• The Journal of Korean Physical Therapy
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• 제30권1호
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• pp.35-40
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• 2018

Purpose: This study examined whether the quality of life of parents of children with cerebral palsy is affected by the functions, activities, participation, and environmental factors using an ICF-CY check list. Methods: This study recruited in 26 parents of children with cerebral palsy. The functions, activities, participation, and environmental factors of the children were evaluated using ICF-CY checklist. To measure the quality of life of parents, this study used world health organization quality of life (WHOQOL-BREF), which was composed of a total of 26 questions. The GMFCS (gross motor function classification system) was used to assess the degree of disability in the children. Multiple regression analysis was performed to examine the effects of the ICF-CY checklist on the quality of life. Correlation analysis was performed to examine the correlation between GMFCS and WHOQOL. Results: The functions, activities, participation, and environmental factors were significantly different from WHOQOL-BREF. On the other hand, the contextual factor showed a significant difference in the neuromusculoskeletal and movement-related functions (b7), and service, systems, and policies (e5)(p<0.05). Conclusion: This study suggests that the functions and environmental factors affect the quality of life of parents of children with cerebral palsy. Therefore, these findings suggest that contextual factors, such as neuromusculoskeletal and movement-related functions (b7), and service, systems and policies (e5), which can be facilitators, should be considered for improving the quality of life of parents of children with cerebral palsy.

• 한국전문물리치료학회지
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• 제24권1호
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• pp.41-50
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• 2017

Background: The Pediatric Balance Scale (PBS) was developed to assess of balance ability in children with balance problem. The PBS was translated into Korean and its reliability had been studied. However, it had need to be verified using psychometric characteristics including item fit and rating scale. Objects: The purpose of this study was to investigate the item fit, item difficulty, and rating scale of the Korean version of PBS using Rasch analysis. Methods: In total, 40 children with cerebral palsy (CP) (boy=17, girl=23) who were diagnosed with level 1 or 2 according to the Gross Motor Function Classification System participated in this study. The PBS was performed, and was verified regarding the item fit, item difficulty, rating scale, and separation index and reliability using Rasch analysis. Results: In this study, the 'transfer', and 'turning to look behind left and right shoulders while standing still' item showed misfit statistics. in total 40 children with CP. Also, 'transfer', 'standing unsupported with feet together' and 'standing with one foot in front' items showed misfit statistics in diplegia CP group. Regardless of the classification of CP, the most difficult item was 'standing on one foot', whereas the easiest item was 'sitting with back unsupported and feet supported on the floor'. The 4 rating scale categories of PBS were acceptable with all criteria. Both item and person separation indices and reliability showed acceptable values. Conclusion: The PBS has been proven reliable, valid and is an appropriate tool, but it needs to modify the items of PBS according to CP classification.

• 말소리와 음성과학
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• 제3권1호
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• pp.135-143
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• 2011

This study evaluated the respiratory capacity of spastic cerebral palsy children who were grouped by GMFCS (Gross Motor Function Classification System) levels and identified the acoustic characteristics of three different types of Korean stops (stop consonants) which are needed for the temporal coordination of larynx and supra-larynx, in these children. Thirty-two children with dysarthria due to spastic cerebral palsy were divided into two subgroups: 14 children classified at GMFCS levels I~III were placed in Group 1 and 18 classified at GMFCS levels IV~V were placed in Group 11, and 18 children with normal speech were selected and placed in the control group. /a/ pronged phonation (sustained vowel /a/) and nine Korean VCV syllables were used. Examined acoustic characteristics were maximum phonation time (MPT) and closure duration and aspiration duration. The results were as follows: 1) The MPTs of the cerebral palsy (CP) groups, both Group I and Group II, were significantly shorter than those of the normal group. 2) The closure durations of the two CP groups were longer than those of the normal group for all 9 target syllables. 3) The aspiration durations of the two CP groups were longer than those of the normal group. 4) The closure duration of the normal and CP Group I was significantly different among tense, aspirated, and lax. However, the CP Group II was different from normal. 5) The aspiration duration of the normal and CP Group I was significantly different among aspirated, tense, and lax. However, the CP Group II was different from normal. 6) The place of articulation influenced less than the manner of articulation on closure and aspiration duration.

• Clinical and Experimental Pediatrics
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• 제64권7호
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• pp.313-321
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• 2021

Here we describe the neurodevelopmental outcomes of very low birth weight (VLBW) infants (birth weight ≤1,500 g) at 3 years of age in the Neonatal Research Network of Japan (NRNJ) database in the past decade and review the methodological issues identified in follow-up studies. The follow-up protocol for children at 3 years of chronological age in the NRNJ consists of physical and comprehensive neurodevelopmental assessments in each participating center. Neurodevelopmental impairment (NDI)-moderate to severe neurological disability-is defined as cerebral palsy (CP) with a Gross Motor Function Classification System score ≥2, visual impairment such as uni- or bilateral blindness, hearing impairment requiring hearing amplification, or cognitive impairment with a developmental quotient (DQ) of Kyoto Scale of Psychological Development score <70 or judgment as delayed by pediatricians. We used death or NDI as an unfavorable outcome in all study subjects and NDI in survivors using number of assessed infants as the denominator. Follow-up data were collected from 49% of survivors in the database. Infants with follow-up data had lower birth weights and were of younger gestational age than those without follow-up data. Mortality rates of 40,728 VLBW infants born between 2003 and 2012 were 8.2% before discharge and 0.7% after discharge. The impairment rates in the assessed infants were 7.1% for CP, 1.8% for blindness, 0.9% for hearing impairment, 15.9% for a DQ <70, and 19.1% for NDI. The mortality or NDI rate in all study subjects, including infants without follow-up data, was 17.4%, while that in the subjects with outcome data was 32.5%. The NRNJ follow-up study results suggested that children born with a VLBW remained at high risk of NDI in early childhood. It is important to establish a network follow-up protocol and complete assessments with fewer dropouts to enable clarification of the outcomes of registered infants.

• 대한물리의학회지
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• 제17권3호
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• pp.31-40
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• 2022

PURPOSE: This study was conducted to investigate the effects of postural control training using a visual blind board, on head control, trunk control, and the sitting abilities of children with moderate-to-severe cerebral palsy. METHODS: Ten children with moderate to severe cerebral palsy participated in this study. Postural control training with a visual blind board was given for 40 minutes per session, 3 times a week for 4 weeks (12 sessions). Before and after the intervention, head control, trunk control, and sitting abilities were quantified using the head control scale, Korean version-trunk control measurement scale, and the sitting part of the Korean version-gross motor function measure-88, respectively. RESULTS: Postural control with the visual blind board significantly improved the head control ability of children with moderate to severe cerebral palsy (p = .015). Their trunk control abilities also showed significant improvement after the intervention (p = .016). However, their sitting ability did not show a significant change. CONCLUSION: These results showed that postural control training using a visual blind board is effective in improving the head and trunk control abilities of children with cerebral palsy. Further studies with suitable sample sizes and control groups are needed to reach a conclusion about the use of postural control training with visual blind boards for improvement of postural control of children with moderate to severe cerebral palsy.

• 대한정형외과학회지
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• 제54권4호
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• pp.309-316
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• 2019

목적: 뇌성마비 환자의 주거 환경과 재활 접근성을 조사하여 현재 시행되고 있는 장애인 주거 관련 법률에 대한 문제점에 대해 고찰해보고 장애인 건강권에 관한 법률 제정의 기초 자료를 제공하고자 한다. 대상 및 방법: 주거, 재활, 접근성 3개의 키워드로 문헌을 검색하여 주거 환경, 재활 접근성이라는 2개의 아이템을 선정한 후 설문지를 작성하였다. 문항은 총 51문항을 작성하였고 그중 24문항은 리커트 척도, 27문항은 다지선다형으로 구성되어 있다. 뇌성마비 환자와 보호자를 대상으로 설문조사를 시행하였다. 결과: 연구대상자 100명 중 재가보호 중인 환자는 93명, 시설보호 중인 환자는 7명으로 나타났다. 재가보호 중인 경우 65%는 아파트에 거주하고 있었고, 주로 2층 이상의 지상층에 거주하고 있었으며 그중 40%는 엘리베이터가 없는 건물에 거주하고 있었다. 연구 대상자의 Gross Motor Function Classification System (GMFCS) 단계에 따라 GMFCS I, II, III은 보행가능군, IV, V는 보행불가군으로 나누어 군별로 느끼는 어려움을 조사하였다. 재가보호 중인 경우 두 군 모두 혼자서 재활센터 방문하는 것을 가장 어려워했고, 시설보호 중인 경우 보행가능군은 혼자 시설 밖으로 나가기, 보행불가군은 혼자서 화장실 이용하기를 가장 어려워하는 것으로 나타났다. 응답자의 83%는 뇌성마비 환자에게 재활이 필요하다고 생각하지만, 실제로 재활을 받는 뇌성마비 환자는 33%에 불과했다. 재활을 받는 경우, 평균 주 3.6회, 회당 39분 동안 치료를 받는다고 응답하였다. 결론: 주거약자법은 접근로와 관련된 규정이 없고 장애인등편의법에서는 공동주택에 대한 주 출입구 접근로의 항목만 규정하고 있다. 하지만 본 연구에서 단독주택에 거주하는 뇌성마비 환자는 18%로, 이들은 접근로가 확보되지 않은 주거 환경에서 살고 있다. 뇌성마비 환자들이 고층으로 이동하기 위한 수단에 대한 법률은 없으며, 실내로 진입하기 위한 접근로에 관한 법률은 미흡한 실정이다. 현재 시행 중인 장애인등편의법, 주거약자법 그리고 2017년 12월에 시행된 장애인건강권법의 성공적인 시행을 위해서는 장애인과 보호자가 현실적으로 느끼는 어려움을 반영한 시행 규칙이 제정되어야 할 것이다. 이를 위해 본 연구 결과를 바탕으로 대규모 설문을 통해 뇌성마비 환자의 주거와 재활에 대한 조사가 필요하다고 생각한다.

• 대한감각통합치료학회지
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• 제18권2호
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• pp.55-68
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• 2020

목적 : 본 연구에서는 최근 10년간 국내에서 발표된 아동 감각통합치료에 대한 중재효과를 체계적으로 분석하여 이해하기 쉽도록 제시하고자 한다. 연구방법 : 학술연구정보서비스(RISS)와 디비피아(DBpia)의 검색엔진을 사용하여 2011년에서 2020년 6월까지 출판된 국내 논문을 대상으로 하였다. 검색어는 "감각통합", "감각처리", "ASI(Ayres Sensory Integration)"이었다. 총 19개의 논문을 분석하였다. 연구결과는 PICO(Population, Interventions, Outcomes, Comparisons), 국제기능장애 건강분류(International Classification of Function, Disability and Health; ICF)방법과 수정한 The Evidence Alert Traffic Light Grading System을 사용하여 그림으로 제시하였다. 결과 : 아동 감각통합치료를 가장 많이 적용한 진단은 발달지연이었고, 중재법은 개별 감각통합치료가 가장 많았다. ICF의 신체구조 및 기능에 해당하는 중재는 91%에서 긍정적인 효과를 보였다, 세부 영역은 감각조절 및 감각처리, 소운동과 대운동, 신체도식, 신체-자기개념, 균형, 기본 움직임, 자세조절 및 손기능, 집중, 자존감이었다. 결론 : 아동 감각통합치료의 중재효과를 ICF의 분류와 그림으로 간단히 제시하여 치료사, 연구자, 아동의 가족들이 쉽게 이해하고 이용할 수 있는 근거를 마련하고자 하였다.

• 한국콘텐츠학회논문지
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• 제10권6호
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• pp.480-488
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• 2010

이 연구의 목적은 PBS(Pediatric Balance Scale)와 WeeFIM(Functional Independence Measure for Children)을 이용해 전자게임을 이용한 가상현실프로그램이 경직성 뇌성마비 아동의 균형 및 일상생활활동에 미치는 영향을 알아보고 평가도구 간의 상관관계를 구하는데 있다. 대동작기능분류체계 제 I, II 단계의 경직성 뇌성마비 아동 20명을 가상현실군과 대조군으로 10명씩 무작위 배치하여 주 3회, 매 30분씩 12주간 운동을 실시하였다. 가상현실군은 근력운동과 가상현실프로그램을, 대조군은 근력운동만 실시하였다. 그 결과, 가상현실군에서 실험 후에 균형과 일상생활활동이 유의하게 향상되었고(p<0.05), PBS와 WeeFIM 간에 유의한 상관관계를 나타냈다(p<0.05). 가상현실프로그램은 경직성 뇌성마비아동의 균형과 일상생활 활동을 향상시킬 수 있는 흥미로운 중재법으로 사용될 수 있을 것이며, PBS는 뇌성마비아동의 기능을 예측할 수 있는 유용한 평가도구 임을 알 수 있었다. 또한 저렴한 비용의 가상현실프로그램을 홈 프로그램으로도 이용할 수 있을 것이다.

• 한국산학기술학회논문지
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• 제17권12호
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• pp.186-192
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• 2016

중년기여성의 문화복지로서 한국무용의 효과성에 대한 연구이다. 본 연구의 목적을 달성하기 위해 질적인 접근(qualitative approach)하였고, 자료 수집기간은 2016년 2월 10일에서 2016월 4월 1일까지였으며, 자료수집방법은 심층면담을 주로 사용하였다. 연구결과는 문화복지로서 한국무용에 참여하는 중년기 여성은 첫째, 정서적 영역 측면에서 자아성취와 사회소속감을 느꼈고, 중년기 우울증을 해소하여 심리적 안정에 많은 효과를 보았음을 알수 있었다. 또한 자율성과 생산성이 떨어진 연구대상자들은 한국무용 참여를 통한 자존감 회복에 큰 효과가 나타났다. 둘째, 운동영역으로서의 한국무용은 한국전통음악과 함께 동작을 표현함으로써 대근육과 소근육을 강화를 하여 평소 쓰지 않던 근육을 활용했다. 중년여성들은 평소 앓고 있었던 신체증상이 완화됨을 경험하였고, 이는 운동반경을 넓힘에 따라 전반적 운동기능이 향상되었다고 볼 수 있다. 셋째, 인지적 영역 측면에서 한국무용 중 친숙하고 익숙한 한국음악의 멜로디가 기억과 회고의 기회를 주며 중년기 여성의 어머니, 할머니가 좋아했던 음악을 들으면서 편안한 시절의 회상력을 증진시킬수 있었다. 마지막으로, 사회적 영역에서 한국무용은 음악과 동작을 통해 대상자 스스로를 수용하여 주고, 관계 속에서 느낀 고립과 갈등을 극복할 수 있는 매개체의 역할을 수행한다고 하였다. 또한 사회공동체의 일원으로 익힌 한국무용을 지역사회에 환원함으로 해서 지역사회와의 연계로 인한 자아실현도 하게 되었다.

• 동의신경정신과학회지
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• 제28권2호
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• pp.49-59
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• 2017

Objectives: To measure the quality of life in patients according to virtual cerebral palsy severity by using the Korean version of EQ-5D-Y proxy, Visual Analogue Scale (VAS), and Time Trade-Off method (TTO). Methods: The study was conducted in parents of children and adolescents aged 4 to 15 years in Seoul. We analyzed the difference in the utility value according to five levels of cerebral palsy severity in the Gross Motor Function Classification System (GMFCS) and test-retest reliability. Results: 1. There were significant differences in VAS, TTO, and EQ-5D-Y proxy according to the cerebral palsy severity (p<.001). 2. VAS was significantly different according to the respondent's visit to the medical institution, the presence of disease in the respondent, a visit to the child's medical institution, the age of the child, and the sex of the child. The value of TTO was significantly different according to the respondent's visit to the medical institution, respondent's sex, and the age of the child. Also, EQ-5D-Y proxy was significantly different according to the age of the child. 3. Intraclass correlation coefficient values were more than 0.6 for both VAS and TTO at all stages. But for the EQ-5D-Y proxy, the value was less than 0.6 at all stages. Conclusions: The quality of life assessment using EQ-5D-Y proxy showed significant differences in the severity of cerebral palsy. However, large-scale studies using EQ-5D-Y proxy are needed because of low test-retest reliability.