• Title/Summary/Keyword: Spasticity Cerebral palsy

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A Comparative Study on the Effects of GMFM and ICF Sub-item Function on the Sub-item Activity and Participation Restriction of the ICF (GMFM과 ICF의 하위영역 기능이 ICF의 하위영역 활동과 참여문제에 미치는 영향 비교)

  • Lee, Jin;Kim, Eun kyong;Chun, Hyelim
    • Journal of Korean Physical Therapy Science
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    • v.26 no.3
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    • pp.15-22
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    • 2019
  • Background: The purpose of this study is to explore the effect of the functions of GMFM and ICF-CY on the activities and participation of ICF-CY sub-items. Design: Cross-sectional study. Method: This study compared and analyzed 95 children with cerebral palsy [type of CP: spasticity 86 (90.5%), hypotonia 4 (4.2%), mixed 5 (5.3%); type of palsy: quadriplegia 13 (13.7%), diplegia 71 (74.7%), hemiplegia 11 (11.6%)] using sub-items of functions, activities and participation from GMFM and ICF-CY. Result: The results show that the activities and participation of ICF-CY (9 sub-items) have significant effect on the functions of GMFM and ICF-CY (8 sub-items) (p<0.05). Conclusion: It is intended to provide data to establish practical therapeutic goals and interventions for functions, activities and participation, which are sub-categories of ICF-CY in cerebral palsy.

Individualized Therapy to Manage Quadriplegic Spastic Cerebral Palsy with Unani Treatment Modalities

  • Fahmida Kousar;Arshiya Sultana;Shahzadi Sultana;Taseen Banu;Arfa Begum
    • CELLMED
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    • v.13 no.14
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    • pp.16.1-16.14
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    • 2023
  • Objective: Cerebral palsy (CP) is a neurodevelopment disorder attributed to an insult or injury to the developing brain with abnormalities in muscular tone, movement and motor skill. Improvement in quality of life and ameliorating symptoms can be achieved. Therefore, this case report details a distinctive approach to treating a 5-year-old male child with quadriplegic spastic cerebral palsy utilizing Unani treatment modalities. Methods: The treatment regimen commenced with 'Habb Ayarij for constipation followed by Sharbat Ustukhuddus administered orally. Notably, Sharbat Ustukhuddus was combined with Melia Azedarach L. leaves vapour bath. Subsequently, Roghan Babunna douche was performed followed by Dalk Layyin andcontinued until symptomatic improvement was observed. Majun Falasfa, Khamira Marwareed and Khameera Gauzaban were administered for 30 days. The therapeutic outcome included anthropometrical measurements, developmental milestones, spasm/reflex scale, and muscle power grading. Results and conclusion: Over the course of a 2-year follow-up, several clinical findings emerged. These included notable improvements in anthropometric measurements, developmental milestones such as improved head control and sitting ability, and a reduction in spasticity of the upper limbs, along with decreased muscle spasms. The therapeutic outcome of this individualized and holistic approach is potentially due to the multifaceted properties of medicinal plants (Musakkin wa Muharrik wa Muqawwi-i- A'sab wa Dimāgh, Munawwim, Dafi-i-Tashannuj, Muqawwi-i-Qalb-i-Ruh). Furthermore, the use of Dalk and Naṭūl was instrumental in providing nourishment to musculoskeletal cells and initiating intracellular signaling cascades. While these findings are encouraging, further research in the form of case series andrandomized controlled trials is warranted to validate the efficacy of this unique holistic approach.

Microsurgical Selective Obturator Neurotomy for Spastic Hip Adduction

  • Park, Yeul-Bum;Kim, Seong-Ho;Kim, Sang-Woo;Chang, Chul-Hoon;Cho, Soo-Ho;Jang, Sung-Ho
    • Journal of Korean Neurosurgical Society
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    • v.41 no.1
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    • pp.22-26
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    • 2007
  • Objective : Cerebral palsy may induce harmful spastic hip adduction. We report the result of microsurgical selective obturator neurotomy, performed on 12 spastic hip adductions of 6 patients, followed clinically for at least 26 months postoperatively. Methods : Microsurgical selective obturator neurotomies, involving microsurgical resection of the anterior obturator nerve branches were performed on 6 patients from January 2000 through June 2003. All patients presented with the inability to sit and 2 patients complained of persistent, intractable pain. We used intraoperative bipolar stimulation to identify selected motor branches. Results : The procedure was performed bilaterally in all patients. In the 3 patients in whom contractures were present, microsurgical selective obturator neurotomies were accompanied by an additional tenotomy of the adductor muscles. Selective tibial neurotomy was performed on three of six patients who originally presented with a spastic ankle. Postoperatively, all spastic hip adductions were corrected more than 60 degrees in passive abduction-adduction amplitude. However, one patient who did not receive active postoperative physiotherapy demonstrated a decreased passive abduction-adduction amplitude upon follow-up. There were no surgical complications. Conclusion : We think microsurgical selective obturator neurotomy may be an effective procedure in the treatment of localized, harmful spastic hip adduction after failure of well conducted conservative treatment. As muscular contractions are often associated with spasticity of the hip adductors, an adjunctive tenotomy may be an option. Comprehensive postoperative physiotherapy is essential to improve long-term results.

Electromechanically assisted walking in patients with cerebral palsy: A meta-analysis

  • Kim, Kwonhoi;Lee, Sukmin
    • Physical Therapy Rehabilitation Science
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    • v.10 no.1
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    • pp.22-31
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    • 2021
  • Objective: This review aims to analyze the effects of electromechanically assisted walking in patients with cerebral palsy(CP). Design: A systematic review and meta-analysis. Methods: We reviewed systematically using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist guidelines. The inclusion criteria for this study were all CP patients. The intervention was electromechanically assisted walking. The outcome measures included gait parameters, function, spasticity. Studies excluded from this review were excluded from the review if they were non-English languages and if the study was not published as a full report, and if they were not randomized controlled trials (RCTs) designs. The RevMan 5.4 program was used to evaluate and explain the results. The risk of bias was evaluated independently by two reviewers. The quantitative meta-analysis, including mean differences (MD) and associated standard deviations (SD) from baseline and follow-up assessments, were recorded. Results: A total of 634 articles were searched. Two hundred eighty-nine duplicate articles were excluded, and 345 of 634 originals were left for selection. Of these 74 papers, 44 were out of topic, and 19 reported no mean or standard deviation values. And one was a non-experimental study. Finally, ten studies were included. All 10 RCTs of electromechanically assisted walking were analyzed. The meta-analysis showed a significant improvement in gait cycle (95% CI (confidence intervals), 0.09 to 0.19, I2=0%), Gross Motor Function Measure (GMFM) D (95% CI, 3.27 to 13.17, I2=0%) and GMFM E (95% CI, 0.22 to 6.41, I2=0%). Conclusions: Electromechanically assisted training helps in walking in patients with CP.

The Effects of Functional Electrical Stimulation on Hand Function of Children With Spastic Cerebral Palsy (기능적 전기자극이 경직성 뇌성마비 아동의 상지 기능에 미치는 영향)

  • Bang, Hyun-Soo;Kim, Dong-Hyun
    • The Journal of Korean Academy of Sensory Integration
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    • v.14 no.2
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    • pp.1-10
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    • 2016
  • Objective: This study aims investigating the effects of functional electrical stimulation (FES) on hand function of children with spastic cerebral palsy. Methods: The participants of this study are 20 children with spastic cerebral palsy aged between 11 to 16 years old. All the subjects underwent 24 sessions of FES during 8 weeks. Each FES was 20 minutes per session, and 3 sessions of FES were provided in a week. Measurements used to assess hand function are Jebsen Hand Function Test, Modified Ashworth Scale and 3D Motion Analysis. After establishment of the baseline for each client by all the measurements, reevaluations were performed every 2 weeks using Jebsen Hand Function Test and the Modified Ashworth Scale. The 3D Motion Analysis was performed only before- and after the 8 weeks of FES treatment. Results: After the FES, there was significant decrease in completed time for the all 6 subtasks of Jebsen Hand Function Test were (p<.05) and also significant decrease in spasticity score of Modified Ashworth Scale as well (p<.05). 3D Motion Analysis showed that the hand tapping and the finger tapping has been significantly improved (p<.05), and the pronation-supination movement of lower arm has been significantly improved as well. Conclusion: Based on the results of this study, it is evidenced that functional electrical stimulation is effective treatment for hand function of children with cerebral palsy. For future research, it is recommended to examine various protocols of FES including impact of long-term application.

Effect of Vibration Stimulation Training on Upper Extremity Function in Children with Cerebral Palsy (뇌성마비 아동의 진동 자극 훈련이 상지기능에 미치는 영향)

  • Kang, Set-Byul;Kim, Man-Je;Yoo, Doo-Han
    • The Journal of Korean Academy of Sensory Integration
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    • v.21 no.1
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    • pp.23-33
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    • 2023
  • Objective : The purpose of this study is was to find ouetermine whether training to applying vibration stimulation to the biceps brachii of children in the late stages of spasticity hemiplegic cerebral palsy can helps to improve the function of the upper extremity. Methods : This The study was conducted on with three children with cerebral palsy, all between the ages of 13 and 15 years. Among the experimental research methods of used with individual subjects, an AB research design using multiple basic baseline individual experimental studies was used, and vibration stimulation was provided to the paralyzed hand during the intervention period. The An evaluation was conducted before and after each session used to measure the function of the upper extremity using was conducted after each session of the Rapael Smart Board and The Jebsen-Tayler hand function test and the Motor Activity Log (MAL) were conducted before and after the experiment. Results : As a result of measuring the smooth The average score and total scores of for using the Rapael Smart Board to measure the upper extremity function in following each therapeutic session using the Rafale smart pegboard showed that, Subject 3 did not showevidenced a no significant change in the average value, and but Subjects 1 and 2 did showed a significant changes in their average values. All three subjects showed significant changes in the Jepson-Taylor hand function test and in the Motor Activity Log test, as evaluated before and after the intervention. Conclusion : Training The using use of vibration stimulation showed a positive effect on in improving upper limb function and exercise in hemiplegia hemiplegic children with who had little experience on using their hemiplegic side.

Treatment of Snoring and Sleep Apnea with Botulinum Toxin (보툴리눔 독소를 이용한 코골이 및 수면무호흡 치료)

  • Jang, Jae-Young;Chung, A-Young;Kim, Seong-Taek
    • Journal of Dental Rehabilitation and Applied Science
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    • v.29 no.4
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    • pp.391-398
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    • 2013
  • Botulinum toxin has been used for treating strabismus, blepharospasm, cerebral palsy, cervical dystonia, hyperhydrosis, facial wrinkle and chronic migraine under US Food and Drug administration approval. Also it has been tried spasticity-induced pain, post-herpetic neuralgia, myofascial pain and aphthous ulcer as off-label use. In this study, we reviewed recent studies that suggested effects of botulinum toxin on snoring and sleep apnea.

A Study on Children Suffering from Cerebral Palsy in Terms of ADL Evaluation (일상생활동작 평가를 통한 뇌성마비아동에 대한 연구)

  • Park Youn-ki;Lim Ho-Chan;Ahn Byung-Jub;Bae Sung-Soo
    • The Journal of Korean Physical Therapy
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    • v.1 no.1
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    • pp.27-45
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    • 1989
  • This study aims at helping cerebrally palsied children to overcome and minimize their sufferings, inducing them to perform ordinary activities of daily living for themselves by coducting ADL Tests which are fundamental activities in daily life and presenting treatment plan for their overall rehabilitation and basic data for achieving the training objective. For that purpose, 173 cerebrally palsied children were selected and given ADL performance Tests from Dec. 1987 to Oct. 1988 and the following results were obtained. 1. Correlation coefficients for each ADL category indicated significant statistical value at .01 level. 2. Correlation coefficient between school-year variable and ADL category variable was significant at .01 level. 3. Correlation between age variable and ADL variable category proved significant at .01 level as well. 4. Correlation coefficients between each category in terms of functional state of extremities were significant at .01 level. 5. The difference in ADL achievements between each category by school year were as follows ; 1) In the category of meeting nature's tall, the age span of more than 4 school years showed statistical significance. 2) In the category of putting off and on clothing, the age span of 3 school years indicated statistical significance. 3) In taking meals statistical significance was found in the age span of 4 school years. 4) In finger movements the age span of more the 4 school years indicated statistical significance. 5) In walking activities statistical significance was noticed in the age span of 2 or 3 school years. Besides, in category by school year, and exceptional case was noticed that the 6th graders were lower than the 5th graders in self-reliance rate. 6. the difference in ADL achievements by type of palsy, children of triplegia were the lowest, while those of monoplegia were the highest. 7. The difference in ADL achievements by kind of palsy, patients of athetosis showed lower rate of self-reliance than those of spasticity, and particularly the latter showed a high rate of self-reliance in taking meals$(83.5\%)$. The former were relatively low in self-reliance and lowerst in meeting nature's call $(59.8\%)$.

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An Evaluation of Significance of Oriental Medicine on Treating Speech Impediment and Limb Impediment Among the Children with Development Disabilities (발달장애아동의 언어장애와 수족장애에 대한 한방치료의 유의성 평가)

  • Jung, Woon-Ki;Han, Dong-Youn;Kim, DaI-Rae;Huh, Young-Jin
    • Journal of Sasang Constitutional Medicine
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    • v.17 no.1
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    • pp.120-129
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    • 2005
  • 1. Objectives This study was conducted to establish a standard and classify suitability in the treatment of speech impediment and limb impediment among the children with development disabilities using Oriental Medicine treatment on the ground of Sasang Constitutional Medicine. 2. Methods 43 patients with pediatric development disabilities with speech impediment and 10 patients with pediatric development disabilities with limb impediment as the main symptoms had been chosen in this study. Oriental Medicine treatments on the ground of Sasang Constitutional Medicine were rendered and evaluated responses as well as pursuing most proper treatment methods. 3. Results & Conclusions 1) For pediatric development disabilities with speech impediment, Oriental Medicine treatment showed a significant effect on similarity of Autism and Cerebral Palsy, but insignificant effect on innate Autism. 2) For pediatric development disabilities with limb impediment, Bee venom was effective for severe limb impediment and limb asthenia, while as eight principles herbal acupuncture effective for mild limb impediment and spasticity. 3) Sasang Constitutional Medicine for treating speech impediment and limb impediment among the children with development disabilities showed general improvement as a fundamental healing through coordinating inner organ activities.

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Effect of Articulation Abilities on the Articulator Strength Training by IOPI of Spasticity Dysarthric Speech (IOPI를 활용한 조음기관 훈련 프로그램이 경직형 마비말장애의 조음 능력에 미치는 영향)

  • Lee, Jang-Shin;Lee, Ji-Yun;Kim, Sun-Hee
    • Therapeutic Science for Rehabilitation
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    • v.9 no.1
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    • pp.91-99
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    • 2020
  • Objective : The purpose of this study was to investigate the effects of the IOPI articulator strength training program on articulator(tongue and lip) muscle strength, numbers of /l, s, ʨ/ articulation accuracy, articulatory numbers, articulation regularity and accuracy in the alternate motion rates, and sequential motion rate changes in patients with spastic dysarthria. Methods : Three cases of patients with spastic dysarthria living in Jeju, Korea, were included in this study. A single subject design was selected to study changes in articulator(tongue and lip) muscle strength, numbers of /ㄹ, ㅅ, ㅈ/ articulation accuracy, articulatory numbers, articulation regularity and accuracy in the alternate motion rates and sequential motion rates. Results : After the articulator strength training program was conducted on patients with spastic dysarthria, there were positive changes in articulator(tongue and lip) muscle strength, numbers of /ㄹ, ㅅ, ㅈ/ articulation accuracy, articulatory numbers, articulation regularity and accuracy on the alternate motion rates and sequential motion rates. Conclusion : Our findings suggest that IOPI articulator strength training program could be very useful for the most representative childeren with cerebral palsy if conducted in various subtypes of dysarthric patients and linked with articulatory function training with IOPI at home.