• The Journal of Korean Physical Therapy
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• v.32 no.6
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• pp.341-347
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• 2020

Purpose: The purpose of this study is to introduce a tool for evaluating eye movement and analyze the reliability of measurement based on 10 cases of evaluating the oculomotor function of children with spastic cerebral palsy Methods: The participants were selected by 6 medical and welfare institutions in Busan as GMFCS grade 1-3 among spastic diplegia and hemiplegia. Seven examiners evaluated 3 children for the evaluation of inter-rater agreement of Ocular Motor Score (OMS) and evaluated the condition of the ocular motor of 10 children using OMS, a re-examination was performed at six weeks after the initial examination. SPSS ver.25.0 was used to calculate the interclass correlation coefficient and Wilcoxon's signed-rank test, Mann Whitney-U test. Results: The inter-rater agreement of OMS was 0.89. Second mean values were decreased compared first examination in motility/ductions/version, saccades and smooth pursuit, but there was no significant difference. Children under 6 years old had a high mean value of saccades in first examination and the motility/ductions/version, fixation, saccades in second examination, but there was no significant difference. Spastic diplegia children's mean values were higher in head posture, fixation in 8 gaze directions than hemiplegia children in both first and second examination, but there were no significant differences. Conclusion: Ocular motor function in 10 children of spastic children who participated in the study and could see that the scores was differed depending on age, type, grade of cerebral palsy. OMS may be available for this purpose.

• 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.

• Journal of Korean Physical Therapy Science
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• v.18 no.2
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• pp.17-28
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• 2011

Purpose: The aim of this study was to ascertain the effects of the lower extremity muscle strengthening exercise on balance and ambulation of children with cerebral palsy. Methods: 10 subjects who participated in this research undertook the 12-week the lower extremity muscle strengthening exercise program, which consisted of a series of mat exercises and sling exercises. The statistical significances were examined by using Wilcoxon signed-rank test, a non-parametric test, for evaluating the improvement of balance and ambulation of the subjects. In order to evaluate the correlation among the variables, Pearson's correlation coefficients were also calculated. In all statistical analyses the significance level was selected as ${\alpha}$=0.05. Results: Berg balance scale(BBS) was significantly increased after the intervention(p<.05). Percentage weight bearing(PWB) was decreased after the intervention, but there was no significant difference. Time up and go test(TUG) value was significantly decreased(p<.05). Gait velocities was increased after the intervention, but there was no significance. Stride length, step lengths of the affected side and the sound side were significantly increased after the intervention(p<.05). In the correlation analyses of the measures before the intervention, TUG had significant negative correlation to BBS and gait velocity(p<.05). Stride length, step lengths of the sound side and the affected side had significant positive correlation between themselves(p<.01). In the correlation analyses of the measures after the intervention, TUG had significant negative correlation to BBS and gait velocity(p<.05). BBS revealed significant positive correlations to stride length, step lengths of the sound side and the affected side(p<.05). Stride length, step lengths of the sound side and the affected side had significant positive correlation between themselves(p<.01). Conclusion: Based upon the outcomes as above, it is likely that the muscle strength exercises have substantial effects on balance and ambulation of children with cerebral palsy. Thus various lower extremity muscle strengthening exercise programs are required to be studied and developed in order to contribute to functional improvements of children with cerebral palsy.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.1
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• pp.1-10
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• 2014

PURPOSE: The purpose of this study was to investigate the effects of flexible derotator of femur orthosis (FDO) during treadmill gait training on the quadriceps-angle (Q-angle), lateral pelvic tilt, gait speed, and number of steps in children with cerebral palsy. METHODS: Seven children with cerebral palsy who had rotational deformity of the lower extremities participated in this study. We used single group repeated measure design. The procedure consisted of baseline phase, intervention phase, and post-intervention phase. The baseline phase consisted of stretching and strengthening exercise and treadmill gait training without FDO. The treatment phase not only included the same procedures as those for baseline, but also included FDO during treadmill gait training. Postural alignment of the lower extremities was assessed with the Q-angle, and lateral pelvic tilt using the Dartfish software program. A 10-m walk test was used to evaluate gait speed and number of steps. RESULTS: For postural alignment, there was significant differences after the application of FDO (p<.05). For gait ability, there was significant differences in all phases (p<.01). CONCLUSION: These finding suggest that the application of FDO during treadmill gait training had a positive effect on the improvement of postural alignment and gait ability in children with cerebral palsy having rotational deformity.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.2
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• pp.123-130
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• 2016

PURPOSE: This study was conducted to determine correlations between grip and lower limb muscle strength and pulmonary function and respiratory muscle in children with cerebral palsy. METHODS: Subjects were 17 children with cerebral palsy. Inclusion criteria for participation were having GMFCS from I to III grade and ability to independently blow into a spirometer. Pulmonary function and respiratory muscle were measured with a spirometer. All subjects performed maximal expiratory flow maneuvers using a spirometer in order to determine their forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF) and FEV1/FVC, and maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP). Muscle strength was measured in terms of grip strength and lower limb muscle strength in terms of knee extension strength with a dynamometer and manual digital muscle tester respectively. Data were analyzed using Person product correlation. RESULTS: Grip strength significantly positively correlated with FVC (r=0.95, p<0.01), FEV1 (r=0.95, p<0.01), PEF (r=0.84, p<0.01), MIP (r=0.65, p<0.01) MEP (r=0.71, p<0.01) and lower limb strength with FVC (r=0.72, p<0.01), FEV1 (r=0.69, p<0.01), PEF (r=0.54, p<0.05), and MEP (r=0.69, p<0.01). CONCLUSION: Grip and lower limb muscle strengths of children with cerebral palsy were positively correlated pulmonary function and respiratory muscle.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.4
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• pp.195-201
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• 2019

PURPOSE: This study aimed to quantify the effects of whole body vibration (WBV) stimulation training on the muscle thickness and gross motor function in children with spastic cerebral palsy. METHODS: Twenty children diagnosed with spastic cerebral palsy were assigned randomly to the Whole Body Vibration (WBV) group (n=10) and control group (n=10). The WBV group received vibration therapy including five different therapy, and the control group received only five general physiotherapy sessions. After 10 weeks of intervention, the muscle thickness was measured using ultrasound, and the Gross Motor Function D and E items were evaluated. RESULTS: After the intervention, both groups showed a significant increase in muscle thickness and gross motor function (p<.05). The WBV group showed a significant increase in the quadriceps femoris and tibialis anterior muscles compared to the control group, whereas no significant increase in the gastrocnemius muscle was observed (p<.05). The WBV group showed significant improvement in the Gross Motor Function D and E scores compared to the control group (p<.05). CONCLUSION: WBV training may be a useful way of improving the lower extremity muscle strength in children with spastic cerebral palsy, which may help improve the gross motor function.

• The Journal of Korean Physical Therapy
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• v.25 no.4
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• pp.204-209
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• 2013

Purpose: Children with cerebral palsy generally have a high incidence of respiratory problem, resulted from poor coughing, airway clearance problem, respiratory muscle weakness, kyphoscoliosis and so forth. The purpose of this study is to investigate the possible factors that can be affected to forced vital capacity (FVC) in children with cerebral palsy. Methods: Total thirty six children with diplegic and hemiplegic cerebral palsy were recruited in this study. They were evaluated by general demographic data (i.e., age, gender, body mass index (BMI)) and variables related to respiratory functions (i.e., chest mobility, waist mobility, maximal phonation time, and maximum inspiratory/expiratory pressure (MIP/MEP)). The correlation between forced vital capacity and the rested variables were analyzed, and multiple regression with stepwise method was conducted to predict respiratory function, in terms of FVC as the dependent variable, and demographic and other respiratory variables as the independent variable. Results: FVC showed a significant correlation with waist mobility (r=0.59, p<0.01), maximal phonation time (r=0.48, p<0.05), MIP (r=0.73, p<0.01), and MEP (r=0.60, p<0.01). In addition, the multiple regression analysis model indicated that FVC could be predicted by the assessment of each waist mobility and MIP. Conclusion: These finding suggest that respiratory function is related to body size and respiratory muscle strength, and that BMI, waist mobility, and MIP can be predictable factors to affected respiratory function in term of FVC.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.1
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• pp.117-125
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• 2013

PURPOSE: The purpose of this study was to investigate the effect of trunk muscle strengthening exercises on balance performance of sitting posture and upper extremity function, targeting the children with spastic diplegic cerebral palsy. METHODS: 20 children with spastic diplegic cerebral palsy were sampled at random and the tests were conducted for 6 weeks, 3 times per week. For experimental groups, basic physical therapy and trunk muscle strengthening exercises were conducted and for control groups, only basic physical therapy was conducted. BPM(Balance Performance Monitor) was used to measure balance performance and QUEST(quality of upper extremity skills test) was used to measure the upper extremity function. RESULTS: The comparison of changes in sitting balance performance in between experimental groups and control groups show significant difference (p<.05), the changes of the upper extremity function in experimental groups and control groups show significant difference (p<.05). CONCLUSION: Trunk muscle strengthening exercises are effective in improving balance performance and the upper extremity function for the children with spastic diplegic cerebral palsy.

• The Journal of the Korea Contents Association
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• v.10 no.5
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• pp.268-284
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• 2010

The purpose of this study was to evaluate the effects of horseback riding simulation training(HRST) on gross motor function of children with cerebral palsy. Twenty-four children with cerebral palsy participated were divided into two groups randomly. Control group and experimental group both received 30 minutes of regular neuro-rehab exercises for three times a week per twelve weeks, but experimental group received additional 15 minutes of the HRST. Gross Motor Function Measure(GMFM) was used to evaluate the changes before and after HRST. Normalized GMFM scores were compared using Mann-Whitney U test, statistical significance was set at a=.05. The results were as followings: First, in each compared before and after the experiment, the control group showed significantly increased GMFM score in dimensions A and B. The experimental group showed significant increasing in all dimensions of GMFM test. Second, the experimental group showed significant differences comparing to control group in dimensions C, D and E of GMFM test. Consequently, HRST should be considered as a therapeutic method for physical therapy for the children with cerebral palsy to improve the functional movements.

• The Journal of Korean Physical Therapy
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• v.26 no.4
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• pp.274-279
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• 2014

Purpose: The aim of this study was to determine the change of static and dynamic foot pressure on trunk stabilization exercise in children with spastic diplegic cerebral palsy. Methods: This study examined five male children participants ages 10~14 years old with spastic diplegic cerebral palsy. All subjects participated in a 6-week sling exercise program for trunk stabilization; the exercise was performed three times per week and each session lasted 50 minutes. The subjects were measured for static and dynamic foot pressure and bilateral symmetry of both feet before and after the trunk stabilization exercise. Results: The static foot pressure increased significantly before and after the trunk stabilization exercise (left foot: before $0.41{\pm}0.02%BW/cm^2$ after $0.79{\pm}0.02%BW/cm^2$, right foot: before $0.14{\pm}0.03%BW/cm^2$, after $0.43{\pm}0.44%BW/cm^2$) (p<0.05) and bilateral symmetry of both feet increased (before $0.27{\pm}0.18%BW/cm^2$, after $0.37{\pm}0.05%BW/cm^2$) with more weight shift on left foot than right foot, but was not statistically significant (p>0.05). The dynamic foot pressure increased (left foot: before $2.58{\pm}0.44%BW/cm^2$, after $3.40{\pm}0.31%BW/cm^2$, right foot: before $2.75{\pm}0.19%BW/cm^2$, after $3.26{\pm}0.18%BW/cm^2$) with more weight shift on right foot than left foot, but was not statistically significant (p>0.05), and bilateral symmetry of both feet decreased (before $0.31{\pm}0.36%BW/cm^2$, after $0.13{\pm}0.20%BW/cm^2$) (p<0.05). Conclusion: The findings of this study indicated that the trunk stabilization exercise has a positive impact on static and dynamic foot pressure in children with spastic diplegic cerebral palsy.