• Phonetics and Speech Sciences
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• v.12 no.3
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• pp.95-103
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• 2020

The current study aimed to identify the characteristics of speech rate and pause in children with spastic cerebral palsy (CP) and their relationships with speech intelligibility. In all, 26 children with CP, 4 with no speech motor involvement and age-appropriate language ability (NSMI-LCT), 6 with no speech motor involvement and impaired language ability (NSMI-LCI), 6 with speech motor involvement and age-appropriate language ability (SMI- LCT), and 10 with speech motor involvement and impaired language ability (SMI-LCI) participated in the study. Speech samples for the speech rate and pause analysis were extracted using a sentence repetition task. Acoustic analysis were made in Praat. First, it was found that regardless of the presence of language impairment, significant group differences between the NSMI and SMI groups were found in speech rate and articulation rate. Second, the SMI groups showed a higher ratio of pause time to sentence production time, more frequent pauses, and longer durations of pauses than the NSMI groups. Lastly, there were significant correlations among speech rate, articulation rate, and intelligibility. These findings suggest that slow speech rate is the main feature in SMI groups, and that both speech rate and articulation rate play important roles in the intelligibility of children with spastic CP.

• Physical Therapy Korea
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• v.30 no.2
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• pp.128-135
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• 2023

Background: Despite the fact that aquatic exercise is one of the most popular alternative treatment methods for children with cerebral palsy (CP), there are few research regarding its effectiveness. Objects: The purpose of this study was to examine the effects of aquatic exercise on upper extremity function and postural control during reaching in children with CP. Methods: Ten participants (eight males and two females; 4-10 years; Gross Motor Function Classification System levels II-IV) with spastic diplegia were recruited to this study. The aquatic exercise program consisted of four modified movements that were selected from the Halliwick 10-point program to enhance upper extremity and trunk movements. The participants attended treatment two times a week for 6 weeks, averaging 35 minutes each session. The Box and Block Test (BBT), transferring pennies in the Bruininks-Oseretsky Test (BOT), and pediatric reaching test (PRT) scores were used as clinical measures. Three-dimensional motion analysis system was used to collect and analyze kinematic data. Differences in BBT and BOT values among pre-treatment, post-treatment, and retention (after 3 weeks) were analyzed using a Friedman test. In addition, the PRT scores and variables (movement time, hand velocity, straightness ratio, and number of movement units) from the three-dimensional motion analysis were tested using a Wilcoxon signed-rank test. The significance level was established at p < 0.05. When the results appeared to be statistically significant, a post-hoc test for multiple comparisons was performed with the Wilcoxon signed-rank test. Results: All clinical measures, which included BBT, transferring pennies of BOT, and PRT, were significantly increased between pre-intervention and post-intervention scores and between pre-intervention and retention scores after treatment (p = 0.001). Three-dimensional motion analysis mostly were significantly improved after treatment (p = 0.001). Conclusion: Aquatic exercise may help to improve body function, activity, and participation in children with varying types of physical disabilities.

• Journal of Preventive Medicine and Public Health
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• v.14 no.1
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• pp.13-22
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• 1981

A study was conducted to provide comprehensive information on epidemiological state of crippled schoolchildren in Chungnam area from November 23,1979 to June 19,1980. In this study, two step survey was conducted upon whole primary, middle and high school, and subsequent selected 537 cases in total 3,063 crippled children. The results obstained are as follows; 1. The prevalence rate of orthopedic defect children was 3.7 per 1,000 and dominant male as 6:4. 2. It was relatively higher the school grade and prevalence rate more increased. Prevalence rate was highest in high school as 4.7 per 1,000, middle in middle school as 4.4 per 1,000 and lowest in primary school as 3.1 per 1,000. 3. The most predominant group was $15{\sim}19$ age as 52.9 percent. 4. The most common job of their parent was agriculture as 52.9 percent and next job sales and service. Economic state of Cripple's parent have revealed no particular difference. 5. In a family, the most common incidence rate was first children in both sex and decreased by ordered sibling. 6. Poliomyelitis was the most common cause as 71.5 percent and next cerebral palsy 11.9 percent. 7. The most common affected site was lower extremity (Right: 42.3%, Left: 35.5%) and next upper extremity. Right was more dominant as 55 : 45. 8. Intelligence was decresed in cerebral palsy predominantly than other cause of defect, including poliomyelitis. 9. For the treatment of their condition at onset of illness, crippled children was utilized private clinic and herb medicine, but was changed tendency of treatment as acupucture and moxibustion after diagnosis of cause of defect.

• Physical Therapy Korea
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• v.24 no.1
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• pp.41-50
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• 2017

Background: The Pediatric Balance Scale (PBS) was developed to assess of balance ability in children with balance problem. The PBS was translated into Korean and its reliability had been studied. However, it had need to be verified using psychometric characteristics including item fit and rating scale. Objects: The purpose of this study was to investigate the item fit, item difficulty, and rating scale of the Korean version of PBS using Rasch analysis. Methods: In total, 40 children with cerebral palsy (CP) (boy=17, girl=23) who were diagnosed with level 1 or 2 according to the Gross Motor Function Classification System participated in this study. The PBS was performed, and was verified regarding the item fit, item difficulty, rating scale, and separation index and reliability using Rasch analysis. Results: In this study, the 'transfer', and 'turning to look behind left and right shoulders while standing still' item showed misfit statistics. in total 40 children with CP. Also, 'transfer', 'standing unsupported with feet together' and 'standing with one foot in front' items showed misfit statistics in diplegia CP group. Regardless of the classification of CP, the most difficult item was 'standing on one foot', whereas the easiest item was 'sitting with back unsupported and feet supported on the floor'. The 4 rating scale categories of PBS were acceptable with all criteria. Both item and person separation indices and reliability showed acceptable values. Conclusion: The PBS has been proven reliable, valid and is an appropriate tool, but it needs to modify the items of PBS according to CP classification.

• Journal of Korean Neurosurgical Society
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• v.66 no.3
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• pp.289-297
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• 2023

Technological advances in neonatology led to the improvement of the survival rate in preterm babies with very low birth weights. However, intraventricular hemorrhage (IVH) has been one of the major complications of prematurity. IVH is relevant to neurodevelopmental disorders, such as cerebral palsy, language and cognitive impairments, and neurosensory and psychiatric problems, especially when combined with brain parenchymal injuries. Additionally, severe IVH requiring shunt insertion is associated with a higher risk of adverse neurodevelopmental outcomes. Multidisciplinary and longitudinal rehabilitation should be provided for these children based on the patients' life cycles. During the infantile period, it is essential to detect high-risk infants based on neuromotor examinations and provide early intervention as soon as possible. As babies grow up, close monitoring of language and cognitive development is needed. Moreover, providing continuous rehabilitation with task-specific and intensive repetitive training could improve functional outcomes in children with mild-to-moderate disabilities. After school age, maintaining the level of physical activity and managing complications are also needed.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.6 no.2
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• pp.116-119
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• 2010

Trauma to the lips and tongue can occur by accidental self-biting after dental treatment. After local anesthesia, it is likely that the patient may feel painless even in biting the tongue. In case of young children and disabled patients, the dentists should be careful not to bite the tongue. In this report, we present a case of deep lingual laceration due to biting the tongue in the course of dental treatment under general anesthesia. A 33 year-old male was transferred to our hospital to treat tongue laceration. Before 2 hour on arrival, he had received dental care under general anesthesia at a dental hospital for the disabled because of cooperation difficulty and cerebral palsy. During recovery from general anesthesia, he tried to bite his own tongue involuntary. The doctors and nurses tried to prevent the patient from being injured. Despite these efforts, massive bleeding occurred from the injured sites of the tongue. Because we could not communicate with him, we decided to evaluate the extent of the injury and treat the injured sites under general anesthesia. The laceration wound was sutured for nearly 1 hr general anesthesia. During recovery we inserted mouth prop into the oral cavity to prevent further injuries from tongue biting. After full recovery from general anesthesia he didn't try to bite his tongue. After 4 hour admission, he was discharged without other complications.

• Physical Therapy Korea
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• v.3 no.3
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• pp.44-58
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• 1996

The purpose of this study was to compare and evaluate various hand functions in the most common position (chair sitting, standing, floor sitting) used by cerebral palsied children with spastic diplegia. The results, analysed statistically, could be useful in suggesting treatment strategy for the improvement of hand function in such patient. For this study, 27 children mild or moderate spastic diplegia were chosen. They were patients of the Rehabilitation Hospital, Yonsei University Medical Center. Both dominant and nondominant hands were tested by the Box and Block Test. Bilateral hand function was tested by bead striding and card sorting activities. Collected data was analysed using univariate correlation analysis and MANOVA. Results were as follows: 1) In chair sitting there was a significant positive correlation between dominant hand scores in the Bloc and Box Test and chronological age, gestation period, and time of treatment initiation. In bilateral hand function, card sorting scores correlated positively with time of treatment initiation. 2) In standing, there was a significantly positive correlation between dominant hand scores in the Block and Box Test and time of treatment initiation. 3) In floor sitting, there was a significantly positive correlation between the dominance hand scores in the Block and Box Test and the tine of treatment initiation. Bead stringing, a bilateral hand activity, correlated positively with gestation period and birth weight but negatively with the postnatal incubation period. 4) That score of children who walked showed no significant difference in any of the three postures. 5) Highest test scores in children who could nat walk were in the Box and Block Test for nondominant hand in bead stringing for bilateral hand function. There scores occurred with the children in thee chair sitting posture. The results showed that, in order to improve hand function in children with spastic diplegia, it is necessary to maintain a well supported upright trunk posture with variations allowed for relevance to the chosen position of thee improvements hand activity being performed.

• The Journal of Korean Physical Therapy
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• v.22 no.6
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• pp.35-42
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• 2010

Purpose: To investigate the rater reliability of a Pediatric Balance Scale (PBS) for children with cerebral palsy, and to investigate possible differences among raters according to their clinical work experience and testing experience. Methods: Study participants included 18 children with spastic cerebral palsy who could walk. They were instructed by pediatric physical therapists, two of whom had ten years of clinical work experience and two who had less than one year of experience. The children's ability to achieve physical balance was videotaped for PBS items. The raters watched the tapes and evaluated each child twice. Rater reliability was analyzed using the intraclass correlation coefficient (ICC). Differences between experienced and novice raters were analyzed using a paired t-test. The statistical significance level was set to 0.05. Results: The total PBS scores averaged 45.78~48.00 and 45.72~47.67 for first and second tests. Intra-rater reliability was very high (ICC=0.89~0.99), and the repeated measurement coincidence was high (p>0.05). Inter-rater reliability was high (ICC=0.83~0.84), but there was a bit of a difference in the coincidence (p<0.05). The experienced raters' reliability and coincidence were higher than those of the novices, and there were differences in reliance and coincidence between experienced and novice raters (p<0.05). Conclusion: Inter-rater and intra-rater reliability is very high. However, rater reliability showed defferences depending on clinical work experience and testing experience. When testing pediatric patients with the PBS, the rater's clinical experience and test experience may affect the test results.

• Journal of Korean Medical Science
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• v.33 no.48
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• pp.309.1-309.13
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• 2018

Background: The aim of this study was to observe long-term outcomes of very low birth weight infants (VLBWIs) born between 2013 and 2014 in Korea, especially focusing on neurodevelopmental outcomes. Methods: The data were collected from Korean Neonatal Network (KNN) registry from 43 and 54 participating units in 2013 and 2014, respectively. A standardized electronic case report form containing 30 items related to long-term follow up was used after data validation. Results: Of 2,660 VLBWI, the mean gestational age and birth weight were $29^{1/7}{\pm}2^{6/7}$ weeks and $1,093{\pm}268g$ in 2013 and $29^{2/7}{\pm}2^{6/7}$ weeks and $1,125{\pm}261g$ in 2014, respectively. The post-discharge mortality rate was 1.2%-1.5%. Weight < 50th percentile was 46.5% in 2013 and 66.1% in 2014. The overall prevalence of cerebral palsy among the follow up infants was 6.2% in 2013 and 6.6% in 2014. The Bayley Scales of Infant Developmental Outcomes version II showed 14%-25% of infants had developmental delay and 3%-8% of infants in Bayley version III. For the Korean developmental screening test for infants and children, the area "Further evaluation needed" was 5%-12%. Blindness in both eyes was reported to be 0.2%-0.3%. For hearing impairment, 0.8%-1.9% showed bilateral hearing loss. Almost 50% were readmitted to hospital with respiratory illness as a leading cause. Conclusion: The overall prevalence of long-term outcomes was not largely different among the VLBWI born between 2013 and 2014. This study is the first large national data study of long-term outcomes.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.8
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• pp.431-440
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• 2019

This study was conducted to investigate changes in activities of daily living (ADLs) according to the Gross Motor Function Classification System (GMFCS) after one year of physical and occupational therapy and to compare the responsiveness of ADL tools. A total of 48 children with spastic cerebral palsy participated in the study. The GMFCS, Functional Independence Measure for Children (WeeFIM), and Pediatric Evaluation of Disability Inventory (PEDI) were measured. The results showed that the GMFCS was significantly correlated with the PEDI (p<0.05), while there was a significant difference in the change of ADLs measured by the PEDI, but not the WeeFIM. There was a significant difference in the changes in ADLs according to the GMFCS, and the change in ADLs in the high functional level group was significantly higher than in the low functional level group (p<0.05). After physical and occupational therapy, the degree of improvement of ADLs varied according to the GMFCS, but seemed to be improved in a clinically meaningfully way. The PEDI is sensitive to changes in ADLs, so it may be used widely in clinical practice.