• 한국전문물리치료학회지
• /
• 제31권2호
• /
• pp.131-141
• /
• 2024

Background: Standing frames are a common intervention for children with cerebral palsy (CP), yet there is a lack of standardized dosing recommendations, impeding the enhancement of treatment outcomes in this population. Objects: This paper aims to optimize dosing strategies for standing frame programs in children with CP. It evaluates effective durations and frequencies for using standing frames to improve gait, hip joint integrity, functional activities, joint range of motion, and muscle tone. The goal is to provide evidence-based clinical recommendations to guide practitioners in treating pediatric CP patients. Methods: A comprehensive research was conducted across seven databases, yielding 23 studies meeting inclusion criteria. Strength of evidence was assessed using established tools. Clinical recommendations were formulated based on the amalgamation of existing evidence. Results: The paucity of evidence-based dosing recommendations for children with CP supported standing device is highlighted in this review. Key findings suggest that standing frames implemented 5 days per week demonstrate positive effects on gait (45 minutes/day, 3 times/week), hip joint integrity (60 minutes/day), functional activities (60 minutes/day in 30° to 60° of bilateral hip abduction), joint range of motion (60 minutes/day), and muscle tone (30 minutes/day). Conclusion: This systematic review of the treatment regimens for children with CP is providing useful insights to the dosing strategies of standing frames. The evidence supports a 30-60 minutes per day and 3-5 days a week intervention with specified durations for optimal outcomes. In enhancing the effectiveness of standing frames, as well as promoting evidence-based practices in the management of children with CP, these clinical recommendations offer guidance for practitioners.

• 한국산학기술학회논문지
• /
• 제20권8호
• /
• pp.431-440
• /
• 2019

이 연구는 경직성 뇌성마비 아동을 대상으로 1년간 물리 및 작업치료 후 대동작 기능분류체계에 따라 일상생활동작 변화정도가 차이가 있는지 그리고 소아장애척도지수와 아동용 일상생활 기능독립 측정 중 어떤 평가도구가 일상생활 동작의 변화에 민감하게 반응하는지를 알아보기 위해 시행되었다. 48명의 경직성 뇌성마비 아동이 참여하였고, 대동작 기능분류체계, 아동용 일상생활 기능독립 측정, 그리고 소아장애척도지수를 측정하였다. 연구결과, 대동작 기능분류체계는 소아장애척도지수와 유의한 상관을 보였지만(p<0.05) 아동용 일상생활 기능독립 측정과 유의한 상관을 보이지 않았다. 또한 중재 전과 후 일상생활동작의 변화는 아동용 일상생활 독립측정인 경우 유의한 차이를 보이지 않았지만, 소아장애척도지수인 경우 유의한 차이를 보였다(p<0.05). 대동작 기능분류체계에 따라 일상생활동작의 변화는 유의하게 차이가 있었으며, 기능수준이 높은 경우 일상생활동작이 변화가 유의하게 컸었다(p<0.05). 물리 및 작업치료 후 대동작 기능 분류체계에 따라 일상생활동작의 향상정도는 다르지만 임상적으로 의미 있게 향상되는 것으로 보이며, 소아장애척도지수는 일상생활동작의 변화에 민감하게 반응하므로 임상에서 폭 넓게 활용하는 것이 필요한 것으로 여겨진다.

• 대한물리의학회지
• /
• 제12권4호
• /
• pp.133-138
• /
• 2017

PURPOSE: The purpose of this study was to investigate the effect of modified motor developmental intervention on the SCM muscle thickness and the range of motion (ROM) of neck in subjects with congenital muscular torticollis. METHODS: Thirteen subjects who had congenital muscular torticollis were participated in this study and they were offered the modified motor developmental interventions for 8 weeks by pediatric physical therapist. SCM thickness of affected and non-affected side and ROM of neck rotation were collected between before and after intervention. SCM thickness was measured by using Ultrasound Unit (IU 22, Ultrasound system, Philips, Netherlands) and ROM of neck was measured by using the goniometer (Arthrodial protractor, North coast, USA). Data were represented as means ${\pm}SD$. Paired t-test was used to determine the effect of interventions on the SCM muscle thickness and neck ROM. RESULTS: SCM thickness of affected side was significantly decreased after the modified motor developmental interventions and that of non-affected side was generally increased but it was not significantly difference between pre and post interventions. ROM of neck rotation and lateral flexion was significantly increased after interventions. CONCLUSION: These results suggested that the modified motor developmental interventions could improve the recovery of SCM muscle thickness and neck ROM.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제25권3호
• /
• pp.163-179
• /
• 2022

Although functional gastrointestinal disorders (FGIDs) are very common in pediatric patients, there is a scarcity of published epidemiologic data, characteristics, and management patterns from Saudi Arabia, which is the 2nd largest Arabic country in terms of area and the 6th largest Arabic country in terms of population, with 10% of its population aged <5 years. Functional constipation (FC) is an FGID that has shown a rising prevalence among Saudi infants and children in the last few years, which urges us to update our clinical practices. Nine pediatric consultants attended two advisory board meetings to discuss and address current challenges, provide solutions, and reach a Saudi national consensus for the management of pediatric constipation. The pediatric consultants agreed that pediatricians should pay attention to any alarming signs (red flags) found during history taking or physical examinations. They also agreed that the Rome IV criteria are the gold standard for the diagnosis of pediatric FC. Different therapeutic options are available for pediatric patients with FC. Dietary treatment is recommended for infants with constipation for up to six months of age. When non-pharmacological interventions fail to improve FC symptoms, pharmacological treatment with laxatives is indicated. First, the treatment is aimed at disimpaction to remove fecal masses. This is achieved by administering a high dose of oral polyethylene glycol (PEG) or lactulose for a few days. Subsequently, maintenance therapy with PEG should be initiated to prevent the re-accumulation of feces. In addition to PEG, several other options may be used, such as Mg-rich formulas or stimulant laxatives. However, rectal enemas and suppositories are usually reserved for cases that require acute pain relief. In contrast, infant formulas that contain prebiotics or probiotics have not been shown to be effective in infant constipation, while the use of partially hydrolyzed formula is inconclusive. These clinical practice recommendations are intended to be adopted by pediatricians and primary care physicians across Saudi Arabia.

• 한국산학기술학회논문지
• /
• 제13권9호
• /
• pp.3999-4008
• /
• 2012

본 연구는 물리치료사의 직무에 따른 Work-Related Musculoskeletal Disorder(WMSD)s에 대한 증상을 파악하기 위하여 통증치료군(56명), 성인 운동치료군(53명), 소아 운동치료군(22명)을 대상으로 근골격계 증상조사표와 Rapid Upper Limb Assessment(RULA)를 사용하여 근골격계 증상 및 작업의 유해도를 알아보기 위해 실시하였다. 그 결과 통증치료군 69.6%, 성인 운동치료군 84.9%, 소아 운동치료군 81.8%, 평균 77.9%의 자각 증상 호소율을 보였다. RULA를 이용한 인간공학적 위험 평가에서 Final Wrist & Arm Score와 Final Score에서 성인 운동치료군이 단위 시간당 작업 부하량이 가장 많은 것으로 나타났으며 Action Level은 통증치료군이 평균 $3.0{\pm}0.9$, 성인 운동치료군은 $3.3{\pm}0.6$, 소아 운동치료군은 $3.2{\pm}0.8$로 성인 운동치료군에서 가장 높았다. 근골격계 증상에 영향을 미치는 요인 중 키, 가사 노동, 육체적 부담정도, 과거 사고가 통계적으로 유의하였다. 이에 따라 물리치료사의 WMSDs를 방지하기 위한 장비 및 교육시스템이 보급되어야 할 것으로 사료된다.

• 대한물리의학회지
• /
• 제8권4호
• /
• pp.637-645
• /
• 2013

PURPOSE: The purpose of this study was to examine the effect of using a suspension device for arm reaching activity on trunk stability and gross motor function of children with spastic diplegia cerebral palsy. METHODS: The subject in this study consisted of 11, GMFCS(Gross Motor Function Classification System) III~IV children with spastic diplegia cerebral palsy, all of whom agreed to participate in the study. All subjects were divided into two groups: the experimental group using a suspension device, and the control group using no suspension device. For each group, a thirty-minute intervention was done twice per week during 8 weeks. Before and after intervention, each test was measured using TIS(Trunk Impairment Scale), GMFM (Gross Motor Function Measure) and PRT(Pediatric Reaching Test) to change trunk stability, gross motor function and arm reaching activity. The data were analyzed with the Wilcoxon signed rank test. RESULT: All two groups had a meaningful increase in GMFM-Sit data measured before and after intervention. The experimental group had a significant increase from an average of 78.83 to an average of 84.83 in GMFM-Crawling. For both groups, there was a substantial increase in the change in sitting position and arm reaching. CONCLUSION: According to the results of this study, the arm reaching activity using suspension device had an effect on trunk stability and gross motor function and it changed arm reaching activity.

• 대한소아치과학회지
• /
• 제48권2호
• /
• pp.209-220
• /
• 2021

소음은 불쾌감과 신체적 변화를 일으키는 원치 않는 소리로 정의된다. 이 연구는 진료실 환경에서 발생하는 소음의 강도를 평가하고 소아치과의사의 소음환경을 조사하기 위해 시행되었다. 사람의 양측 귀 형태를 재현한 마이크와 휴대용 소음계를 활용하여 소음을 녹음하고 소음의 강도를 계산하였다. 한국 고용노동부 산하 안전보건공단의 소음 측정 규정에 따라 시행하여 다음과 같은 결과를 얻었다. 16일 간 시행한 결과 8시간-가중평균소음수준은 최고 58.54 dBA, 최저 33.97 dBA, 평균 49.33 dBA로 측정되었으며 누적소음노출량은 최고 1.28%, 최저 0.04%, 평균 0.49%로 측정되었다. 이는 한국 안전보건공단의 기준치인 85 dBA에 미치지 못하는 값이다. 협조도와 술식에 따른 환자별 최고 소음수준을 비교하였을 때 치수치료 군과 Frankel grade 1등급 군이 가장 높았다. 소아치과의사의 소음환경은 한국 안전보건공단이 제시한 근로자의 작업환경 기준에는 미치지 못했지만 소아치과 진료실의 환경을 고려한 새로운 기준을 마련하여 소음 환경을 재평가할 필요가 있다.

• Child Health Nursing Research
• /
• 제21권2호
• /
• pp.123-130
• /
• 2015

Purpose: The purpose of this study was to understand the intellectual and psychological features of children with Moyamoya disease who were patients in the Department of Pediatric Neurosurgery of Severance Hospital. Methods: From December 2010 through December 2012, 63 patients with diagnoses of Moyamoya disease and 59 children in a normal group were enrolled. This study was conducted using the Korean-Wechsler Intelligence Scale for Children, Rey-Kim Memory Test for children, Korean Child Behavior Checklist and Pediatric Quality of Life Inventory$^{TM}$4.0. Results: The results showed that the intellectual and psychological profiles of children with Moyamoya disease were lower than the average of the normal control group. The tested patients showed significantly lower scores for Performance Intelligence Quotient cognition level. Also, in terms of quality of life, children with Moyamoya disease had lower levels of physical and school functionality. The results were in line with those of previous studies involving psychological tests of children with chronic diseases. Conclusion: Considering the intellectual and psychological characteristics of children with Moyamoya disease, integrated psychological intervention plans including elements such as supportive therapy for patients and programs for parental education are required.

• The Korean Journal of Pain
• /
• 제20권1호
• /
• pp.60-65
• /
• 2007

Complex Regional Pain Syndromes (CRPS) type I and type II are neuropathic pain conditions that are being increasingly recognized in children and adolescents. The special distinctive features of pediatric CRPS are the milder course, the better response to treatment and the higher recurrence rate than that of adults and the lower extremity is commonly affected. We report here on a case of pediatric CRPS that was derived from ankle trauma and long term splint application at the left ankle. The final diagnoses were CRPS type I in the right upper limb, CRPS type II in the left lower limb and unclassified neuropathy in the head, neck and precordium. The results of various treatments such as medication, physical therapy and nerve blocks, including lumbar sympathetic ganglion blocks, were not effective, so implantation of a spinal cord stimulator was performed. In order to control the pain in his left lower limb, one electrode tip was located at the 7th thoracic vertebral level and two electrode tips were located at the 7th and 2nd cervical vertebral levels for pain control in right upper limb, head, neck and right precordium. After the permanent insertion of the stimulator, the patient's pain was significantly resolved and his disabilities were restored without recurrence. The patient's pain worsened irregularly, which might have been caused by psychological stress. But the patient has been treated with medicine at our pain clinic and he is being followed up by a psychiatrist. (Korean J Pain 2007; 20: 60-65)

• 대한물리의학회지
• /
• 제6권2호
• /
• pp.189-197
• /
• 2011

Purpose: Trunk muscle weakness in the children with cerebral palsy can lead to postural and alignment problems, breathing difficulties, and so on. Therefore, children with cerebral palsy can benefit from exercises that strengthen the muscles in their trunks. The purpose of this study was to investigate the effects of trunk muscle strengthening exercise on functional gross movement and balance ability in children with spastic diplegic cerebral palsy. Methods: We used single group repeated measure design in 8 children(four males, four females; aged 6~12 years; mean 8.3 years) with diplegia. The functional gross motor outcome measured by using the GMFM and balance ability of all children was measured by pediatric balance scale. All participants were alternately received trunk strengthening exercise and neurodevelopment treatment for 40 minutes twice per week during 8 weeks. Results: Significant and clinical meaningful improvement in functional gross motor and balance ability were shown. Conclusion: The results indicate that trunk strengthening exercise has a positive effect on both functional gross motor and balance ability in children with spastic diaplegic cerebral palsy.