• Journal of the Korean Society of Physical Medicine
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• v.14 no.3
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• pp.91-107
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• 2019

PURPOSE: This study examined the effects of breathing exercise in the water on the pulmonary function and maximum phonation time in children with cerebral palsy. METHODS: The subjects were 24 children with cerebral palsy at GMFCS levels I-III, who were allocated randomly to either the aquatic breathing exercise group or general breathing exercise group 12 subjects per group. Each subject was required to complete 40 minutes of exercise twice a week for eight weeks. Those in the aquatic breathing exercise group performed aquatic breathing exercise, whereas those in the general breathing exercise group performed general aquatic exercise. RESULTS: Significant differences in $FEV_1$, PEF, VC, TV, ERV, and maximum phonation time were observed in the aquatic breathing exercise group after intervention, but there were no significant differences in either FVC, $FEV_1/FVC$, IC, or IRV. In the general breathing exercise group, there were no significant differences in the FVC, $FEV_1$, $FEV_1/FVC$, PEF, VC, IC, TV, IRV, ERV, and maximum phonation time after intervention. In terms of the pulmonary function, the two groups showed a significant difference in the change in $FEV_1$, PEF, and TV after intervention, but not in the FVC, $FEV_1/FVC$, VC, IC, ERV, IRV, and maximum phonation time. CONCLUSION: These results above show that aquatic breathing exercise training in water is more effective in improving the pulmonary function than general breathing exercise training.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.3
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• pp.51-59
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• 2019

Purpose : To evaluate the effect of comprehensive art therapy on physical function and activities of daily living in children with cerebral palsy (CP). Methods : Ten ambulant children with diplegic (n=8) or hemiplegic (n=2) CP participated in this study. All were randomly assigned to either the art therapy group (n=5) or the control group (n=5). Both groups received physical therapy based on neurodevelopmental techniques for 20 minutes a day, 1 day a week, for a period of 12 weeks. Children in the art therapy group received additional comprehensive art therapy for 70 minutes once a week for 3 months. Tests for various measurements-Motricity Index (MI) for strength, Trunk Control Test (TCT) for trunk ability, Gross Motor Function Measure (GMFM) and Gross Motor Function Classification System (GMFCS) for gross motor function, Denver Developmental Screening Test-II (DDST-II) for developmental milestones, Functional Independence Measure of Children (WeeFIM) for abilities to complete daily activities, Leg and Hand Ability Test (LHAT) for limb function-were performed before and after treatments. Results : The upper extremity and whole extremity strengths of MI, self-care and total scores of WeeFIM, and leg and arm functions of LHAT improved significantly only for individuals in the art therapy group after the art therapy (p<.05). The value of MI after treatment was at the upper extremity and whole extremity strengths the leg function of LHAT was also significantly improved compared to the control group (p<.05). Conclusion : This study revealed that comprehensive art therapy along with physiotherapy was effective in increasing upper extremity strength and leg ability in children with CP. This suggests that comprehensive art therapy may be a useful adjunctive therapy for children with CP.

• 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.

• Science of Emotion and Sensibility
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• v.24 no.4
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• pp.139-148
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• 2021

This study aimed to verify how a multisensory storytelling-based activity-based intervention affects social interaction in children with cerebral palsy. As a quasi-experimental investigation, this study used a single-blind, two-group pre-post test design. This study comprised 24 children aged 7 to 8 y who had been diagnosed with spastic cerebral palsy and were classified as having GMFCS stages I to III. Twelve children were randomly assigned to experimental and control groups, with neither the children nor their guardians knowing which group they were placed in. The group program comprised 16 sessions of 60 min each, twice a week for eight weeks. The experimental group engaged in an activity-centered intervention centered on multisensory storytelling, whereas the control group engaged in structured physical activity. The activities were assessed using the peer relations skills scale to determine the extent to which social interaction had changed prior to and during the child's intervention. The SPSS 25.0 for Windows (IBM Corp, USA) application was used to analyze the data, and the significance level (α) for statistical verification was set to 0.05. Furthermore, the Wilcoxon Signed-Rank and Mann-Whitney U tests were used to assess the differences in social interaction between the experimental and control groups. Significant differences were observed in the total of the peer relationship skill scale and cooperation and empathy areas of the subtest in the intragroup change of the peer relationship skill scale between the experimental and control groups. However, the experimental group demonstrated a significant difference in the initiative area, whereas the control group demonstrated no significant difference. A significant difference was observed in the amount of change between the two groups in the initiative area and total of the subtest of peer relationship skills but no significant difference in the collaboration and empathy areas. We gave a multisensory storytelling-based activity-based intervention based on multisensory storytelling to children with cerebral palsy and saw a significant improvement in peer relationship skills. It may be proposed as an effective intervention strategy for children with cerebral palsy who struggle with social contact.

• Journal of the Korean Orthopaedic Association
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• v.54 no.4
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• pp.309-316
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• 2019

Purpose: This study examined the residential environment and accessibility of rehabilitation for cerebral palsy (CP) to identify the problems with residential laws pertaining to the disabled and provide basic data on the health legislation for the rights of the disabled. Materials and Methods: The literature was searched using three keywords: residence, rehabilitation, and accessibility. Two items were selected: residential environment and rehabilitation accessibility. The questionnaire included 51 items; 24 were scored using a Likert scale and 27 were in the form of multiple-choice questions. Results: This study included 100 subjects, of which 93 lived at home and seven lived in a facility. Of these 93 subjects, 65% were living in apartments, usually two or more floors above ground, and 40% of them were living without elevators. According to the Gross Motor Function Classification System, subjects with I to III belonged to the ambulatory group and IV, V were in the non-ambulatory group. Subjects from both groups who lived at home found it most difficult to visit the rehabilitation center by themselves. In contrast, among those who lived at the facility, the ambulatory group found it most difficult to leave the facility alone, while the non-ambulatory group found it most difficult to use the toilet alone. Moreover, 83% of respondents thought that rehabilitation was necessary for CP. On the other hand, 33% are receiving rehabilitation services. Rehabilitation was performed for an average of 3.6 sessions per week, 39 minutes per session. Conclusion: There is no law that ensures secure and convenient access of CP to higher levels. Laws on access routes to enter rooms are insufficient. The disabled people's law and the disabled person's health law will be implemented in December 2017. It is necessary to enact laws that actually reflect the difficulties of people with disabilities. Based on the results of this study, an investigation of the housing and rehabilitation of patients with CP through a large-scale questionnaire will necessary.

• Physical Therapy Korea
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• v.23 no.1
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• pp.55-64
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• 2016

Background: The International Classification of Functioning, Disability, and Health-core set (ICF-core set) for children and youth (CY) with cerebral palsy (CP) provides a useful conceptual framework and a guide for health care planning and measuring the changes brought by interventions across a multitude of dimensions from body functions to personal activities, social participation, and environmental factors for them. Objects: This single case study was reported to illustrate the use of a goal directed approach in applying the ICF-core set for CY with CP from a physical therapist perspective. Methods: An eleven year old boy with spastic CP, Gross Motor Function Classification System (GMFCS) level V, and his mother participated in an evaluation of his functioning state. The intervention goal was set through an interview using the ICF-core set, Canadian Occupational Performance Measure (COPM) and Goal Attainment Scale (GAS). Physical therapy was carried out on an outpatient basis using a goal directed approach for 30 min, 1 time/week during 12 weeks and the boy's gross motor function was assessed using the Gross Motor Function Measure (GMFM)-66 version (item set 2) before and after the intervention. Results: As measured by the boy's mother, the COPM score showed a meaningful clinical change (performance=mean 3.5, satisfaction=mean 2.5) and the T-score of GAS changed 34.4 after the goal directed approach. The GMFM-66 (item set 2) score changed from 31.8 to 38.7 and evaluation using the ICF-core set displayed improvement in 6 items of activity level between before and after the intervention. Conclusion: The ICF-core set for CY with CP is useful for understanding the overall functioning of CY with this condition and provides an opportunity to share and integrate information and opinions from different disciplines. We consider it as a useful tool in the universal language for the therapy and education of CY with CP.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.9
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• pp.4098-4106
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• 2012

This study aims to investigate the effect of trunk muscle strengthening exercises on balance performance of sitting posture and muscle tone, targeting the children with spastic diplegic cerebral palsy. 16 children with spastic diplegic cerebral palsy in IV phase of GMFCS were sampled at random and the tests were conducted for 6 weeks, 3 times per week. For experimental groups, only trunk muscle strengthening exercises were conducted and for control groups, only basic physical therapy was conducted. The trunk muscle strengthening exercise consisted of 2 exercises to strengthen abdominal muscles and back muscles. BPM(Balance Performance Monitor) was used to measure balance performance and MMAS(Modified Modified Ashworth Scale) was used to measure muscle tone. As a result, the changes of sitting balance performance in experimental groups and control groups show significant difference in the changes of sway path and sway velocity(p<.05), the comparison of changes in sitting balance performance in between experimental groups and control groups show significant difference in the changes of sway path and sway velocity(p<.05). Knee flexor muscles and hip adductor muscles in both groups show no significant difference in changes of the muscle tone(p>.05). Therefore, the balance performance in both experimental groups and control groups was improved. However, the experimental group had more significant improvement in balance performance and no change in muscle tone was detected in both groups. Thus, these findings show trunk muscle strengthening exercises are effective in improving the balance performance of sitting posture for the children with spastic diplegic cerebral palsy without changing muscle tone.

• The Journal of the Korea Contents Association
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• v.10 no.6
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• pp.480-488
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• 2010

The aim of this study were to examine the effects of virtual reality program on balance and activities of daily living in children with spastic cerebral palsy (CP) using the Pediatric Balance Scale (PBS) and the Functional Independence Measure for Children (WeeFIM), and to measure relationship between the PBS and the WeeFIM. For this, A total of 20 spastic CP classified as the Gross Motor Function Classification System (GMFCS) I and II were employed. The Participant's were allocated randomly to 2 groups: a virtual reality group (n=10) and the control group (n=10). Both groups received muscle strengthening exercise for 3 sessions, 30 minutes per week over a 12 week period. The virtual reality group practiced additional virtual reality program. The virtual reality group showed significant increases in balance (p<0.05) and activities of daily living (p<0.05). There were a significant correlation between the PBS and the WeeFIM (p<0.05). Application of the virtual reality program to treat the spastic CP will be feasible and suitable. And the PBS was a useful tool to predict activities of daily living in the spastic CP.

• Journal of Oriental Neuropsychiatry
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• v.28 no.2
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• pp.49-59
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• 2017

Objectives: To measure the quality of life in patients according to virtual cerebral palsy severity by using the Korean version of EQ-5D-Y proxy, Visual Analogue Scale (VAS), and Time Trade-Off method (TTO). Methods: The study was conducted in parents of children and adolescents aged 4 to 15 years in Seoul. We analyzed the difference in the utility value according to five levels of cerebral palsy severity in the Gross Motor Function Classification System (GMFCS) and test-retest reliability. Results: 1. There were significant differences in VAS, TTO, and EQ-5D-Y proxy according to the cerebral palsy severity (p<.001). 2. VAS was significantly different according to the respondent's visit to the medical institution, the presence of disease in the respondent, a visit to the child's medical institution, the age of the child, and the sex of the child. The value of TTO was significantly different according to the respondent's visit to the medical institution, respondent's sex, and the age of the child. Also, EQ-5D-Y proxy was significantly different according to the age of the child. 3. Intraclass correlation coefficient values were more than 0.6 for both VAS and TTO at all stages. But for the EQ-5D-Y proxy, the value was less than 0.6 at all stages. Conclusions: The quality of life assessment using EQ-5D-Y proxy showed significant differences in the severity of cerebral palsy. However, large-scale studies using EQ-5D-Y proxy are needed because of low test-retest reliability.