• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.2
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• pp.122-131
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• 2019

The majority of children with cerebral palsy (CP) have feeding difficulties and are especially prone to malnutrition. The early involvement of a multidisciplinary team should aim to prevent malnutrition and provide adequate nutritional support. Thorough nutritional assessment, including body composition, should be a prerequisite for the nutritional intervention. As in typically-developed children nutritional support should start with dietary advice and the modification of oral feeding, if safe and acceptable. However, for prolonged feeding, in the presence of unsafe swallowing and inadequate oral intake, enteral nutrition should be promptly initiated and early gastrostomy placement should be evaluated and discussed with parents/caregivers. Gastrointestinal problems (oropharyngeal dysfunction, gastroesophageal disease, and constipation) in children with CP are frequent and should be actively detected and adequately treated as they can further worsen the feeding process and nutritional status.

• Physical Therapy Rehabilitation Science
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• v.9 no.1
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• pp.55-65
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• 2020

Objective: The most important goal of hippotherapy is to improve function, gait, and balance. The purpose of this study was to investigate the effects of hippotherapy on function, gait, and balance of children with cerebral palsy (CP). Design: A systematic review and meta-analysis. Methods: We've searched the PubMed, EMBASE, and Cochrane Library CENTRAL databases for English experimental studies published up until September 2018. To analyze the effects of hippotherapy on the function, gait, and balance of children with cerebral palsy, the systematic review and meta-analysis were performed on Patient/Participants/Population Problem, Intervention, Comparison, Outcome with Timing, Setting Study Design. Papers retrieved from the database were removed from the literature management database. Methodological quality evaluation was evaluated using Cochrane's risk of bias. Data was analyzed using the Revman 5.3 program of the Cochrane library. Results: In this study, we found that the effect size of hippotherapy, denoted as d, was -3.82, and that hippotherapy had the most effect on gait, but no statistical significant difference was observed. We also found no significant difference in function and balance after hippotherapy. It was found from the funnel plot that there was no publication bias as the plot was symmetrically distributed around the dotted line. Conclusions: There are many unclear studies and a lack of randomized controlled trials (RCTs) in this research area. More RCTs on the effects of hippotherapy on children with CP should be conducted in the future.

• The Journal of Pediatrics of Korean Medicine
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• v.17 no.2
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• pp.173-198
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• 2003

Back ground : Cerebral palsy(CP) is a static encephalopathy caused by an insult to the brain during the prenatal, perinatal, or postnatal period (ie, up to 2 years). CP can lead to global dysfunction but always includes motor problems Objective : The purpose of this study is to investigate the current tendency of oriental approach to the CP and promote oriental treatment of CP in Korea Method : Investigation of current literature and clinical paper in Korea and Chinese Result and Conclusion : 1) CP fall under the category of wu-chi(five kinds of retardations : 五遲), wu-ruan(five kinds of flaccidity : 五軟), wu-ying(five kinds of Stiffness : 五硬) in oriental medicine and correspond to naoxing-tanhuan in current chinese medicine. 2) CP is mainly caused by weakness of the liver and kidney(肝腎不足), weakness of the spleen and stomach(脾胃虛弱), and the method of treatment is tonify the liver and kidney(補益肝腎), tonify the spleen and replenish qi(補脾益氣), but yu-chi(the faculty of speech : 語遲) is caused by deficiency of the heart(心虛) so that treated with method of invigorating the heart and nourishing blood(補心養血). Recently blood stagnancy the stagnation of qi(氣滯血瘀) is considered as the cause of CP, promoting qi circulation to invigorate blood(行氣活血) is mentioned the treatment of method. 3) In addtion to a herbal medication and acupuncture, the various treatments of scalp acupuncture(頭鍼), acupoint injection(穴位注射), catgut embedding therapy(埋鍼) etc. had been applicated to CP and for the objective evaluation of remedial value, TCD, EEG, BMD have been used.

• Integrative Medicine Research
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• v.7 no.4
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• pp.333-340
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• 2018

Background: Traditional Korean medicine (TKM) is widely used to treat children with cerebral palsy (CP) in Korea; however, studies investigating factors that influence the use of TKM are scarce. Thus, we investigated the clinical factors that might influence the use of TKM. Methods: A population-based, cross-sectional, multicenter survey was performed from August 2014 to May 2016. The history of TKM use, type and severity of CP, current treatment characteristics, presence of accompanying disabilities or other health problems not directly related to CP, and monthly cost for the treatment of CP were surveyed. Results: In total, 182 children were recruited, and 78 children (42.9%) had used TKM. Among these 78 children, 50 (64.1% of the TKM-use group) had used both acupuncture and herbal medication, 15 (19.2%) had used acupuncture only, and 13 (16.7%) had used herbal medication only. Children with non-typical CP, accompanying disabilities and general health problems tended to use TKM. The monthly cost of treatment for CP was significantly higher in the TKM-use group than that in the no-TKM-use group, suggesting that economically disadvantaged children may have difficulty in accessing TKM. Dietary supplements, conventional pharmacological treatments, and rehabilitation therapies did not affect TKM use. Conclusion: Children with non-typical symptoms or those with poor overall health status are likely to use TKM. Additionally, TKM use leads to increased treatment costs. Studies investigating the motivation for starting or ceasing TKM therapy, socioeconomic factors and the attitude of parents towards complementary and alternative medicine should be performed.

• Journal of Acupuncture Research
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• v.19 no.4
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• pp.89-100
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• 2002

Objective : We want to have a correct understanding and the distance about the Oriental Medical therapy on the CP(cerebral palsy) children. Methods : We made up a question of parents of CP children and analyzed it. Conclusion : 19 patients were taken physical treatment and 12 patients were taken occupational treatment in company with physical treatment(In our OPD CP patient) Parents complained about poor surroundings of our hospital for children and deficiency of physical treatment. The most satisfactory thing is acupuncture treatment, then the next thing is aroma therapy. On the satisfaction degree about the Oriental Medical therapy, very good is 27.3%, good 45.5%, ordinary 27.3% and unsatisfaction is none. The place Oriental medical therapy before our hospital was taken is local Oriental medical clinic, 9 cases out of 22.

• Physical Therapy Korea
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• v.19 no.3
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• pp.81-90
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• 2012

The aim of the current study was to assess the effectiveness of backward gait training on the treadmill in patients with spastic diplegic cerebral palsy (CP). Twelve patients with spastic diplegic CP participated in the study. An 8-week course of backward gait training was administered to the subjects for 3 days per week. Pre-intervention and post-intervention assessments of temporal-spatial gait parameters, the symmetry of the bilateral lower extremity weight bearing, and gross motor function were analyzed using motion analysis system, force plate, and Gross Motor Function Measurement (GMFM). There were significant improvements (p<.05) in the measures of both step length and right stance phase time. Joint kinematics showed increase in right hip abduction in initial contact and terminal swing, right hip external rotation and knee flexion in mid-swing, left ankle dorsiflexion in initial contact and terminal swing (p<.05). The symmetry of the bilateral lower extremity weight bearing and GMFM also significantly increased (p<.05). These findings indicate that backward gait training using a treadmill is beneficial for patients with spastic diplegic CP.

• Speech Sciences
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• v.15 no.3
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• pp.103-116
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• 2008

Cerebral palsy children represent abnormal vocalization pattern caused by respiration problem and paralyzed oral motor muscle that are the basics of speech production. Thus, this study examined the effect of respiration and articulator training programs on the basic ability of speech production in CP children. The subjects of this study were 4 children with 3 of spastic CP and 1 of ataxia CP. The respiration and articulator program was conducted in 30 sessions for 30 minutes each. Pre-test was administered twice before the program, ongoing test was administered every 5 session during the period of experiment, and post-test was administered twice. The program included speech production such as respiration training, lips, jaw, cheek, and tongue exercise, and velopharyngeal training, and related articulator training. The following results were obtained. First, all subject children were less than 5 seconds in maximum phonation time before the experiment and 2 were improved by more than 4$\sim$5 seconds during the experiment, but 2 had relatively low rising width. Second, while children with less than 30dB before the experiment became bigger in strength during the experiment, children with more than 35dB before the experiment showed a minor change. Subject child 4 had lower vocal strength in the post-test period. Finally, although each subject had individual difference in syllable diadochokinetic ability, the function was improved and the number of repetition in one respiration was also increased.

• MALSORI
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• no.58
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• pp.1-18
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• 2006

The purpose of this study was to investigate diadochokinetic (DDK) characteristics in the subjects with spastic cerebral palsy (CP) by severity. DDK characteristics were measured through rate, regularity, accuracy and consistency in Alternate Motion rate (AMR) and Sequential Motion rate (SMR) tasks. The subjects participated in this study included 27 subjects with spastic CP (mild- 9, moderate- 9, severe- 9) and 9 normal persons who are around 11-20 years old. On the result of this study, rate in AMR was significant difference between all spastic groups and normal group, and rate in SMR was significant difference between normal and mild groups and moderate and severe groups. In regularity of the DDK tasks, severe group had significant difference the other groups. Finally, accuracy and consistency of the DDK tasks exhibited significant difference between all spastic groups and normal group. In conclusion, the subjects with spastic CP have a tendency to produce slow and irregular syllable repetition as severity increases, but to produce inaccurate and inconsistent syllable repetition regardless of severity in the DDK tasks.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.2
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• pp.97-105
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• 2019

PURPOSE: This study examined the factors related to school-based activity performance in school-aged children with spastic cerebral palsy (CP). METHODS: The Gross Motor Function Systems (GMFCS), Manual Ability Classification System (MACS), Communication Function Classification System (CFCS) as functional classifications, and the physical activity performance of the School Function Assessment (SFA) were measured in 79 children with spastic CP to assess the student's performance of specific school-related functional activities. RESULTS: All the function classification systems were correlated significantly with the physical activity performance of the SFA ($r_s=-.47$ to -.80) (p<.05). The MACS (${\beta}=-.59$), GMFCS (${\beta}=-.23$), CFCS (${\beta}=-.21$), and age (${\beta}=-.15$) in order were predictors of the physical activity performance of the SFA (84.8%)(p<.05). CONCLUSION: These functional classification systems can be used to predict the school-based activity performance in school-aged children with CP. In addition, they can contribute to the selection of areas for intensive interventions to improve the school-based activity performance.

• The Journal of Korean Physical Therapy
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• v.25 no.5
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• pp.246-251
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• 2013

Purpose: The purpose of this study was to provide quantitative data regarding development of the chest wall in children with cerebral palsy (CP) according to Gross Motor Function Classification System (GMFCS) levels and age using the radiological image diameter measurement method. Methods: Subjects included 112 children with CP and 110 healthy children, All of the children underwent simple chest x-ray. The diameters of the upper chest ($D_{apex}$) and lower chest ($D_{base}$) were measured on the anteroposterior (AP) view of a chest x-ray, and the $D_{apex}$ to $D_{base}$ ratio was calculated. Chest wall ratios were compared among children with CP at GMFCS levels I ~ III, GMFCS levels IV and V, and healthy children. Results: The results showed significant differences between the upper and lower chest wall diameters of children with CP at GMFCS levels IV and V, and healthy children (F=4.54, p=0.01; F=3.20, p=0.04). Results of comparison between the chest wall ratios of children with CP and healthy children, showed that the upper chest walls of healthy children were significantly larger in children younger than 48 months (p<0.05), and both the upper and lower chest walls of healthy children were significantly larger compared to children with CP in children older than 48 months (p<0.05). Conclusion: Radiographic measurement for examination of chest wall development is relatively simple, and the results yield quantitative data on development of the chest wall for children with CP. In addition, therapeutic interventions may be considered based on the results.