• The Journal of Korean Physical Therapy
• /
• 제24권6호
• /
• pp.398-404
• /
• 2012

Purpose: This is designed to study the effect of weight-support walking training through motor learning on motor functions of children with cerebral palsy, in particular their activity of daily living and balance. Methods: Thirteen children with spastic cerebral palsy, at gross motor function classification system (GMFCS) levels III~IV, underwent treadmill walking training. It used principles of weight support, 4 times a week for 7 weeks, 10 minutes at a time, before and after neurodevelopmental physical therapy. Everyday functions were measured using Functional Independence Measure for Children (Wee-FIM). The ability to keep their balance was measured using electronic measuring equipment from good balance system and the assessment was made before and after the experiment. Results: There were significant differences (p<0.05) between pre and post experiment levels of functional independence in everyday life, in self-care activities, mobility, locomotion and social cognition. With regard to changes in standing balance, there were significant differences before and after the experiment (p<0.05) in GMFCS level III. There was a reduction in the agitation velocity in the x- and y-axes which measures the left-to-right shaking; in GMFCS level IV, velocity moment was reduced. Conclusion: Walking training using a treadmill can help improve the everyday activity and balance in children with spastic cerebral palsy. It can also be served as a useful purpose as a method of intervention in pediatric care.

• 한국전문물리치료학회지
• /
• 제24권1호
• /
• pp.41-50
• /
• 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.

• The Journal of Korean Physical Therapy
• /
• 제22권3호
• /
• pp.37-44
• /
• 2010

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.

• 한국전문물리치료학회지
• /
• 제12권4호
• /
• pp.20-25
• /
• 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
• /
• 제9권3호
• /
• pp.191-196
• /
• 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.

• 한국전문물리치료학회지
• /
• 제3권1호
• /
• pp.57-64
• /
• 1996

Spinal cord injury in child often occurs without evidence of fracture or dislocation. The mechanisms of neural damage in this syndrome of spinal cord injury without radiographic abnormality(SCIWORA) include flexion, hyperextension, longitudinal distraction, and ischemia. Inherent elasticity of the vertebral column in infants and young children, among other age-related anatomical peculiarities, render the pediatric spine exceedingly vulnerable to deforming forces. The neurological lesions encountered in this syndrome include a high incidence of complete and severe partial cord lesions. Children younger than 8years old sustain more serious neurological damage and suffer a larger number of upper cervical cord lesions than children aged over 8 years. Of the children with SCIWORA. 52% have delayed onset of paralysis up to 4 days after injury, and most of these children recall transient paresthesia, numbness, or subjective paralysis. The long-term prognosis in cases of SCIWORA is grim. Most children with complete and severe lesions do not recover; only those with initially mild neural injuries make satisfactory neurological recovery.

• The Journal of Korean Physical Therapy
• /
• 제27권2호
• /
• pp.81-84
• /
• 2015

Purpose: The purpose of this study was to compare the effect of 'knowledge of result' and 'knowledge of performance', two types of extrinsic feedbacks, during the sit-to-stand movement in children with hemiplegic cerebral palsy. Methods: A total of ten children with hemiplegic cerebral palsy (ages 8 to 12 years) were recruited for the study. Subjects with hemiplegic cerebral palsy performed sit-to-stand movement in front of a mirror. Their performance was supervised and revised for normal movement by a pediatric physiotherapist. In the knowledge of the result, subjects performed sit-to-stand using a chair with an armrest in their mind with normal movement. In the knowledge of performance, subjects performed sit-to-stand under verbal instructions. Randomized cross over trials were used in this study. Main outcome measurements were as follows: mediolateral speed, anteroposterior speed, velocity moment, extent in mediolateral direction, extent in anteroposterior direction, and vertical distance of the center of pressure. Results: The mediolateral speed and extent of center of pressure was higher for 'knowledge of performance' in comparison with the other type of extrinsic feedbacks (p<0.05). The other parameters, including anteroposterior speed and extent, and vertical speed of the center of pressure, did not differ between the two types of extrinsic feedbacks (p>0.05). Conclusion: These findings suggested that training in sit-to-stand movement with 'knowledge of result' may result in better use of extrinsic feedback.

• 대한통합의학회지
• /
• 제8권1호
• /
• pp.193-202
• /
• 2020

Purpose : The objective of this study was to provide information about the need and perception of continuing education(CE) according to gender in physical therapists. This study also aimed to provide basic data for the improvement of quality of the CE program with physical therapists. Methods : The study analyzed basic data from Korea Physical Therapy Association regarding the 350 physical therapists in Gwangju metropolitan city (Male; 102, female; 248). The questionnaire consisted of 3 categories: general characteristics, need of CE, and perception. For need of CE and perception, it assessed using a 5-point Likert scale. Data were analyzed using frequency analysis, and simple regression analysis using dummy variable. Results : The need of CE showed a weak positive correlation in the only the pediatric physical therapy according to gender in physical therapists (R²=.012) (p<.05). Both male and female physical therapists had the highest need in the musculoskeletal system, followed by nervous system. The perception of CE were not significantly correlated according to gender in physical therapists (p>.05). Both male and female physical therapists were high on the cyber-CE (Q4) and on the need for CE (Q1, Q2, Q3). Whereas, a lower score was found in category that CE helped in the performance of the work (Q6, Q7, Q8). Conclusion : In this study, there was little or no significant correlation between need and perception of CE according to gender in physical therapists. Both male and female physical therapists recognize the need for CE, whereas they are less satisfied the efforts of CE in the performance of the work. Therefore, improvement of CE through various programs should be made to enhance the perception of CE.

• 대한건축학회논문집:계획계
• /
• 제34권10호
• /
• pp.83-94
• /
• 2018

In many theoretical and empirical studies on the design issues of therapeutic healthcare facilities, spatial configuration that promotes users' wayfinding behavior, has been emphasized as a significant factor to mitigate stressful experiences and to enhance restorative quality in the healthcare environment. This is also applicable to the healthcare setting for children. However, not much evidence has been reported with regard to the relationship between spatial configuration and wayfinding behaviors in this specific setting. Moreover, healthcare facilities for children with physical disabilities need more attention to provide easy wayfinding due to various physical restrictions. The aim of this study is therefore, to unfold the relationship between spatial configuration and visual cognitive qualities of outpatient spaces in the selected children's rehabilitation hospitals in Seoul, by examining visual cognitive attributes such as visibility, accessibility, and intelligibility. In the first phase, the spatial layout of the hospitals was analyzed, with an emphasis on the major outpatient areas such as the entrance lobby, doctors' examination, and physical therapy zones. In the second phase, a space syntax tool was implemented to examine visual cognitive characteristics of the spatial configuration. The spatial configuration parameters measured were integration, integration core, visual isovist field continuity, correlation between integration and step depth, and the correlation between integration n and integration 3. As a result, the integration was higher in the hall type configuration. Circulation intersections acted mostly as integration cores for better visibility. Some areas showed the lack of continuity in the visual isovist fields overlap and irregular correlation between integration and step depth. The intelligibility was higher in the circulation area and social interaction spaces such as a cafe, reception waiting, and therapy waiting areas. Based on the analysis, design implication and possible future improvement were discussed to enhance wayfinding experiences in the hospitals for children with physical disabilities.

• 한국전문물리치료학회지
• /
• 제24권2호
• /
• pp.58-65
• /
• 2017

Background: Children with cerebral palsy (CP) have impaired postural control, but critically require the control of stability. Consequently, therapeutic interventions for enhancing postural control in children with CP have undergone extensive research. One intervention is sensorimotor training (SMT) using a Flexi-bar, but this has not previously been studied with respect to targeting trunk control in children with CP. Objects: This study was conducted to determine the effect of SMT using a Flexi-bar on postural balance and gait performance in children with CP. Methods: Three children with ambulatory spastic diplegia (SD) participated in the SMT program by using a Flexi-bar for forty minutes per day, three times a week, for six weeks. Outcome variables included the pediatric balance scale (PBS), trunk control movement scale (TCMS), 10 meter walking test (10MWT), and 3-dimensional movement coordination measurement. Results: The SMT provided no statistically significant improvement in PBS, TCMS, 10MWT, or 3-dimensional movement coordination measurement. However, positive changes were observed in individual outcomes, as balance and trunk control movement were improved. Conclusion: SMT using a Flexi-bar may be considered by clinicians as a potential intervention for increasing postural balance and performance in children with SD. Future studies are necessary to confirm the efficacy of Flexi-bar exercise in improving the functional activity of subjects with SD.