• Physical Therapy Korea
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• v.8 no.1
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• pp.51-58
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• 2001

In children with cerebral palsy, bone density is decreased by disturbance of bone remodelling due to lack of normal weight bearing and muscle contraction through physical activity. Loss of bone density cause fracture, delays treatment with immobilization, and leads to functional limitation. The purpose of this study was to investigate bone mineral density of lumbar spine in children with spastic quadriplegia and diplegia. Six spastic quadriplegia and 14 spastic diplegia were evaluated in this study. QDR 4500 X-ray densitometer was used to measure bone density at lumbar spine (L1~L4). Children with cerebral palsy showed lower bone density than that of normal children. Bone density in children with spastic quadriplegia and diplegia was $-1.812{\pm}.962$, $-1.519{\pm}.935$, respectively. However, there was no significant differences in bone density between children with spastic quadriplegia and diplegia. There was no significant difference in bone density relation to motor development level, height, and weight. Further study is needed to find the appropriate interventions for preventing loss of bone density in children with cerebral palsy.

• The Journal of Korean Academy of Sensory Integration
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• v.4 no.1
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• pp.47-55
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• 2006

Objective : The purpose of this study was to evaluate the correlation between visual perception ability and activities of daily living(ADL) in the children with spastic diplegia who were treated at developmental disabilities children salutary institute. Method : The subject were consisted of 8 children with spastic diplegia(mean age, 10). The visual perception ability was measured by the Developmental Test of Visual Perception(DTVP) and by the Functional Independence Measure for Children(WeeFIM) to evaluate activities of daily living. Collected data analysis were completed by using correlation analysis. Results : Visual perception ability of children with spastic diplegia is the highest in Position in Space(PS) score, and is the lowest in Visual-Motor coordination(VM) score. Average visual perception performance of children with spastic diplegia is the highest in SR(Spatial relationship) score, and is the lowest in VM score. In activities of daily living, eating component were significantly correlated with Visual-Motor coordination. Conclusions : Therefore, accurate evaluation of visual perception ability and visual perception training for children with spastic diplegia will be important to improve patient's activities of daily living skill.

• PNF and Movement
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• v.19 no.2
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• pp.163-172
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• 2021

Purpose: This study investigated the correlation between physical function and forward head posture in spastic diplegia. Methods: The subjects of this study were 10 spastic diplegia patients. We took pictures of the subjects' craniovertebral angle with a digital camera to determine the degree of forward head posture and then analyzed them using the NIH image J program. The physical function test used the TCMS, the BBT, and a spirometer. The data in this study were measured using SPSS version 23.0, and the statistical significance level α was 0.05. A Pearson correlation coefficient analysis was performed to identify the correlation between the degree of the subject's head forward position and physical function. Results: When we performed the BBT and spirometer tests, the subjects' forward head postures were not correlated (p < 0.05). However, with the TCMS, there was a strong correlation between the forward position of the head and balance, with balance decreasing as the head position increased (p < 0.05). Conclusion: Spastic diplegia patients with severe forward head posture showed problems with static balance, dynamic balance, and equilibrium reaction when sitting. Intervention on the right posture and preventive activities will be needed to improve the health of spastic diplegia patients and prevent future problems with physical function.

• The Journal of Korean Physical Therapy
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• v.30 no.4
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• pp.123-128
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• 2018

Purpose: This study examined the effects of neuromuscular electrical stimulation (NMES) and horseback riding using a robotic device on the trunk muscle activity and gross motor function in children with spastic diplegia. Methods: Children with spastic diplegia were divided into two groups: an experimental group (NMES and horseback riding using a robotic device [n=10]) and a control group (placebo NMES and horseback riding using a robotic device [n=10]). Each group received general physical therapy and occupational therapy. Each intervention involved the administration of NMES for 15 minutes and horseback riding using robotic device therapy for 15 minutes three times a week for 4 weeks. The evaluation included both the rectus abdominis muscles (RA), external oblique muscles (EO), thoracic paraspinal muscles (TP), and lumbar paraspinal muscles (LP) activity and GMFM. Results: The RA, EO, TP, and LP muscle activity, GMFM C, D, and E were increased significantly in the experimental and control groups. A significant increase in both the TP muscle activity and GMFM D was observed in the experimental group compared to the control group. Conclusion: This study showed that horseback riding using a robotic device is an effective intervention for trunk muscle activity and GMFM in children with spastic diplegia. However, if NMES is added to the back muscles, it is possible to further increase the thoracic paraspinal muscle activity and standing ability.

• Journal of the Korean Society of Physical Medicine
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• v.7 no.2
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• pp.213-221
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• 2012

Purpose : The purpose of this study was to investigate the effect of Vojta therapy on Gross Motor Function Measurement(GMFM) and Selective Voluntary Motor Control (SVMC) in children with Spastic diplegia. Methods : During this experiment, the subject of four children diagnosed with spastic diplegia was tested using ABA design for Single-subject Experimental Research Design. The procedure consisted of baseline, intervention and follow-up phase which was held thirty minutes each for three times a week for a total of 24 times. Gross motor function was measured using GMFM and selective voluntary motor control was measured using SCALE. Results : According to this study, the gross motor function and selective voluntary motor control of all subjects were improved from their intervention phase to their baseline phase. During the follow phase which the intervention was removed, the ability that was enhanced during the prior phases was still either maintained or only reduced slightly. Conclusion : The Vojta therapy used on children diagnosed with spastic diplegia was effective on both GMFM and SVMC. In other words, the therapy was effective on coordination. However, this study is difficult to be generalized due to the insufficient number of subject. In further studies, it will be necessary to increase the number of trials with a control group in order to generalize the effectiveness of Vojta therapy.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.10 no.1
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• pp.23-28
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• 2012

Purpose : The objectives of this study were to examine changes in gait parameters related to the COP and gait velocity resulting from the use of ankle foot orthosis, and to provide information for the prescription of ankle foot orthosis and gait rehabilitation training. Methods : We sampled a control group of 14 normal children of the same age as the spastic diplegia (spastic diplegia used ankle foot orthosis) and measured their COP at barefoot gait and their gait parameters at three gait velocities. Change in the COP according to the use of ankle foot orthosis measured one-way ANOVA and Gait parameters according to gait velocity used repeated measures ANOVA. Results : As a result of analyzing change in the COP it became close to that of normal children, and changes in gait parameters such as step width, stride length and stride time also became close to those of normal children. Conclusion : In conclusion, when spastic diplegia used ankle foot orthosis, their balancing ability was improved as a result of decreased change in the COP, and their changes in gait parameters also became close to those of the control group. These results show that the use of ankle foot orthosis improves spastic diplegia gait functions.

• Physical Therapy Korea
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• v.22 no.4
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• pp.79-86
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• 2015

This study examined the effects of trunk stabilization exercise on balance and trunk control in children with spastic diplegia. Four children with ambulatory spastic diplegia participated in the trunk stabilization exercise program using a Both Sides Utilized (BOSU) ball, 30 minutes a day, two times a week for eight weeks. Outcome variables included the pediatric balance scale, trunk control movement scale and multifidus thickness using ultrasound image. After trunk stabilization exercise, there was statistically no significant improvement in pediatric balance scale, trunk control movement scale and multifidus thickness. However, individual outcomes were observed with some positive changes. Balance, trunk control movement, and thickness of multifidus were found to be improved. Trunk stabilization exercise using a BOSU ball could improve trunk control and increase the thickness of multifidus in children with spastic diplegia. Further investigation is needed to evaluate subjects according to type of cerebral palsy and to understand the relationship between postural control and gait.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.4
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• pp.583-592
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• 2013

PURPOSE: This study aimed to investigate muscles activation relate to core stability during 5 therapeutic exercise in children with spastic diplegia. METHODS: The subjects of this study were 8 children with typical development and 12 children with spastic diplegia who have been treated in Bobath children's hospital, all of whom agreed to participate in the study. All subjects were measured to see their muscles activation of rectus abdominalis, external oblique abdominalis, elector spinae, gluteus maximus, rectus femoris, and semitendinosus with surface EMG. RESULTS: The results of this study were as follows : 1) There were statistically significant difference in the root mean square(RMS) of all muscles according to 5 therapeutic exercise in children with spastic diplegia. 2) There were statistically significant difference in the RMS of all muscles according to 5 therapeutic exercise in children with typical development. 3) Significant differences of the RMS between diplegic children and normal children were found in elector spinae and rectus femoris only curl-up exercise. CONCLUSION: As the above results, we suggest that 5 therapeutic exercises could be used for a core stability or core strengthening program. Depending on the individual needs of children with cerebral palsy, some of exercises may be more beneficial than others for achieving strength.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.2
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• pp.75-87
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• 2018

PURPOSE: The purpose of this study was to describe and analyze the components of physical therapy interventions to enhance postural control and mobility in children with spastic diplegia. METHODS: Thirsty-eight physical therapists working in rehabilitation settings volunteered to record the components of physical therapy interventions used during 894 treatment sessions for 179 children with spastic diplegia presenting with difficulties in postural control and mobility. Descriptive statistics were used to analyze the general characteristics of the therapists, the patients, and the frequency of the interventions. A one-way analysis of variance (ANOVA) and chi-square test were used to describe the components of the interventions and the goals of treatment. RESULTS: In clinical practice, physical therapists primarily used methods including "Hands-on: facilitation" (n=1990, 36.47%) and "Hands-off: practice" (n=1355, 24.83 %). Only 13.96% (n=762) of the interventions allowed patients to be independent or active outside of the treatment sessions. Interventions reflecting the therapeutic aims were performed for sitting (17.53%), standing (18.25%), and walking (27.39%). CONCLUSION: Physical therapists mostly used "therapistled" interventions to treat impaired postural control and mobility in children with spastic diplegia. Interventions to facilitate independent activity or practice outside the treatment sessions are infrequently used. These types of interventions were used regardless of the aims of treatment.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.4
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• pp.37-44
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• 2019

PURPOSE: The purpose of this study was to compare sitting balance and coordination spastic cerebral palsy in children using the Korean version of Trunk Impairment Scale (K-TIS) as well as to provide basic data about effective postural control treatment for clinicians handling these two types. METHODS: The K-TIS was measured in 29 children diagnosed with diplegic and quadriplegic cerebral palsy (18 with diplegia and 11 with quadriplegia). The average and standard scores of the children's K-TIS subscales and items of the two groups were measured. The two groups' subscales and items were analyzed by using the Mann-Whitney U test. RESULTS: Static sitting balance, dynamic sitting balance, coordination, and total score for children with diplegia were statistically high (p<.05). For all items under static sitting balance, the score for children with diplegia was higher. The first differences in the repeated items of dynamic sitting balance and coordination area that rotates between the upper and lower body were presented. CONCLUSION: The difference in balance and coordination in sitting positions is exhibited in children with diplegia and quadriplegia. For children with spastic quadriplegia, treatments should focus on static sitting balance and coordination, together with a focus on dynamic sitting balance and coordination.