• The Journal of Korean Physical Therapy
• /
• v.31 no.2
• /
• pp.103-110
• /
• 2019

Purpose: This study evaluated the usefulness of International Classification of Functioning, disability and health core set for children and youths with cerebral palsy (ICF-core set for CP) by comparing the Gross Motor Function Measure-88 (GMFM-88), which is the most widely used outcome measure in children with cerebral palsy (ICF-core set for CP). Method: One subject (Female, 14) was evaluated by GMFM-88 and ICF-core set for CP. In addition, the concept of GMFM-88 was compared with the concept of the ICF-core set for CP in compliance with ICF linking rules. The numerical values both of the GMFM-88 categories and the ICF-core set for CP's items were compared. Results: The ICF b760 was linked to the GMFM-88 59~61. d415 was linked to 57~58 of GMFM-88. d450 was linked to GMFM-88's 65~72. d455 was linked to GMFM-88 at 77and 80~83. Conclusion: The association of the ICF-core set for CP and GMFM-88 was confirmed. In addition, the number of categories of ICF-core set for CP was smaller than the number of items of GMFM-88. In conclusion, the ICF-core set for CP is an evaluation tool that can identify the various features of children. In addition, GMFM-88 was linked to the ICF core set for CP according to the ICF linking rules.

• Physical Therapy Korea
• /
• v.28 no.2
• /
• pp.101-107
• /
• 2021

Background: Studies suggest that induced emotional changes can affect the sensory-motor system involved in the practice of muscle activity and movement in physical aspects. Previous studies have shown focused on effects just feedback on muscle activity associated with emotions but rarely have focused induced emotional change on gross motor function such as muscle activity. Objects: The purpose of this study was to compare biceps activity and emotion that before and after viewing a video was induced positive or negative emotion. Methods: The study enrolled 34 healthy male and female who scored at normal points on the Center for Epidermiological Studies-Depression Scale. The study measured over two weeks, showing subjects pleasant and sad videos one by one in a week. We performed to measure the biceps brachii activity which is maximal voluntary isometric contraction (MVIC) and the visual analog mood scale (VAMS) scores before and after one week. The significance level was set to α = 0.05. Results: There was no significant difference in muscle activity of the biceps brachii before and after each video was viewed (p > 0.05). However, the visual analogue mood scale showed an increase in VAMS after viewing each video (p < 0.05). Conclusion: We figured out induced emotional changes are cause actual emotional changes but there are no differences in muscle activity. In this research, watching the video with a short time looks like insufficient to change muscle activity. Nevertheless, there might be different when we check various muscles with sufficient time for viewing the video. Further study is needed to measure a variety of muscles with more time for viewing the video.

• The Korean Journal of Pain
• /
• v.7 no.2
• /
• pp.162-169
• /
• 1994

Blockade of cervicothoracic sympathetic ganglion (stellate ganglion controls pain on face, head, neck, shoulder, upper limbs, and upper chest, including their viscera and sympathetically maintained pain. This procedure also increases blood flow to the above areas and relieves hyperreactivity of sympathetic nervous system. Clinically, repeated stellate ganglion blocks with local anesthetic agent may become difficult with complications such as accidental intravascular or subdural injection, recurrent laryngeal nerve or bracheal plexus paralysis, pneumothorax and edema on injection site. Therefore, at times long-term cervicothoracic ganglion block with neurolytics is necessitated but its applications are prohibited by the critical structures surrounding ganglion. There are also few reports of neurolytic stellate ganglion block. This study was performed to observe the complications, gross changes of surrounding structures, and microscopic findings of ganglion cells after neurolytic block and to certify the possibility of clinical use of neruolytic stellate ganglion block. The unilateral superior cervical sympathetic ganglion of rabbit was blocked with absolute ethyl alcohol 0.4 ml at the level of cricoid cartilage. Normal ganglion was used as a control and 5 animals were sacrificed at each intervals of 7, 15 and 50 days after block. The results were as follows; 1) All experimental animals showed no specific changes of behavior, motor function. No necrotic tissues were present in the block area during the observation period. There were some gross scar tissues along the fascia of muscles surrounding the needle injection site, but gross atrophy of muscles or injured major vessels were not found. 2) Microscopically, structures of normal ganglion of rabbit were very similar to those of humans. Seven days after absolute ethyl achohol injection there were marked edema of ganglion cells and nuclei with irregular nuclear membrane. Some of the ganglion cells lost their nuclei and showed degenerative changes. Fifteen days after block, cell edema were decreased and loss of the Nissl's body was prominant. The ganglion cell structures looked close to normal but the cytoplasm and nucleus were generally contracted 50 days after block. These results suggest absolute ethyl alcohol injection on cervical sympathetic ganglion with above method mainly blocks pre- and post-synaptic fibers and the long-term neurolytic blockade of this ganglion may be possible in rabbits.

• Physical Therapy Rehabilitation Science
• /
• v.10 no.1
• /
• pp.22-31
• /
• 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.

• Physical Therapy Korea
• /
• v.30 no.2
• /
• pp.128-135
• /
• 2023

Background: Despite the fact that aquatic exercise is one of the most popular alternative treatment methods for children with cerebral palsy (CP), there are few research regarding its effectiveness. Objects: The purpose of this study was to examine the effects of aquatic exercise on upper extremity function and postural control during reaching in children with CP. Methods: Ten participants (eight males and two females; 4-10 years; Gross Motor Function Classification System levels II-IV) with spastic diplegia were recruited to this study. The aquatic exercise program consisted of four modified movements that were selected from the Halliwick 10-point program to enhance upper extremity and trunk movements. The participants attended treatment two times a week for 6 weeks, averaging 35 minutes each session. The Box and Block Test (BBT), transferring pennies in the Bruininks-Oseretsky Test (BOT), and pediatric reaching test (PRT) scores were used as clinical measures. Three-dimensional motion analysis system was used to collect and analyze kinematic data. Differences in BBT and BOT values among pre-treatment, post-treatment, and retention (after 3 weeks) were analyzed using a Friedman test. In addition, the PRT scores and variables (movement time, hand velocity, straightness ratio, and number of movement units) from the three-dimensional motion analysis were tested using a Wilcoxon signed-rank test. The significance level was established at p < 0.05. When the results appeared to be statistically significant, a post-hoc test for multiple comparisons was performed with the Wilcoxon signed-rank test. Results: All clinical measures, which included BBT, transferring pennies of BOT, and PRT, were significantly increased between pre-intervention and post-intervention scores and between pre-intervention and retention scores after treatment (p = 0.001). Three-dimensional motion analysis mostly were significantly improved after treatment (p = 0.001). Conclusion: Aquatic exercise may help to improve body function, activity, and participation in children with varying types of physical disabilities.

• Physical Therapy Korea
• /
• v.24 no.1
• /
• pp.51-60
• /
• 2017

Background: In cerebral palsy (CP), parents' quality of life and rearing attitude are considered possible factors that influence patients' quality of life, function level, and performance in daily activities. Despite these facts, little attention has been given to demonstrate a relation between these factors. Objects: This study aimed to demonstrate the relationship between parents' quality of life, functional level, and performance in daily activities, the quality of life of school-aged children with spastic CP. Methods: This study included 24 parents of school-aged children with spastic CP. The KIDSCREEN-52 and World Health Organization quality of life (WHOQOL)-BREF questionnaires (including physical, psychological, social, and environmental domains) were used as research tools to assess the quality-of-life profiles of the children with spastic CP and those of their parents, respectively. In addition, the function levels and performance in daily activities of the children with CP were assessed by using the gross motor function measure (GMFM) and modified Barthel index (MBI). Correlation and multiple regression analyses were performed to clarify the determinants of the quality of life of the children with CP. Results: The KIDSCREEN-52 score correlated with the total score (r=.735, p<.01) and all domains of the WHOQOL-BREF questionnaire (physical: r=.542, p<.01; psychological: r=.690, p<.01; social: r=.568, p<.01; and environmental: r=.783, p<.01). In addition, significant correlation was found between the KIDSCREEN-52 and MBI scores (r=.411, p<.05), and between the MBI and GMFM scores (r=.427, p<.05). After controlling for age, gender, paralytic type, GMFM, and MBI, the WHOQOL-BREF score ($R^2=.621$), particularly in the environmental domain ($R^2=.699$), remained independently related to the quality of life of the children. Conclusion: These findings suggest that the quality of life of school-aged children with spastic CP can be influenced by the quality of life of their parents. This study provides useful information for future studies to investigate the quality of life of children with CP.

• Physical Therapy Korea
• /
• v.8 no.1
• /
• pp.20-34
• /
• 2001

This paper presents the relevance between GMFM and the spatiotemporal parameters of gait in children with cerebral palsy. Twenty-one children ($73.11{\pm}30.06$ months) with cerebral palsy participated in this study. GMFM was performed and spatiotemporal parameters of gait were measured by foot print gait analysis. A correlation analysis was used to investigate the correlation between GMFM scores and spatiotemporal parameters of gait. A linear regression analysis was employed to find how much each gait spatiotemporal parameters could be predicted from GMFM scores. The total GMFM scores was significantly correlated with walking speed, cadence, and stride length. Dimensions D (standing) and E (walking, running, and jumping) were more significantly correlated with gait spatiotemporal parameters than dimensions A (lying and rolling), B (sitting), and C (crawling and kneeling). The GMFM scores were useful for predicting spatiotemporal parameters. However, it is difficult to predict the status of gait development using GMFM scores because GMFM scores and gait spatiotemporal parameters are only measured as quantities not qualities. In the field, it is easily found that many children with cerebral palsy are unable to walk in any way. Consequently, gait analysis cannot be performed in many cases. Therefore, it is more reasonable to investigate the influence of GMFM on spatiotemporal parameters, rather than vice versa.

• Clinical and Experimental Pediatrics
• /
• v.60 no.12
• /
• pp.403-407
• /
• 2017

Purpose: Quadriplegic children with cerebral palsy are more susceptible to osteoporosis because of various risk factors that interfere with bone metabolism. Pamidronate is effective for pediatric osteoporosis, but there are no guidelines for optimal dosage or duration of treatment in quadriplegic children with osteoporosis. We aimed to evaluate the efficacy of low-dose pamidronate treatment in these patients. Methods: Ten quadriplegic patients on antiepileptic drugs (6 male, 4 female patients; mean age, $10.9{\pm}5.76years$), with osteoporosis and gross motor function classification system level V, were treated with pamidronate (0.5-1.0 mg/kg/day, 2 consecutive days) every 3-4 months in a single institution. The patients received oral supplements of calcium and vitamin D before and during treatment. The lumbar spine bone mineral density (BMD) z score and biochemical markers of bone metabolism were measured regularly during treatment. Results: The main underlying disorder was perinatal hypoxic brain damage (40%, 4 of 10). The mean cumulative dose of pamidronate was $4.49{\pm}2.22mg/kg/yr$, and the mean treatment period was $10.8{\pm}3.32months$. The BMD z score of the lumbar spine showed a significant increase from $-4.22{\pm}1.24$ before treatment to $-2.61{\pm}1.69$ during treatment (P=0.008). Alkaline phosphatase decreased during treatment (P=0.037). Significant adverse drug reactions and new fractures were not reported. Conclusion: Low-dose pamidronate treatment for quadriplegic children with cerebral palsy increased lumbar BMD and reduced the incidence of fracture.

• The Journal of Korean Physical Therapy
• /
• v.25 no.5
• /
• pp.246-251
• /
• 2013

Purpose: The purpose of this study was to provide quantitative data regarding development of the chest wall in children with cerebral palsy (CP) according to Gross Motor Function Classification System (GMFCS) levels and age using the radiological image diameter measurement method. Methods: Subjects included 112 children with CP and 110 healthy children, All of the children underwent simple chest x-ray. The diameters of the upper chest ($D_{apex}$) and lower chest ($D_{base}$) were measured on the anteroposterior (AP) view of a chest x-ray, and the $D_{apex}$ to $D_{base}$ ratio was calculated. Chest wall ratios were compared among children with CP at GMFCS levels I ~ III, GMFCS levels IV and V, and healthy children. Results: The results showed significant differences between the upper and lower chest wall diameters of children with CP at GMFCS levels IV and V, and healthy children (F=4.54, p=0.01; F=3.20, p=0.04). Results of comparison between the chest wall ratios of children with CP and healthy children, showed that the upper chest walls of healthy children were significantly larger in children younger than 48 months (p<0.05), and both the upper and lower chest walls of healthy children were significantly larger compared to children with CP in children older than 48 months (p<0.05). Conclusion: Radiographic measurement for examination of chest wall development is relatively simple, and the results yield quantitative data on development of the chest wall for children with CP. In addition, therapeutic interventions may be considered based on the results.

• The Journal of Korean Physical Therapy
• /
• v.29 no.1
• /
• pp.16-26
• /
• 2017

Purpose: This study was conducted to develop a Korean version of the trunk control measurement scale (TCMS) and examine the reliability and concurrent validity of the K-TCMS in children with cerebral palsy. Methods: Subjects for the study were 23 children with cerebral palsy (CP)(mean age: 84.70 months) recruited from one CP clinic. For the interrater and test-retest reliabilities, four raters (A, B, C, D) measured the K-TCMS two times using video clips with an interval of two weeks. For the concurrent validity, the Korean version of the gross motor function measure (K-GMFM) was chosen. Inter-rater reliability and test-retest reliability of the three K-TCMS subscale (static sitting balance, dynamic sitting balance and dynamic reaching) scores and the total scores were investigated using the intra-correlation coefficient ($ICC_{3,1}$). Spearman's correlation coefficient (r) was calculated to investigate the concurrent validity. Results: The inter-rater reliability of the K-TCMS subscales and total scores were all high ($ICC_{3,1}=0.968-0.992$). For the test-retest reliability, $ICC_{3,1}=0.827-0.962$. The concurrent validity between the K-TCMS's total and three subscale scores and K-GMFM's total score were r=0.600-0.667. Conclusion: The results suggest that the K-TCMS can be used in clinical and research settings as a standardized tool for CP children. The K-TCMS might be also useful for selecting treatment goals and planning interventions for children with cerebral palsy.