• The Journal of Korean Society for Neurotherapy
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• v.22 no.3
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• pp.11-18
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• 2018

Purpose This study is to investigate the effect of sling exercise on the balance capacity of spastic diplegia cerebral palsy patient based on Bobath concept. Methods A single subject experiment was designed targeting an 8year old child with the rigid bilateral cerebral palsy. The static balance test used the 30 second Rombug test of BT4, and the dynamic balance test used the timed up and go test. Results In the 30second Rombug test of BT4, the child had a smaller median outcome than baseline and withdrawal period. In the TUG test, the walking speed in the intervention period was improved comparing to the baseline and withdrawal period. Conclusion The sling exercise based on the Bobath concept has been proved that it is an effective intervention to improve the static and dynamic balance capacity of patients with rigid bilateral cerebral palsy.

• Annals of Rehabilitation Medicine
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• v.42 no.6
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• pp.854-862
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• 2018

Objective To investigate the effect of treadmill training with eyes open (TEO) and closed (TEC) on the knee joint position sense (JPS), functional balance and mobility in children with spastic diplegia. Methods Forty-five children with spastic diplegia aged 11-13 years participated in this study. They were randomly assigned to three groups of equal number. The control group (CON) underwent designed physical therapy program whereas, the study groups (TEO and TEC) underwent the same program, in addition to treadmill gait training with eyes open and closed, respectively. Outcome measures were the degree of knee joint position error, functional balance and mobility. Measurements were taken before and after 12 weeks of intervention. Results After training, the three groups showed statistically significant improvement in all measured outcomes, compared to the baseline with non-significant change in the knee JPS in the CON group. When comparing posttreatment results, the TEC group showed greater significant improvement in all measured outcomes, than the TEO and CON groups. Conclusion Treadmill training with eyes open and closed is effective in rehabilitation of children with diplegia, but blocked vision treadmill training has more beneficial effect.

• The Journal of Korean Academy of Sensory Integration
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• v.13 no.2
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• pp.21-29
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• 2015

Objective : This study compares sensory processing ability of children with and without spastic diplegia. In addition, it investigates characteristics of sensory processing differentiated by developmental phase such as pre-school age versus school age. Methods : Participants in this study are ordinal children without specific condition and children with spastic diplegia who are aged 3 to 10 years olds. Using Short Sensory Profile (SSP), sensory processing function of the participants was measured. The survey was distributed to caregivers of the children from November, 2013 to February, 2014, and it was suggested that the caregivers to record the questionnaire directly after approval from a rehabilitation hospital, a university hospital, welfare center, day care center, preschool and elementary school to participate in our study. Results : Group of children with spastic diplegia showed lower score than group of children with no special condition in the total score and the each score of all items of Short Sensory Profile. There was significant difference between the two groups in terms of the total score of sensory processing and the 5 factors except tactile sensitiveness and taste/smell sensitiveness among the 7 factors of test. In the comparison of different age groups, pre-school age group showed lower total score than school age group. Conclusion : This study provides a foundational evidence that can be used when therapist evaluate sensory processing function of children with spastic diplegia. There is need for more study about sensory processing functions of various types of children with cerebral palsy.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.4
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• pp.637-645
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• 2013

PURPOSE: The purpose of this study was to examine the effect of using a suspension device for arm reaching activity on trunk stability and gross motor function of children with spastic diplegia cerebral palsy. METHODS: The subject in this study consisted of 11, GMFCS(Gross Motor Function Classification System) III~IV children with spastic diplegia cerebral palsy, all of whom agreed to participate in the study. All subjects were divided into two groups: the experimental group using a suspension device, and the control group using no suspension device. For each group, a thirty-minute intervention was done twice per week during 8 weeks. Before and after intervention, each test was measured using TIS(Trunk Impairment Scale), GMFM (Gross Motor Function Measure) and PRT(Pediatric Reaching Test) to change trunk stability, gross motor function and arm reaching activity. The data were analyzed with the Wilcoxon signed rank test. RESULT: All two groups had a meaningful increase in GMFM-Sit data measured before and after intervention. The experimental group had a significant increase from an average of 78.83 to an average of 84.83 in GMFM-Crawling. For both groups, there was a substantial increase in the change in sitting position and arm reaching. CONCLUSION: According to the results of this study, the arm reaching activity using suspension device had an effect on trunk stability and gross motor function and it changed arm reaching activity.

• Journal of Korean Physical Therapy Science
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• v.19 no.3
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• pp.23-30
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• 2012

The purpose of this study was to apply treadmill training through motor learning to cerebral palsy children and examine its effects on their Gross Motor Functions. The subjects of this study were 13 spastic diplegia children who had difficulty in independent gait, and GMFCS level III, IV. We performed treadmill gait training using the principle of weight bearing, based on 4times a week for 30 minutes before and after each session physical therapy we gave weight bearing treadmill training 5 to 10 minutes, during 7 weeks(April 9, 2012~May 26, 2012) fittingly for the children's gait characteristics. In order to test how the weight bearing treadmill training affects spastic diplegia children's gross motor functions, we measured body mobility with Gross Motor Function Measure (GMFM). These data were collected before and after the experiment and analyzed through comparison. Data collected from the 13 spastic diplegia children the results were as follows. For evaluating with regard to change in body mobility, significant difference was observed between before and after the experiment in measured gross motor functions, which were crawling, kneeling, standing, walking, jumping and running(p<0.05). According to the results of this study, when gait training through motor learning was applied to spastic cerebral palsy children, it made significant changes in their body mobility. Accordingly, for the effective application of gait training through motor learning to cerebral palsy children, it is considered necessary to make research from different angle on how such training affects children's mobility, activity of muscles in the lower limbs, and gait characteristics.

• The Journal of Korean Physical Therapy
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• v.32 no.6
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• pp.341-347
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• 2020

Purpose: The purpose of this study is to introduce a tool for evaluating eye movement and analyze the reliability of measurement based on 10 cases of evaluating the oculomotor function of children with spastic cerebral palsy Methods: The participants were selected by 6 medical and welfare institutions in Busan as GMFCS grade 1-3 among spastic diplegia and hemiplegia. Seven examiners evaluated 3 children for the evaluation of inter-rater agreement of Ocular Motor Score (OMS) and evaluated the condition of the ocular motor of 10 children using OMS, a re-examination was performed at six weeks after the initial examination. SPSS ver.25.0 was used to calculate the interclass correlation coefficient and Wilcoxon's signed-rank test, Mann Whitney-U test. Results: The inter-rater agreement of OMS was 0.89. Second mean values were decreased compared first examination in motility/ductions/version, saccades and smooth pursuit, but there was no significant difference. Children under 6 years old had a high mean value of saccades in first examination and the motility/ductions/version, fixation, saccades in second examination, but there was no significant difference. Spastic diplegia children's mean values were higher in head posture, fixation in 8 gaze directions than hemiplegia children in both first and second examination, but there were no significant differences. Conclusion: Ocular motor function in 10 children of spastic children who participated in the study and could see that the scores was differed depending on age, type, grade of cerebral palsy. OMS may be available for this purpose.

• Journal of Korean Physical Therapy Science
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• v.10 no.1
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• pp.38-46
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• 2003

Since the current tendencies show us the increasing number of cerebral palsy children and the standard longevity, we need to find out more research about the following various problems. Therefore I have tried to figure out the difference of oxygen saturation and heart rate between before ambulation and after. Objects chosen are 17 C.P children on the process of treatment those who were able to walk and 8 normal children in Ah-San hospital, Gang-Nung. They haven't had either any operation or suffered heart disease and I measured their oxygen saturation and heart rate by using pulse-oximeter and are analyzed by SPSS (10.07 version). Results are the followings; 1. There was no difference of oxygen saturation and heart rate between pre-ambulation and post-ambulation of normal and spastic hemiplegia children. 2. There showed the significant statistic difference of oxygen saturation, heart rate between pre-ambulates and post-ambulation of normal and spastic diplegia(p<.05). 3. There was no difference of oxygen saturation, heart rate in C.P between(p>.05), but shows the significant statistic difference in heart rate(p<.05). As I compared the oxygen saturation and heart rate of spastic and normal children on between pre-ambulation and post-ambulation, theres is significant statistic difference on both items (p<.05). However there was no difference of oxygen saturation among hemiplegia, normal and diplegia children while the pulse rate showed the significant difference(p<.05). According to this clinical research, CP children's oxygen saturation and heart rate had no change between pre and post compared to normal children. But there was difference in diplegia. This is why we need to invest time to study these kinds of research about various analysis and comparison of oxygen saturation and heart rate, and furthermore making use of pulse-oxymetry in physical therapy room for the children involved would be beneficial to calculate in accuracy without any discomfort for the patient as well.

• Journal of the Korea Convergence Society
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• v.9 no.2
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• pp.91-99
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• 2018

The aim of this study was to investigate the short-term effects of combined postural correction exercises (CPCE) on muscle stiffness and muscle activity in children with cerebral spastic diplegia(CSD). The subjects were 3 children (2 male and 1 female) with CSD from 4 to 7 years old. The measurement sites were upper trapezius muscle(UT), rectus abdominis muscle(RA), and gluteus maximus muscle(Gmax), muscle stiffness and muscle activity were measured using Myoton and surface EMG, and the symmetry of both sides was also examined. As a result, children with severe compensatory action showed decreased muscle stiffness and muscle activity in UT and RA and increase in Gmax after CPCE intervention. Especially, the left and right symmetry of the muscles was decreased. In this study, despite some limitations, CPCE have shown a positive effect in posture correction of children with CSD.

• Journal of the Korean Society of Physical Medicine
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• v.7 no.3
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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.

• Physical Therapy Korea
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• v.3 no.3
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• pp.44-58
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• 1996

The purpose of this study was to compare and evaluate various hand functions in the most common position (chair sitting, standing, floor sitting) used by cerebral palsied children with spastic diplegia. The results, analysed statistically, could be useful in suggesting treatment strategy for the improvement of hand function in such patient. For this study, 27 children mild or moderate spastic diplegia were chosen. They were patients of the Rehabilitation Hospital, Yonsei University Medical Center. Both dominant and nondominant hands were tested by the Box and Block Test. Bilateral hand function was tested by bead striding and card sorting activities. Collected data was analysed using univariate correlation analysis and MANOVA. Results were as follows: 1) In chair sitting there was a significant positive correlation between dominant hand scores in the Bloc and Box Test and chronological age, gestation period, and time of treatment initiation. In bilateral hand function, card sorting scores correlated positively with time of treatment initiation. 2) In standing, there was a significantly positive correlation between dominant hand scores in the Block and Box Test and time of treatment initiation. 3) In floor sitting, there was a significantly positive correlation between the dominance hand scores in the Block and Box Test and the tine of treatment initiation. Bead stringing, a bilateral hand activity, correlated positively with gestation period and birth weight but negatively with the postnatal incubation period. 4) That score of children who walked showed no significant difference in any of the three postures. 5) Highest test scores in children who could nat walk were in the Box and Block Test for nondominant hand in bead stringing for bilateral hand function. There scores occurred with the children in thee chair sitting posture. The results showed that, in order to improve hand function in children with spastic diplegia, it is necessary to maintain a well supported upright trunk posture with variations allowed for relevance to the chosen position of thee improvements hand activity being performed.