• The Journal of Korean Physical Therapy
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• 제29권1호
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• pp.16-26
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• 2017

Purpose: This study was conducted to develop a Korean version of the trunk control measurement scale (TCMS) and examine the reliability and concurrent validity of the K-TCMS in children with cerebral palsy. Methods: Subjects for the study were 23 children with cerebral palsy (CP)(mean age: 84.70 months) recruited from one CP clinic. For the interrater and test-retest reliabilities, four raters (A, B, C, D) measured the K-TCMS two times using video clips with an interval of two weeks. For the concurrent validity, the Korean version of the gross motor function measure (K-GMFM) was chosen. Inter-rater reliability and test-retest reliability of the three K-TCMS subscale (static sitting balance, dynamic sitting balance and dynamic reaching) scores and the total scores were investigated using the intra-correlation coefficient ($ICC_{3,1}$). Spearman's correlation coefficient (r) was calculated to investigate the concurrent validity. Results: The inter-rater reliability of the K-TCMS subscales and total scores were all high ($ICC_{3,1}=0.968-0.992$). For the test-retest reliability, $ICC_{3,1}=0.827-0.962$. The concurrent validity between the K-TCMS's total and three subscale scores and K-GMFM's total score were r=0.600-0.667. Conclusion: The results suggest that the K-TCMS can be used in clinical and research settings as a standardized tool for CP children. The K-TCMS might be also useful for selecting treatment goals and planning interventions for children with cerebral palsy.

• The Journal of Korean Physical Therapy
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• 제20권1호
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• pp.49-56
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• 2008

Purpose: Lack of a valid prognosis of gross motor development in children with cerebral palsy (CP) and the absence of longitudinal data on which to base an opinion in Korea have made it difficult to plan treatment and counsel prognosis issues accurately. The purposes of this study were to examine whether the Gross Motor Function Classification System (GMFCS) is valuable to prognostication about gross motor progress in children with CP in Korea. Methods: Medical records of 61 patients were retrospectively reviewed that visited outpatient department and were diagnosed as CP. Various information was surveyed including CP type, visual acuity, cognitive function, motor acquisition age, ambulatory status, development curves of Gross Motor Function Measure (GMFM) according to each of the 5 level of GMFCS. All of them were compared with other studies. Also the gross motor development curves and the maximum GMFM score derived from this study were compared with the Palisano's report and the Rosenbaum's report. Results: Based on a total of 494 GMFM assessments provided by this study, the 5 distinct motor development curves and the maximum GMFM score were created. These observations is corresponding with the Palisano's and the Rosenbaum`s Development curves. Conclusion: The 5 distinct motor development curves (GMFCS) that were created by Palisano's and Rosenbaum's study is useful in Korea, providing parents and clinicians with a means to plan interventions and to judge progress over time.

• Genes and Genomics
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• 제40권12호
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• pp.1339-1349
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• 2018

Cerebral palsy (CP) is a non-progressive neurological disease, of which susceptibility is linked to genetic and environmental risk factors. More and more studies have shown that CP might be caused by multiple genetic factors, similar to other neurodevelopmental disorders. Due to the high genetic heterogeneity of CP, we focused on investigating related molecular pathways. Ten children with CP were collected for whole-exome sequencing by next-generation sequencing (NGS) technology. Customized processes were used to identify potential pathogenic pathways and variants. Three pathways (axon guidance, transmission across chemical synapses, protein-protein interactions at synapses) with twenty-three genes were identified to be highly correlated with CP. This study showed that the three pathways associated with CP might be the molecular mechanism of pathogenesis. These findings could provide useful clues for developing pathway-based pharmacotherapies. Further studies are required to confirm potential roles for these pathways in the pathogenesis of CP.

• 한국전문물리치료학회지
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• 제17권4호
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• pp.69-76
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• 2010

The purposes of this study were to examine the reliability and validity of Korean translation of Pediatric Evaluation of Disability Inventory (PEDI-K) in school-aged children with cerebral palsy (CP). The PEDI-K, Functional Independence Measure for Children (WeeFIM) and Gross Motor Function Classification System (GMIFCS) were completed in 104 school-aged children with CP by therapists. The internal consistency of the PEDI-K was calculated by Cronbach's alpha (${\alpha}$) for assessing reliability. Concurrent validity was evaluated by correlation with the subsets of WeeFIM. Discriminant validity was assessed by comparing GMFCS levels with tests of the PEDI-K. The results showed that internal consistency was good (Cronbach's ${\alpha}$ ranged from .97~.98). Concurrent validity was demonstrated. The correlation with WeeFIM was high in the Functional Skills (self-care, r=.74~.94; mobility, r=.59~.91; social function, r=.65~.93) and in the Caregiver Assistance (self-care, r=.75~.94; mobility, r=.63~.90; social function, r=.78~.96). Discriminant validity was demonstrated on significant decreases in domain scores with increasing GMFCS levels. Reliability and validity have been demonstrated on the PEDI-K. This study extends usage of PEDI-K in clinical activities and research.

• Journal of Animal Science and Technology
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• 제55권2호
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• pp.141-146
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• 2013

This study was performed on 26 disabled adolescent participants (16 male, 10 female) with the objective of testing changes in equilibrium after engagement in horseback riding. Participants of total 26 persons were divided into three groups as follows: 6 children with Cerebral Palsy (CP), 14 children with Intellectual Disability (ID) and 6 children with Autism (AT). Participants engaged in therapeutic horseback riding (TR) two times per week for 30 minutes per session. The 26 participants demonstrated a considerable increase in equilibrium ability, with an average increase in equilibrium time of $44.22{\pm}50.70$ sec after TR. Equilibrium also increased according to disability group: CP (P < 0.05), ID (P < 0.001), and AT (P < 0.05). TR should be considered as a possible method for improving functionality in the physically disabled. This data may also be usefully applied to the development of a horseback riding program for the improvement of equilibrium in the disabled.

• 한국전문물리치료학회지
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• 제21권3호
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• pp.55-62
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• 2014

This study investigated the relationship between function classification systems and the Pediatric Evaluation of Disability Inventory (PEDI) functional skills in children with cerebral palsy (CP). Two hundred and eleven children with CP participated in this study. The Korean-Gross Motor Function Classification System (K-GMFCS), Korean-Manual Ability Classification System (K-MACS), Korean-Communication Function Classification System (K-CFCS), and self-care, mobility, and social function domains of the Korean-Pediatric Evaluation of Disability Inventory (K-PEDI) functional skills were measured by physical therapists or occupational therapists. All of the function classification systems were significantly correlated with PEDI functional skills ($r_s$=-.549 to -.826) (p<.05). Especially, K-GMFCS, K-MACS, and K-CFCS were correlated significantly with mobility, self-care, and social function, respectively. Using stepwise multiple regression analysis, we established that K-GMFCS, K-MACS, and K-CFCS were predictors of self-care skills (74.3%) and mobility skills (79.5%) of the K-PEDI (p<.05). In addition, K-CFCS and K-MACS were predictors of social function (65.9%) of the K-PEDI (p<.05). The information gathered in this study using the levels measured in the function classification systems may be useful to clinicians for estimating the PEDI functional skills in children with CP.

• Physical Therapy Rehabilitation Science
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• 제9권1호
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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.

• 대한물리치료과학회지
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• 제29권4호
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• pp.27-42
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• 2022

Background: Although children with cerebral palsy (CP) are able to walk independently, gait imbalance occurs due to abnormal muscle tone, musculoskeletal deformity, loss of balance, and selective motor control impairment. Gait restriction in the community and school is a major problem of rehabilitation in CP. Home-based therapy (HBT) provides a variety of interventions in which the therapist and the parent work together to resolve the activities and problems caused by the child's body structure. Therefore, we investigate the effectiveness of home-centered therapy on gross motor function in CP and try to present the possibility of clinical application. Design: A Systematic Review Methods: Research papers were published from Jan, 2012 to Jan, 2022 and were searched using Medline and PubMed. The search terms are 'family-centered' OR 'home-based' AND 'cerebral palsy'. A total of nine papers were analyzed in this study. The paper presented the quality level based on Physiotherapy Evidence Database (PEDro) scores to assess the quality of randomized clinical trials studies. Results: The results showed that HBT for strengthening exercise in lower extremity has a positive effect on the isokinetic torque and gross motor function. home-based treadmill therapy in CP is effective to perform at least 12 sessions of treadmill HBP in which the therapist determines the treadmill speed every week and the child's own gait pattern is modified. Conclusion: These results suggest that it will be important data for founding evidence on the effectiveness of home-centered therapy on gross motor function in children with cerebral palsy to advance clinical protocols.

• 대한물리의학회지
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• 제14권4호
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• pp.71-80
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• 2019

PURPOSE: This study examined whether a task-oriented training program is an effective intervention to improve the body function, activity, and participation of children with cerebral palsy (CP). METHODS: Ten children with CP (7-13 years old) performed a task-oriented training program for eight weeks (three sessions per week, 30 minutes each). The taskoriented training program consisted of eight activities. The subjects' body function was assessed using a handheld dynamometer, goniometer, Modified Ashworth Scale (MAS), Balance Performance Monitor (BPM), and the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP). The subjects' activity and participation were assessed using the Gross Motor Function Measure (GMFM) and Timed Up and Go (TUG) test. RESULTS: Task-oriented training provided significant improvements in the subjects' body function. The subjects improved the bilateral isometric muscle strength of the hip flexors, extensors and abductors, knee flexors and extensors, and ankle dorsi- and plantar flexors (p<.05). Bilateral passive hip flexion, abduction, and external rotation, knee flexion, and ankle dorsi- and plantar flexion were also increased (p<.05). In addition, the MAS score of the hip adductors decreased (p<.05) and the BOTMP score increased after training (p<.05). The subjects' activity and participation also improved significantly after training, increasing the GMFM score (p<.05) and decreasing the TUG score (p<.05). On the other hand, the BPM score did not change after training. CONCLUSION: This study suggests that a task-oriented training program can be an effective intervention to improve the body function, activity, and participation for children with CP.

• 대한물리의학회지
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• 제13권1호
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• pp.121-128
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• 2018

PURPOSE: This study assessed the effect of exercise intervention methods on diaphragm movement, pulmonary function, and pulmonary strength in children with cerebral palsy (CP). METHODS: A total of 28 children with CP were randomly allocated to the general exercise group (n=9, GEG), respiratory exercise group (n=10, REG), and intensive exercise group (n=9, IEG). The exercise intervention was performed for 12 weeks. This study measured diaphragm movement, pulmonary function, and pulmonary strength under two different conditions before and after each exercise. Ultrasonography was used for measuring diaphragm movement, and Pony Fx was used to measure the forced expiratory volume in one second ($FEV_1$), peak expiratory flow (PEF), maximum inspiratory pressure (MIP), and maximum expiratory pressure (MEP). A Mann-Whitney test and ANOVA with a significance level of .05 were used for statistical analysis. RESULTS: Significant change was observed between the REG and the IEG as well as between the GEG and the IEG (p<.05). No significant difference was observed between the GEG and the REG. The diaphragm movement, $FEV_1$ PEF, MIP, and MEP were most improved in the IEG (p<.01). CONCLUSION: This study confirmed that intensive exercise is the most effective treatment method for improving diaphragm movement and respiratory function in CP children.