• Physical Therapy Korea
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• v.20 no.3
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• pp.62-73
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• 2013

Pediatric home-based physical therapy (PHBPT) provides professional rehabilitation programs at the patient's home, where the activities of daily life are actually performed. PHBPT also allows to avoid the difficulties of transporting children with disabilities to the clinic. Despite these advantages, PHBPT is not yet widely practiced in Korea. There is little objective information regarding the opinions of the main stakeholders on PHBPT. To investigate the awareness and demand of PHBPT among the main stakeholders, 41 pediatric physical therapists (PT) (of 60 contacted) were recruited from different regions of Korea on the basis of the regional population distribution. The recruited PTs completed their questionnaires and also participated in collecting questionnaires from 35 medical doctors (MD) with whom they worked and from randomly selected 201 parents of children with disabilities recruited. The overall response rate was 85.5%. The awareness of PHBPT differed between PTs (95.1%) and parents (67.2%) (p<.001). The survey showed that 82.9% of MDs had at least heard about PHBPT. Significantly more parents (83.5%) than MDs (57.1%), and 70.0% of PTs, wanted to start PHBPT service immediately (p<.001). Significantly more parents (90.0%) than PTs (73.2%) were willing to participate in PHBPT (p<.001). Opinions on the details of policies and procedures (i.e., necessity for prescription, treatment cost, and treatment frequency) differed among the respondent groups, but all favored a minimal qualification of 6~10 years of pediatric experience and a treatment session duration of 1 hour. These findings provide objective information to support health service administrators to understand the current demand and develop feasible policies and procedures of PHBPT in Korea.

• Physical Therapy Korea
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• v.12 no.4
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• pp.20-25
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• 2005

The Gross Motor Function Measure (GMFM) is an internationally widely used outcome measure. The aim of this study was to evaluate the structural properties of the Korean version of GMFM using the Rasch Model, with regard to scoring within rehabilitation centers in Korea. GMFM data for 206 children with cerebral palsy were collected from 11 outpatient rehabilitation facilities by 29 pediatric therapists. The Winsteps software was used to refine the rating scale. This study suggests that the scoring categories of the Korean version of the GMFM should be collapsed from 0 (subject does not initiate task), 1 (subject initiates task), 2 (subject partially completes task), 3 (subject completes task) to 0 (subject does not initiate task), 1 (subject initiates or partially completes task), 2 (subject completes task) for better accuracy in estimating the gross motor function of children with cerebral palsy.

• Physical Therapy Rehabilitation Science
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• v.9 no.3
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• pp.191-196
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• 2020

Objective: Congenital muscular torticollis (CMT) is a disease with abnormal head and neck posture in infants. It affects the child's movement and development and can lead to complications. Therefore, this study aims to find out what factors influence the rehabilitation treatment duration of infants with CMT. Design: Cross-sectional study. Methods: The subjects were 63 infants under 90 days of age who were diagnosed with CMT. Age, thickness of the sternocleidomastoid muscle (SCM) on the affected and non-affected side, head tilt angle, and head rotation angle of the affected head in infants were collected. The ratio of muscle thickness was calculated from the thickness of the affected SCM and the thickness of the non-affected SCM (A/N ratio). All subjects underwent conservative physical therapy twice a week for 30 minutes, and the end of the treatment was when the angle of head tilt was normal or less than 5 degrees, and the treatment duration was calculated. Results: Age, thickness of affected SCM, and head tilt were significantly correlated with treatment duration (p<0.05). The thickness of the non-affected SCM, A/N ratio, and head rotation angle did not show any correlation with treatment duration. The factors affecting the treatment duration were head tilt and age, showing 21% explanatory power of adjusted R². Conclusions: The main factors affecting the treatment duration of infants with CMT are head tilt and age. Therefore, more attention should be directed to the infant's head tilt and age for effective physical therapy of infants with CMT.

• Physical Therapy Korea
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• v.29 no.2
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• pp.147-155
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• 2022

Background: Although various conventional approaches have been employed to reduce spasticity in neurological rehabilitation, only a few studies have shown scientific evidence for its effectiveness. Thus, we introduced a different concept (Ueda method) of rehabilitation therapy that can complement the limitations of conventional therapy. Objects: This study aimed to investigate the immediate effects of the application of the Ueda method on patients with spasticity after stroke via an electrophysiological study. Methods: We conducted a randomized double-blind pilot study in two rehabilitation hospitals involving 30 stroke patients who were randomly allocated to the Ueda (n = 15) and convention (n = 15) groups. Electromyographic data of six examined muscles in both upper extremities of all patients were recorded. The A-ApA index and activation ratios of upper extremity muscles were evaluated and compared between the groups to confirm post-intervention changes in upper-extremity flexor spasticity and flexion synergies. Repeated-measures analysis of variance was conducted to confirm the therapeutic effect (2 × 2) as a function of group (Ueda vs. convention) and time (pre-/post-intervention) on all outcome measures (p < 0.05). Results: In the Ueda group, the mean A-ApA index values differed significantly before and after the intervention (p = 0.041), indicating a weak evidence level; however, the effect size was medium (d = -0.503). The interaction effects of the A-ApA index between the Ueda and convention groups and between pre-intervention and post-intervention stages were significant (p = 0.012). The effect size was large (n_p² = 0.220). In the Ueda group, the activation ratios of the anterior deltoid fiber significantly decreased after the intervention in all reaching tasks. Conclusion: The Ueda method reduces upper-extremity flexor spasticity and changes its synergy in stroke patients and should be considered a rehabilitation therapy for spastic stroke patients.

• Journal of Yeungnam Medical Science
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• v.41 no.1
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• pp.45-47
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• 2024

Peripheral nerves may be affected or injured for several reasons. Peripheral nerve damage can result from trauma, surgery, anatomical abnormalities, entrapment, systemic diseases, or iatrogenic injuries. Trauma and iatrogenic injuries are the most common causes. The ulnar, median, and radial nerves are the most injured nerves in the upper extremities, while the sciatic and peroneal nerves are the most injured nerves in the lower extremities. The clinical symptoms of peripheral nerve damage include pain, weakness, numbness/ tingling, and paresthesia. Therefore, early diagnosis and appropriate treatment of peripheral nerve injuries are crucial. If a peripheral nerve injury is left untreated, it can lead to severe complications and significant morbidity. The sciatic nerve is one of the most affected nerves. This nerve is generally injured by trauma and iatrogenic causes. Children are more susceptible to trauma than adults. Therefore, sciatic nerve injuries are observed in pediatric patients. When the sciatic nerve is damaged, pain, weakness, sensory loss, and gait disturbances can occur. Therefore, the diagnosis and treatment of sciatic nerve injuries are important to avoid unexpected consequences. Ultrasound can play an important role in the diagnosis of peripheral nerve injury and the follow-up of patients. The aim of this case report is twofold. First, we aimed to emphasize the critical role of ultrasonographic evaluation in the diagnosis of peripheral nerve injuries and pathologies. Second, we aimed to present this case, which has distinguishing features, such as the existence of periostitis ossificans progressiva with sciatic neurotmesis due to a traumatic glass injury.

• Journal of the korean academy of Pediatric Dentistry
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• v.33 no.2
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• pp.323-328
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• 2006

Dentinogenesis imperfecta is an inheritable disease of dentinal defect, generally is inherited as a single autosomal dominant trait. It has a prevalence of 1 in 8000 with the trait, and no significant difference between male and female, with involvement of the primary and permanent teeth. Shields proposed three types of Dentinogenesis imperfecta. Affected teeth have various discoloration, separation of enamel rapid destruction of underlying dentin, and severe attrition. Radiographically, the teeth have cervical constriction, bulbous crown, thin root, obliteration of the root canals and pulp chambers, and periapical lesions in a sound tooth. The objective of treatment is rehabilitation of the esthetics, the masticatory function, and the vertical dimension of occlusion. In these cases, two pediatric patients reported to the Kyungpook University Pediatric clinic, with a chief complaint of discolored teeth and severe attrition. As a result of clinical and radiographic exam, it was diagnosed as Dentinogenesis imperfecta. The posterior teeth were restored with Stainless Steel Crown, and the anterior teeth were restored with composite resin veneering.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.3
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• pp.927-930
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• 2012

Background and Objectives: Artificial neural networks (ANNs) are flexible and nonlinear models which can be used by clinical oncologists in medical research as decision making tools. This study aimed to predict distant metastasis (DM) of colorectal cancer (CRC) patients using an ANN model. Methods: The data of this study were gathered from 1219 registered CRC patients at the Research Center for Gastroenterology and Liver Disease of Shahid Beheshti University of Medical Sciences, Tehran, Iran (January 2002 and October 2007). For prediction of DM in CRC patients, neural network (NN) and logistic regression (LR) models were used. Then, the concordance index (C index) and the area under receiver operating characteristic curve (AUROC) were used for comparison of neural network and logistic regression models. Data analysis was performed with R 2.14.1 software. Results: The C indices of ANN and LR models for colon cancer data were calculated to be 0.812 and 0.779, respectively. Based on testing dataset, the AUROC for ANN and LR models were 0.82 and 0.77, respectively. This means that the accuracy of ANN prediction was better than for LR prediction. Conclusion: The ANN model is a suitable method for predicting DM and in that case is suggested as a good classifier that usefulness to treatment goals.

• Clinical and Experimental Pediatrics
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• v.61 no.2
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• pp.59-63
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• 2018

Purpose: Cardiomyopathy is becoming the leading cause of death in patients with Duchenne muscular dystrophy because mechanically assisted lung ventilation and assisted coughing have helped resolve respiratory complications. To clarify cardiopulmonary function, we compared cardiac function between the home ventilator-assisted and non-ventilator-assisted groups. Methods: We retrospectively reviewed patients with Duchenne muscular dystrophy from January 2010 to March 2016 at Gangnam Severance Hospital. Demographic characteristics, pulmonary function, and echocardiography data were investigated. Results: Fifty-four patients with Duchenne muscular dystrophy were divided into 2 groups: home ventilator-assisted and non-ventilator-assisted. The patients in the home ventilator group were older ($16.25{\pm}1.85years$) than those in the nonventilator group ($14.73{\pm}1.36years$) (P=0.001). Height, weight, and body surface area did not differ significantly between groups. The home ventilator group had a lower seated functional vital capacity ($1,038{\pm}620.41mL$) than the nonventilator group ($1,455{\pm}603.2mL$). Mean left ventricular ejection fraction and fractional shortening were greater in the home ventilator group, but the data did not show any statistical difference. The early ventricular filling velocity/late ventricular filling velocity ratio ($1.7{\pm}0.44$) was lower in the home ventilator group than in the nonventilator group ($2.02{\pm}0.62$. The mitral valve annular systolic velocity was higher in the home ventilator group (estimated ${\beta}$, 1.06; standard error, 0.48). Patients with Duchenne muscular dystrophy on a ventilator may have better systolic and diastolic cardiac functions. Conclusion: Noninvasive ventilator assistance can help preserve cardiac function. Therefore, early utilization of noninvasive ventilation or oxygen may positively influence cardiac function in patients with Duchenne muscular dystrophy.

• Physical Therapy Rehabilitation Science
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• v.11 no.1
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• pp.24-31
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• 2022

Objective: This study attempted to find out if it changes the child's ability to perform daily life activities when visiting the familiar environment and daily living space of children with cerebral palsy and conducting a home activity support program for children and parents. Design: Randomized Controlled Trial Methods: Among 22 children aged 3 to 12 years old, they were assigned to the intervention group and control group. Of these, 12 boys and 10 girls participated in the study. Gross motor function measure and upper extremity function evaluation were used to measure the physical function of children with cerebral palsy, and self-care skills, mobility and social functions were evaluated in the pediatric evaluation of disability inventory. In addition, a parenting sense of competence was used to find out the efficacy of parents in raising children. After the pre-evaluation, basic rehabilitation treatment and intervention programs were applied to the intervention group, and only basic rehabilitation treatment was performed to the control group, and post-evaluation was performed 8 weeks later. Results: As a result of the study, among the items that measured the gross motor function, upper limb function, and daily life performance ability of the intervention group in the difference between the intervention group and the control group, statistically improved in personal processing and movement (p<0.05). In addition, the parenting sense of competence children in the intervention group was statistically significant (p<0.05). Conclusions: The home activity support program will help strengthen the ability of cerebral palsy children to perform daily life as a way to set mutually agreed goals with their families or children and achieve them in a familiar environment.

• Korean Journal of Family Social Work
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• no.55
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• pp.59-90
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• 2017

The purpose of this study is to identify the overall effect of Family Hope Partner Project conducted by the Korean Association for Children with Leukemia and Cancer (KACLC) for pediatric cancer patients and their families and provide empirical basic data for the support of them. For this purpose, this study applied a qualitative research methodology as follows; 6 parents and 5 children who used the service for more than one year through the Family Hope Partner Project participated in the interviews. The interviews were conducted from June to July 2016, and the collected data were analyzed through the processes of qualitative analysis. The results of this study are as follows. Pediatric cancer patients and their families who were previously confronted with problems such as a 'barrier of severe pain' and 'swirling anxiety and exhaustion' experienced multi-dimensional effects, thanks to the intervention of 'a genuine master serving as a stepping stone toward their recovery and growth', who were linked to the pediatric cancer patients through Family Hope Partner Project. In other words, they experienced positive effects such as 'support for overall rehabilitation of pediatric patients', 'improvement of family relations', 'relief of needs for social relations', and 'liberation from pressure'. The results of this study were meaningful, in that it substantially corroborated the multidimensional effects of the Family Hope Partner Project, and presented the development direction of the Family Hope Partner Project, which was the first of its kind at home and abroad initiated by the Korean Association for Children with Leukemia and Cancer (KACLC) for pediatric cancer patients and their families.