This study aims to provide basic size data for the development of a hip dislocation prevention garment for cerebral palsy (CP) children and useful information for the design of garment products for CP children through identifying differences in body shape between CP and non-CP children and reviewing the tibial-stature prediction formulas of previous studies. Forty-seven Korean children with CP aged 2 to 14 years were measured for body size from October 2019 to August 2020. Body measurements of 18 sites, including greater trochanter length, which is an important site for a hip dislocation prevention garment, were collected and analyzed. Data of non-CP children were taken from same age of Size Korea and compared. Tibial-stature prediction formulas suggested in four previous studies were also reviewed. CP children had significantly lower stature as well as circumferential dimensions when compared to non-CP children. Greater trochanter length is difficult to predict through other body dimensions. Thus, direct measurement is required. Of the general key dimensions used in the clothing industry, only hip circumference could explain the body shape of CP children. Tibial-stature prediction formulas cannot always but tend to largely predict the actual stature of CP children.
Purpose: Circumference of the chest and waist can be one of clinical indicator to reflect respiratory function in children with cerebral palsy. In this study, we compared to differences in the chest/waist circumference and maximal phonation time between children with spastic diplegia and hemiplegia. Methods: Seventeen children with spastic diplegic and hemiplegic cerebral palsy were recruited, who were matched to gender, age, height, weight, and body mass index for control of the known factors affected to respiratory function. The chest/waist circumference and were measured in each group, when children took a breath at rest and at maximal voluntary inspiration/expiration. Results: No significant differences were found in the chest and waist circumference and expansion between the two groups. However, only in the waist expansion, children with diplegic CP were significantly lower extensibility of lung, compared to the other group. In comparison of the maximal phonation time, a significant lower score was shown in children with spastic diplegic CP, compared to children with hemiplegic CP. Conclusion: Our results indicated that children with spastic diplegic CP had smaller chest wall and waist, compared to children with spastic hemiplegic CP. In addition, they showed a shorter time for sustaining phonation than spastic hemiplegic CP did. Therefore, spastic diplegic CP will be required for careful monitor regarding respiratory function in rehabilitation settings.
Objective : The aim of this study was to review the use of Korean medicine (KM) or Complementary and Alternative Medicine (CAM) therapies among children with cerebral palsy (CP). Method : Literature searches were performed using Pudmed, CNKI, J-STAGE and four Korean databases. We investigated the frequency, types, predictors of the use of KM or CAM therapies used in children with CP. Results : Thirteen survey studies including use of KM or CAM among children with CP were selected - six Korean studies and seven overseas studies. The utilization rate of CAM among children with CP varied 26.8~56.0% according to the studies. CP children used KM or CAM more than other children with chronic disease. Acupuncture and Korean herbal medicine was the major treatment used in Korea, however physical manipulations such as massage, osteopathy and chiropractic were in high demand in western country. Disease severity of CP, use of CAM in the past by the parent or family member and high education of parent are the factors that significantly affect CAM utilization. Conclusion : Further studies on effectiveness and safety of KM therapies combined with conventional rehabilitation treatment would be required to expand the implementation of KM treatment for CP children.
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.
Purpose: The purpose of this study was to identify the level of burden and social support of mothers with Cerebral Palsy (CP) children, and to determine whether providing social support is an effective strategy to relieve the burden of those mothers. Method: From October to November 2007, the data were collected from 63 mothers with CP children who were admitted and treated for CP at Y rehabilitation center in Seoul. The data were analyzed with t-test, ANOVA, Scheffe's test, Pearson's Correlation Coefficient, and Stepwise Multiple Regression using SPSS 12.0. Results: Burden of mothers was related to the Gross Motor Function Classification System (GMFCS) of the CP children. Social support was negatively correlated and GMFCS was positively correlated with burden of mothers. Social support and GMFCS was statistically significantly related with burden of mothers with CP children by multiple regression analysis. Conclusion: There was a significantly negative correlation between social support and burden. It demonstrated that social support, an important factor relating to burden imposed on mothers of CP children, can be considered as an intervening variable which can contribute to decrease of burden. In addition, applying developmental screening measures are needed to decrease disability severity.
Cerebral palsy (CP) is a prevalent neurodevelopmental disorder characterized by motor and postural impairments caused by central nervous system dysfunction. It significantly impacts children's daily functioning and quality of life. Physical therapy is a crucial intervention for children with CP that aims to improve motor skills and functional abilities. This study aimed to provide a comprehensive overview of holistic physical therapy approaches methods specifically designed for children with CP and examine recent research trends and their implications for optimizing outcomes in this population. This study employed a narrative review approach, conducting a comprehensive examination of the current literature pertaining to physical therapy methods for children with CP. The review encompassed studies exploring assessment techniques, evidence-based interventions, and innovative approaches in the field. It was discerned that encompassing physical therapy strategies, which encompass individualized treatment plans, evidence-based interventions, and the integration of innovative techniques, yield a favorable influence on the motor skills and functional capacities of children with CP. This review synthesizes the current knowledge on effective physical therapeutic strategies for children with CP. Furthermore, this review highlights the need for continued research and innovation in the field of pediatric physical therapy for CP.
The purposes of this study were to examine inter-rater reliability of the Manual Ability Classification System (MACS) by children's age and to identify the correlation between the MACS and the Gross Motor Function Classification System (GMFCS) in children with cerebral palsy (CP). Twenty-six children with CP older than two years participated. Children with CP were classified according to the MACS and the GMFCS by two physical therapists. Inter-rater reliability was analyzed using the Intraclass Correlation Coefficients (ICCs). The results showed that the reliability of the MACS for children aged 2~3 years was .88 and for children aged above 4 years was .98 (p<.05). Children with quadriplegia had a higher level of MACS than children with spastic hemiplegia and diplegia. A moderate relationship between the MACS and the GMFCS was found in all children (rater 1, r=.631; rater 2, r=.438). The MACS will be used for classification of children with CP according to the manual abilities. Thus, it offers a reliable method for communicating between therapists about the manual ability of children with CP who are older than 2 years.
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.
Objectives: The purpose of this study was to analyze the aspects of the Korean medicine (KM) treatment among children with cerebral palsy (CP) according to the disease characteristics. Methods: In a prospective observational multicenter study for children with CP, we analyzed 78 baseline questionnaires of children having experience of KM treatments such as acupuncture and Korean herbal medicine and 43 follow-up data of children who have received KM during the one observation year. Results: Of all the 182 participants, 38 children were currently getting KM treatment and 40 children have discontinued KM treatment. Children with non-spastic CP and more health problems tended to use KM. The most frequent reason for quitting acupuncture therapy was 'suffering of children' and the highest reason of stopping herbal medicine was 'rejection of children'. Among the 133 participants finished one year follow-up, 43 children have received at least one KM treatment. The average number of acupuncture therapy was twice a week and the average monthly cost of acupuncture therapy and herbal medicine were 65,922 won and 476,003 won, respectively. Children under 32 month old have received significantly more acupuncture and children with non-spastic CP have taken significantly more herbal medicine. Conclusions: Further study will be required to confirm the effectiveness of KM and increase the utilization of KM among the children with CP. More efforts should be made to increase the convenience of acupuncture therapy and herbal medicine and to expand the insurance coverage of KM for children with CP.
Purpose: The purpose of this study was to describe the functional (mobility, self-care, social ability) and health-related quality of life in children with cerebral palsy (CP). Methods: A cross- sectional survey of 202 children with CP, mean age $5.91{\pm}1.57$ years, was carried out using the Gross Motor Function Classification System (GMFCS), Gross Motor Function Measure (GMFM), Pediatric Evaluation of Disability Inventory (PEDI), and Child Health Questionnaire (CHQ). Results: The functional assessment of children with CP showed that a more severe GMFCS level was associated with lower functional abilities (p<0.05). The health-related quality of life assessment showed that psychosocial well-being was less impaired than physical well-being. The internal consistency of the three instruments was satisfactory (cronbach's ${\alpha}$>0.80). The three different scales were correlated from moderate to strong (r=0.44 to 0.92). It was also found that mobility, tone distribution, and the parents' education level exerted a significant effect on the quality of life of children with CP (p<0.05). Conclusion: These findings suggest that children with CP have reduced function and quality of life and these are influenced by various factors. However, planning and application of various task-oriented functional interventions to childhood CP may be useful.
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