworth Scale. Meta-regression analysis showed effect size increased when sample size, number of sessions, and length of sessions increased. Conclusion: The results show that aquatic exercise programs have a positive effect on children with cerebral palsy. Therefore, it is necessary to develop a guideline that recommends the appropriate intervention and the identifies the direction of future studies on aquatic exercise programs.

• The Journal of the Korea Contents Association
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• v.9 no.7
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• pp.248-256
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• 2009

The purpose of this study was to investigate the relationship among functional evaluation systems, the Manual Ability Classification System (MACS), the Gross Motor Function Classification System (GMFCS), and the functional status (WeeFIM) in children with spastic cerebral palsy and to provide the foundation data about MACS for evaluation system of hand function in children with spastic cerebral palsy. For this, sixty children with spastic cerebral palsy were employed in this study. The sixty children were evaluated by using the MACS for their hand function and by using the GMFCS for their motor function. The functional status were assessed by using the Functional Independence Measure of Children (WeeFIM). There were a significant correlation between the MACS and the GMFCS (r =.659, p <.05). The good correlation between the MACS and WeeFIM was found (r = -.576, p <.05). The functional status according to the hand function level evaluated by using the MACS were different significantly (p <.05). The MACS in practice will provide usefulness for assessment of hand function in children with spastic cerebral palsy.

• Journal of The Korean Society of Integrative Medicine
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• v.3 no.3
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• pp.35-42
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• 2015

Purpose : The purpose of this study was to analyze the effects of aquatic rehabilitation program on gross motor function measure and balance in children with cerebral palsy. Methods : Subjects of this study, among the children who received the diagnosis cerebral palsy, for children total of 14 people have agreed to research. Cerebral palsy of 14 chilidren were applied to aquatic rehabilitation program. The training courses 30 minutes 3 times weekly, examined the changes in gross motor function ability to examine a total of 4-week course effectively. Result : The results of this study is First, 14 cerebral palsy appeared a significant difference in GMFM-C, GMFM-D and GMFM-E(p<.01). Secondly, 14 cerebral palsy appeared a significant difference appeared in the balance capability after the experiment(p<.01). Conclusion : It is possible that the application of aquatic rehabilitation program is to effective in improvement of gross motor function measure and balance ability to children with cerebral palsy.

• Journal of the Korean Society of Physical Medicine
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• v.7 no.2
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• pp.213-221
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• 2012

Purpose : The purpose of this study was to investigate the effect of Vojta therapy on Gross Motor Function Measurement(GMFM) and Selective Voluntary Motor Control (SVMC) in children with Spastic diplegia. Methods : During this experiment, the subject of four children diagnosed with spastic diplegia was tested using ABA design for Single-subject Experimental Research Design. The procedure consisted of baseline, intervention and follow-up phase which was held thirty minutes each for three times a week for a total of 24 times. Gross motor function was measured using GMFM and selective voluntary motor control was measured using SCALE. Results : According to this study, the gross motor function and selective voluntary motor control of all subjects were improved from their intervention phase to their baseline phase. During the follow phase which the intervention was removed, the ability that was enhanced during the prior phases was still either maintained or only reduced slightly. Conclusion : The Vojta therapy used on children diagnosed with spastic diplegia was effective on both GMFM and SVMC. In other words, the therapy was effective on coordination. However, this study is difficult to be generalized due to the insufficient number of subject. In further studies, it will be necessary to increase the number of trials with a control group in order to generalize the effectiveness of Vojta therapy.

• Journal of The Korean Society of Integrative Medicine
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• v.4 no.4
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• pp.53-65
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• 2016

Purpose : The purpose of this study is to evaluate the effects of virtual reality based exercise program on gross motor function and balance of children with spastic cerebral palsy. Method : Subjects of this study, among the children who received the diagnosis spastic cerebral palsy, for children total of 8 people have agreed to research. Experimental group 4 people, control group 4 people, was a total of 8 people. Group-specific arbitration method, was applied to Nintendo Wii Fit game (experimental group) and exercise program (control group). Each training courses 30 minutes for 4 weeks, examined the changes in Gross Motor Function Measure(GMFM) and Pediatrics Balance Scale(PBS) ability to examine a total of 4-week course effectively. The intervention were compared by measuring before and after. Result : There were significant improvements in the subscales of the gross motor function and balance test of those who practiced with the Nintendo Wii Fit game, while the control group showed no significant changes. Conclusion : Therefore, the virtual based on exercise is effective in improvement of to improve the gross motor function and balance in children with spastic cerebral palsy.

• Journal of the Korean Society of Physical Medicine
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• v.5 no.2
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• pp.281-288
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• 2010

Purpose : The purpose of this study was to examine the correlation between Pediatric Balance Scale(PBS) and Gross Motor Function Measurement(GMFM) with cerebral palsy(CP) children. Methods : 31 ambulatory children with CP were recruited for this study. PBS is a modified version of the Berg’s Balance Scale to access the children with motor impairments. To access the motor functions that directly influence to the functional independence of the ambulatory CP children, total scores of standing category and walking/running/jumping category of GMFM were selectively compared with PBS score by Spearman correlation coefficient analysis. Results : The results revealed high correlation between PBS and GMFM scores both in standing and walking/running/jumping categories(r=.9). Conclusions : Therefore, this study indicates that PBS can be applied not only as a tool to access balance, but also as a measurement to predict and access the level of standing and ambulatory related functions of children with CP.

• Journal of Chest Surgery
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• v.32 no.4
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• pp.341-346
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• 1999

Background: Thirty children ranging from 3 to 15 years of age underwent cardiac valve replacement at Dongsan Medical Center from 1982 to 1997. Material and Method: There were 16 boys and 14 girls. The mean age was 12.1. The underlying pathological cause for valve replacement was congenital heart disease in 17 children and acquired heart disease in 13. The valve replaced was mitral in 15 children, aortic in 11, tricuspid in 3, and combined aortic and mitral in 1. Twenty-one mechanical and 10 tissue valves were placed: primary mechanical valve have been utilized since 1985. Eight of ten patients with tissue valves have had successful second valve replacements 4 to 11 years after the initial operation. Result: The operative mortality was 6.7%, but mortality was higher among patients less than 5 years of age and patients who had previous cardiac operations. Of the 28 operative survivors, 4 patients were lost to follow-up: the remaining patients were observed for a total of 2091 patient/months(mean 74.7 months, maximum 187 months). There was one late death from dilated cardiomyopathy after mitral valve replacement in 7 year-old patient with atrioventricular septal defect. After the operation, all patients with mechanical valves were placed on a strict anticoagulant regimen with Coumadin. The actuarial survival rate was 96% at the end of the follow-up. No instance of thromboembolism or major bleeding were observed in the survivors. Conclusion: These results indicate that valve replacement can be performed with low mortality in children, and with satisfactory long-term survival.

• Journal of Chest Surgery
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• v.35 no.1
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• pp.52-55
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• 2002

We report one case of an 18-day-old female patient, weighing 3.4 kg, with severe cyanosis. The diagnosis was made with only transthoracic echocardiography, which revealed cor triatriatum with an atretic small opening of fibromuscular membrane, obstructive infracardiac total anomalous pulmonary venous drainage(TAPVD), severely restrictive interatrial communication, and scanty mitral inflow and aortic forward flow. The preoperative decision-making for biventricular repair was not easy due to collapsed left heart system caused by remarkably reduced blood flow An emergent operation was performed due to severe cyanosis. All left heart structures were somewhat hypoplastic but thought to be adequate for systemic circulation. Biventricular repair was done without specific intraoperative problems. The postoperative course was uneventful. The patient has been doing well with no evidence of pulmonary vein stenosis or mitral regurgitation for 4 months after operation.

• Physical Therapy Korea
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• v.8 no.1
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• pp.20-34
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• 2001

This paper presents the relevance between GMFM and the spatiotemporal parameters of gait in children with cerebral palsy. Twenty-one children ($73.11{\pm}30.06$ months) with cerebral palsy participated in this study. GMFM was performed and spatiotemporal parameters of gait were measured by foot print gait analysis. A correlation analysis was used to investigate the correlation between GMFM scores and spatiotemporal parameters of gait. A linear regression analysis was employed to find how much each gait spatiotemporal parameters could be predicted from GMFM scores. The total GMFM scores was significantly correlated with walking speed, cadence, and stride length. Dimensions D (standing) and E (walking, running, and jumping) were more significantly correlated with gait spatiotemporal parameters than dimensions A (lying and rolling), B (sitting), and C (crawling and kneeling). The GMFM scores were useful for predicting spatiotemporal parameters. However, it is difficult to predict the status of gait development using GMFM scores because GMFM scores and gait spatiotemporal parameters are only measured as quantities not qualities. In the field, it is easily found that many children with cerebral palsy are unable to walk in any way. Consequently, gait analysis cannot be performed in many cases. Therefore, it is more reasonable to investigate the influence of GMFM on spatiotemporal parameters, rather than vice versa.