• The Journal of Korean Physical Therapy
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• 제30권4호
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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.

• The Journal of Korean Physical Therapy
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• 제15권4호
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• pp.255-298
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• 2003

The purpose of study was to evaluate effects of a trunk muscle strength training on sitting balance of children with spastic cerebral palsy. Five individuals with spastic cerebral palsy(three females. two males; mean aged 6.6) participated three times a week over 6 weeks. Five individuals with spastic cerebral palsy(three females. two males; mean aged 7.0) who did not receive strength training served as control. BPM(Balance Performance Moniter) was used to measured sitting balance and EMG(electromyograph, NORAXON, USA) was used to measured activities of abdominal and erector spine muscle. The obtain result are as follows. 1. The result of this study were following that maximum perturbation area and perturbation velocity were significantly reduced strength training group compared with control group(p<.05). 2. The result of this study were following that maximum perturbation area and perturbation velocity were significantly reduced after strength training compared with pre strength training in strength training group(p<.05). 3. The result of this study were following that maximum perturbation area and perturbation velocity were not significantly reduced at interval of six week in control group(p<.05). 4. The result of this study were following that abdominal muscle activity was significantly increased strength training group compared with control group(p<.05). 5. The result of this study were following that erector spine muscle activity was significantly increased strength training group compared with control group(p<.05). 6. The result of this study were following that abdominal muscle activity and erector spine muscle were significantly increased after strength training compared with pre strength training in strength training group(p<.05). 7. The result of this study were following that abdominal muscle activity and erector spine muscle were not significantly increased at interval of six week in control group(p<.05). In conclusion, the result of this study suggest that improved sitting balance and increased activities of trunk muscle by trunk strength training in spastic cerebral palsy. The result was proposed that therapeutic approach of spastic cerebral palsy with impaired sitting balance should use trunk strength training.

• 대한통합의학회지
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• 제1권3호
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• pp.37-49
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• 2013

Purpose : The purpose of this study was to evaluate the influence of Respiratory Capacity by Vojta's treatment in children with spastic cerebral palsy. Method : The subjects of this study, children diagnosed with spastic cerebral palsy, 12 patients were picked up, who were agreed with this research and were having hospital care for 4weeks at MH and PR medical centers. Result : In comparison of Respiratory muscle activity and Phonation capacity were significant in the group(p<.01) and MPT and Rectus abd(Rt) were significantly correlated in the pre test and SMR and Ex/oblique (Lt) were significantly correlated in the post test. Conclusion : Therefore, the Vojta's treatment is useful to improve the Respiratory muscle activity and Phonation capacity in children with spastic cerebral palsy.

• 음성과학
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• 제11권1호
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• pp.55-64
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• 2004

This study was to determine the effects of a massage and oro-facial exercise program on spastic dysarthric patients' lip muscle function using an electromyogram (EMG). Three subjects with Spastic Dysarthria participated in the study. The surface electrodes were positioned on the Levator Labii Superior Muscle (LLSM), Depressor Labii Inferior Muscle (DLIM), and Orbicularis Oris Muscle (OOM). To examine lip muscle function improvement, the EMG signals were analyzed in terms of RMS (Root Mean Square) values and Median Frequency. In addition, the diadochokinetic movements and the rate of sentence reading were measured. The results revealed that the RMS values were decreased and the Median Frequency moved to a high frequency area. Diadochokinesis and sentence reading rates were improved.

• 한국전문물리치료학회지
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• 제16권2호
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• pp.16-23
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• 2009

The purpose of this study was to investigate the effects postural changes on respiratory muscles and acoustic parameters of the children with spastic cerebral palsy. Nine children with spastic cerebral palsy who required assistance when walking were selected. The ages of the children ranged from 6 to 9 years old. The phonation of the sustained vowel /a/ and the voice qualities of each child such as fundamental frequency($F_0$; Hz), pitch variation (Jitter; %), amplitude variation (Shimmer; %) and noise to harmonic ratio (NHR) were analyzed by Multi-Dimensional Voice Program (MDVP). The muscle activity of three major respiratory muscles: pectoralis major muscle, upper trapezius muscle and rectus abdorminalis muscle, were measured by examining the root mean square (RMS) of the surface EMG to investigate the impact of changes in the adjusted sitting posture of each subject. However, the RMS of pectoralis major muscle showed a significant differences (p<.05). Secondly, there were no significant differences in $F_0$, Jitter and Shimmer between pre and post posture change, but there was a significant difference in NHR (p<.05). The data were collected in each individual; once prior and once after the sitting posture change. The data were analyzed by Wilcoxon signed ranks-test using SPSS version 14.0 for Windows. The findings of this study were as follows; Firstly, the RMS of upper trapezius and rectus abdorminalis muscle were not significant different between pre and post sitting posture changes. From the result, it is concluded that changes in the adjusted sitting posture decreases the abnormal respiratory patterns in the children with spastic cerebral palsy which is characterized by the hyperactivity of the respiratory muscles in breathing. Also, there is increased on the voice qualities in children with spastic cerebral palsy.

• 한국정밀공학회지
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• 제23권7호
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• pp.152-158
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• 2006

The objective of this work is to develop the knee joint model for representing various pendulum motions and quantifying the spasticity. Knee joint model included the extension and flexion muscles. The joint moment consists of both the active moment from the stretch reflex and the passive moment from the viscoelastic joint properties. The stretch reflex was modeled as nonlinear feedback of muscle length and the muscle lengthening velocity, which is Physiologically-feasible. Moreover, we modeled the spastic reflex as having dynamic threshold to account far the various pendulum trajectories of spastic patients. We determined the model parameters of three patients who showed different pendulum trajectories through minimization of error between experimental and simulated trajectories. The simulated joint trajectories closely matched with the experimental ones, which show the proposed model can predict pendulum motions of patients with different spastic severities. The predicted muscle force from spastic reflex appeared more frequently in the severe spastic patient, which indicates the dynamic threshold relaxes slowly in this patient as is manifested by the variation coefficient of dynamic threshold. The proposed method provides prediction of muscle force and intuitive and objective evaluation of spasticity and it is expected to be useful in quantitative assessment of spasticity.

• 대한물리의학회지
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• 제7권3호
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• pp.339-348
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• 2012

Purpose : The purpose of this study is to compare muscle activations of neck, trunk and leg in cerebral palsy of spastic diplegia with genu recurvatum and knee flexion contracture, when using anterior and posterior walkers. Methods : We selected 21 cerebral palsy and received the written consent to participate in this study. The inclusion criteria for participation required patients to have spastic diplegic CP; to be between 3~6 years of age, to have a GMFCS III grade, to have no botulinum toxin injection and orthopedics surgery within before six months starting the study. Measurements of muscle activities (sternocleidomastoid, splenius capitis, rectus abdominis, erector spinea, gluteus maximus, rectus femoris, medial hamstring and calf muscles) were evaluated anterior and posterior walker ambulations. Statistical evaluation of these data were accomplished by utilizing the paired t-test and independent t-test by SPSS 20.0 program. Significance level was set at p<.05. Results : The following results were obtained. There was significant difference on muscle activation of neck, trunk and legs(soleus except) in anterior and posterior walkers. There was no significant difference in muscle activation of neck but significant difference in muscle activation of trunk, legs between genu recurvatum and knee flexion contracture(rectus abdominis, medial hamstring when using anterior walker, rectus abdominis, erector spinea, gluteus maximus, medial hamstring when using posterior walker). Conclusion : The conclusion of this study is the different knee joint forms would have different effect on muscle activation of trunk and legs while cerebral palsy of spastic diplegic ambulated with anterior walker and posterior walker.

• 대한물리의학회지
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• 제14권4호
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• pp.195-201
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• 2019

PURPOSE: This study aimed to quantify the effects of whole body vibration (WBV) stimulation training on the muscle thickness and gross motor function in children with spastic cerebral palsy. METHODS: Twenty children diagnosed with spastic cerebral palsy were assigned randomly to the Whole Body Vibration (WBV) group (n=10) and control group (n=10). The WBV group received vibration therapy including five different therapy, and the control group received only five general physiotherapy sessions. After 10 weeks of intervention, the muscle thickness was measured using ultrasound, and the Gross Motor Function D and E items were evaluated. RESULTS: After the intervention, both groups showed a significant increase in muscle thickness and gross motor function (p<.05). The WBV group showed a significant increase in the quadriceps femoris and tibialis anterior muscles compared to the control group, whereas no significant increase in the gastrocnemius muscle was observed (p<.05). The WBV group showed significant improvement in the Gross Motor Function D and E scores compared to the control group (p<.05). CONCLUSION: WBV training may be a useful way of improving the lower extremity muscle strength in children with spastic cerebral palsy, which may help improve the gross motor function.

• 대한임상전기생리학회지
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• 제3권1호
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• pp.1-12
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• 2005

This study aimed at examining the maximal isometric contraction caused by voluntary exercise and at comparing its aspects of decrease and restoration in their different repeated application, as to the quadriceps muscles of thigh in the subjects composed of patients with spastic hemiplegia and normal adults. Using isokinetic exercise analyser(Biodex Medical Systems Inc., Biodex System 3PRO, U.S.A.), experiment was conducted as to the normal group composed of fifteen adults and the patient group composed of fifteen patients with spastic hemiplegia. As to each group, MVIC(maximal voluntary isometric contraction) of the quadriceps muscle of thigh caused by voluntary exercise and the aspects of decrease and restoration of the isometric contraction were examined with the method to induce isometric exercise, and their SDI(strength decrement index) and SRI(strength recovery index) were also calculated. The results can be summarized as follows: 1. As for decrease of maximal isometric contraction, both groups showed slow decrease in voluntary exercise, but the normal group showed rapid decrease later phase. 2. As for SDI, no significant differences could be observed in comparison between groups. 3. As for restoration of maximal isometric contraction, both groups showed slow restoration in voluntary exercise, but the normal group showed rapid restoration early phase. 4. As for SRI, comparison between groups showed significant differences in voluntary exercise. These results lead us to the conclusions that spastic muscle is characterized by slow decrease and restoration of MVIC in comparison with normal muscle in voluntary exercise.

• 한국융합학회논문지
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• 제9권2호
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• pp.91-99
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• 2018

본 연구에서는 뇌성경직양측마비 아동을 대상으로 융합적인 자세교정치료가 근강직도(muscle stiffness) 및 근활성도(muscle activity)에 미치는 단기적인 영향을 알아보고자 하였다. 연구 대상자는 4세부터 7세의 뇌성경직양측마비 아동 3명(남자2, 여자1)을 대상으로 하였다. 측정부위는 위등세모근, 배곧은근, 큰볼기근이며, 근강직도 측정기(Myoton)와 표면 근전도(EMG)를 이용하여 근강직도와 근활성도를 측정하였으며, 양측 대칭성에 대해서도 알아보았다. 연구결과, 보상작용이 심했던 아동들이 융합적 자세교정 치료 중재 후 전반적으로 위등세모근과 배곧은근에서 근강직도와 근활성도가 감소하였고, 큰볼기근에서는 증가하는 경향을 보였다. 특히 해당 근육에서 왼쪽과 오른쪽의 대칭성이 줄어드는 특성을 보였다. 본 연구에서는 몇 가지 제한점에도 불구하고 융합적인 자세교정치료가 뇌성경직양측마비 아동의 자세교정 측면에서 긍정적인 효과가 있음을 보여 주었다.