• 대한물리의학회지
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• 제7권3호
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• pp.293-302
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• 2012

Background & Purpose : The purpose of this study is to evaluate the impairment of SVMC(selective voluntary motor control) of the lower extremity by assessing each joints of lower limb and to analyze the motional relationship between each joints of lower limb using SCALE(Selective Control Assessment of the Lower Extremity) during the swing phase of gait cycle in children with spastic diplegia. Method : 11 children with spastic diplegia CP who could walk independently and 10 normal developing children were participated. SCALE(Selective Control Assessment of the Lower Extremity) assessments were conducted for 11 children with CP. Gait analysis were accomplished in all participants. Qualisys motion analysis was used as a statistical tool to assess the motional relationship between hip joint, knee joint and ankle joint in each limb. We used descriptive statistics, cross-tabulation, independent t-test, linear regression to analysis motional relationship between each joints of lower limb using by SPSS ver.17.0. Result : Firstly, there were significant differences in SCALE scores between the cerebal palsy group and the control group in knee joint(p<0.05), but no significant difference in hip and ankle joints during the swing phase of gait cycle. Secondly, the difference of SCALE scores showed no statistical motional difference in knee and ankle joints during the swing phase, and showed significant motional difference in hip joints during the swing phase(p<0.05). Thirdly, there was a liner relationship between the motion of hip and ankle joints during the swing phase. Conclusion : The nature of SVMC(selective voluntary motor control) in each joints of the lower limb may reflect the ability of gait, thus SCALE may be used for assessing and for treating the cerebal palsy patients who are able to walk independently. Also we knew that the impairment of SVMC(selective voluntary motor control) increases from the proximal to the distal joints.

• The Journal of Korean Physical Therapy
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• 제25권3호
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• pp.155-159
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• 2013

Purpose: Circumference of the chest and waist can be one of clinical indicator to reflect respiratory function in children with cerebral palsy. In this study, we compared to differences in the chest/waist circumference and maximal phonation time between children with spastic diplegia and hemiplegia. Methods: Seventeen children with spastic diplegic and hemiplegic cerebral palsy were recruited, who were matched to gender, age, height, weight, and body mass index for control of the known factors affected to respiratory function. The chest/waist circumference and were measured in each group, when children took a breath at rest and at maximal voluntary inspiration/expiration. Results: No significant differences were found in the chest and waist circumference and expansion between the two groups. However, only in the waist expansion, children with diplegic CP were significantly lower extensibility of lung, compared to the other group. In comparison of the maximal phonation time, a significant lower score was shown in children with spastic diplegic CP, compared to children with hemiplegic CP. Conclusion: Our results indicated that children with spastic diplegic CP had smaller chest wall and waist, compared to children with spastic hemiplegic CP. In addition, they showed a shorter time for sustaining phonation than spastic hemiplegic CP did. Therefore, spastic diplegic CP will be required for careful monitor regarding respiratory function in rehabilitation settings.

• 대한물리의학회지
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• 제14권4호
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• pp.45-53
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• 2019

PURPOSE: This study examined the differences in the trunk impairment scores according to the levels of the gross motor classification system by evaluating trunk control in children with spastic cerebral palsy using the index of trunk impairment. In addition, the characteristics of trunk control disabilities were investigated according to the cerebral palsy type. METHODS: The subjects were 49 children (mean age 8.57±1.83 years, 11 with hemiplegia, 26 with diplegia, and 12 with quadriplegia) with spastic cerebral palsy levels I to IV under the gross motor function classification system (GMFCS). The coordination and balance of the children with cerebral palsy were evaluated using the index for trunk impairment. Statistical analyses were performed using a Kruskal-Wallis test, and Bonferroni analyses were used as a post-hoc comparison for any significant results. RESULTS: The median of the total scores of trunk impairment was 13 (range, 9-17), which was 56% of the maximum score. The total score of trunk impairment and subscales differed significantly according to the disease severity and type of motor disability. The scores for children with quadriplegia were the lowest compared to children with hemiplegia and diplegia. CONCLUSION: Trunk control function in children with spastic cerebral palsy was reduced, and varied according to the disease severity and types of motor disabilities. The degree of trunk impairment differed from the trunk control ability according to the degree of motor disability of children with cerebral palsy.

• Physical Therapy Rehabilitation Science
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• 제5권4호
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• pp.205-209
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• 2016

Objective: Children with spastic diplegic cerebral palsy show weakness especially in the lower-extremity rather than upper-extremity muscles and display characteristics such as asymmetric alignment, deficits in postural control or balance ability, and slow walking speed. Various therapeutic interventions are applied to children with cerebral palsy, of which taping is widely used in the field of rehabilitation, however, there are few studies of the effects of kinesio taping on gait patterns of children with cerebral palsy. The present study investigated the effects of kinesio taping on gait parameters of children with cerebral palsy. Design: Cross-sectional study. Methods: Four children with spastic diplegia participated in this study. The participants' gait parameters while walking 10 m with and without kinesio taping (tibialis anterior, quadriceps femoris, and gluteus maximus) were recorded. Gait parameters including gait velocity, cadence, step length, stride length, single support time, and double support time were evaluated using the GAITRite. Mean values were obtained after having the subjects walk three times in each condition with a 5-minute rest period between each condition. The order of each condition was assigned randomly. Results: There were significant improvements in gait velocity, step length, stride length, and single support time of the right leg with kinesio taping condition compared to the without kinesio taping condition taping (p<0.05). However, there were no significant differences in cadence, single support time of the left leg, or double support time. Conclusions: The results show that kinesio taping may have a positive effect for improving gait parameters of children with spastic diplegia. However, its usefulness in the rehabilitation of children with cerebral palsy needs to be further investigated.

• The Journal of Korean Physical Therapy
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• 제24권6호
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• pp.398-404
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• 2012

Purpose: This is designed to study the effect of weight-support walking training through motor learning on motor functions of children with cerebral palsy, in particular their activity of daily living and balance. Methods: Thirteen children with spastic cerebral palsy, at gross motor function classification system (GMFCS) levels III~IV, underwent treadmill walking training. It used principles of weight support, 4 times a week for 7 weeks, 10 minutes at a time, before and after neurodevelopmental physical therapy. Everyday functions were measured using Functional Independence Measure for Children (Wee-FIM). The ability to keep their balance was measured using electronic measuring equipment from good balance system and the assessment was made before and after the experiment. Results: There were significant differences (p<0.05) between pre and post experiment levels of functional independence in everyday life, in self-care activities, mobility, locomotion and social cognition. With regard to changes in standing balance, there were significant differences before and after the experiment (p<0.05) in GMFCS level III. There was a reduction in the agitation velocity in the x- and y-axes which measures the left-to-right shaking; in GMFCS level IV, velocity moment was reduced. Conclusion: Walking training using a treadmill can help improve the everyday activity and balance in children with spastic cerebral palsy. It can also be served as a useful purpose as a method of intervention in pediatric care.

• 대한물리의학회지
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• 제6권2호
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• pp.189-197
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• 2011

Purpose: Trunk muscle weakness in the children with cerebral palsy can lead to postural and alignment problems, breathing difficulties, and so on. Therefore, children with cerebral palsy can benefit from exercises that strengthen the muscles in their trunks. The purpose of this study was to investigate the effects of trunk muscle strengthening exercise on functional gross movement and balance ability in children with spastic diplegic cerebral palsy. Methods: We used single group repeated measure design in 8 children(four males, four females; aged 6~12 years; mean 8.3 years) with diplegia. The functional gross motor outcome measured by using the GMFM and balance ability of all children was measured by pediatric balance scale. All participants were alternately received trunk strengthening exercise and neurodevelopment treatment for 40 minutes twice per week during 8 weeks. Results: Significant and clinical meaningful improvement in functional gross motor and balance ability were shown. Conclusion: The results indicate that trunk strengthening exercise has a positive effect on both functional gross motor and balance ability in children with spastic diaplegic cerebral palsy.

• 대한임상전기생리학회지
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• 제2권1호
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• pp.9-17
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• 2004

The purpose of this study are to determine the proper radiographic measurements for hip deformity in spastic cerebral palsy patients, and the correlation of hip deformity with neurological involvement, ability of ambulation. Thirty children with cerebral palsy(22 males, 8 females) were evaluated by measurement of the migration index, acetabular index, center edge angle from bilateral hip APs(anterior posterior view). The result are as follows; 1. The incidence of hip dislocation, among the thirty children fifteen children were found to be dislocated, and more significantly high in non-walking group than in walking group(p<0.05) and in quadriplegia than in diplegia(p<0.05). 2. When compared to normal hip and dislocation hip, the migration index was significantly higher(p<0.01) and the center edge angle was lower in the dislocation hip than in the normal hip. 3. Correlation of radiological findings in right and left hip, the migration index and the center edge angle were highly correlated(p<0.01). We recommand regular intervals X-ray study for early diagnosis and management of hip dislocation in spastic cerebral palsy.

• Clinical and Experimental Pediatrics
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• 제48권9호
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• pp.1004-1008
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• 2005

혈관종은 영아에서 가장 흔한 양성 종양으로 이 중 15-30%는 다발성 혈관종을 보인다. 미만성 신생아 혈관종증은 피부와 다수의 내부 장기를 침범하는 질환으로 치료하지 않는 경우 치명적일 수 있기 때문에 신속하고 적극적인 치료가 요구된다. 치료는 부신피질 호르몬이 1차 선택 약제로 사용되며 이에 반응하지 않으면 인터페론, 절재술, 전색술, 방사선 치료 등을 이용할 수 있다. Interferon alfa-2a는 매우 효과적이나 강직성 양마비(spastic diplegia)와 같은 심각한 합병증이 보고되고 있다. 저자들은 출생 직후 호흡곤란과 전신의 피부 혈관종을 주소로 입원하여 Kasabach-Merritt 증후군을 동반한 미만성 신생아 혈관종증을 진단 받았던 1례에서 스테로이드 치료에 대해 혈소판 감소증 및 소모성 응고장애의 호전은 있었으나 혈관종의 수 및 크기의 호전이 없어 vincristine을 투여하여 치료에 성공하였기에 문헌 고찰과 함께 보고하는 바이다.

• 한국산학기술학회논문지
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• 제14권2호
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• pp.804-810
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• 2013

본 연구는 트레드밀을 이용한 운동학습 훈련이 경직성 뇌성마비 아동의 운동기능과 균형능력에 미치는 영향을 알아보고자 하였다. 대동작기능분류체계(GMFCS) 제 III, IV 단계의 경직성 뇌성마비 아동 16명을 대상으로 운동학습훈련군과 대조군으로 각각 무작위로 8명씩 분류하여, 대조군은 주 4회 근력강화운동을 30분/1회 적용하였고, 운동학습훈련군은 근력강화운동과 트레드밀을 이용한 운동학습훈련을 주 4회 15분/1회 적용하였다. 뇌성마비 아동의 운동기능은 대동작기능평가를 이용하여 측정하였고, 균형능력은 good balance system(Meitur Ltd., Finland)의 전산화 측정장비를 이용하여 측정하였다. 적용방법에 따른 운동학습훈련군과 대조군의 전 후 유의성 검증은 Wilcox Signed Rank Test와 Mann-Whitney U test를 실시하였다. 그 결과, 운동학습훈련군은 훈련 적용 후 운동기능과 균형이 유의하게 항상되었고(p<.05), 대조군에 비해 운동학습훈련군에서 훈련 적용 후 운동기능과 균형이 유의하게 향상되었다(p<.05). 트레드밀을 이용한 운동학습훈련은 경직성 뇌성마비아동의 운동기능과 균형능력을 향상시키는데 도움을 주고, 소아치료 중재방법으로 유용하게 사용될 수 있음을 알 수 있었다.

• 한국전문물리치료학회지
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• 제18권3호
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• pp.16-25
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• 2011

This study aimed to evaluate factors related to the ability of ambulatory patients with cerebral palsy (CP) to walk over vertical and horizontal obstacles. Twenty patients with spastic CP who were able to walk independently for at least 10 m with or without walking devices were recruited for the study. Participants were required to walk over small obstacles (1, 4, and 8 cm in height or width; total of 6 conditions). A 'fail' was recorded when either the lower limbs or the walking device contacted the obstacle. Linear regression analyses were used to determine the effects of age, sex, walking devices, eyeglasses, subtype (hemiplegia or diplegia), ankle foot orthoses, functional level, and score of body mass index on the ability of obstacle crossing. Fifteen participants (75%) failed to adequately clear the foot or walking device over obstacles in at least 1 condition. The chance of failure in crossing vertical obstacle was affected by the use of ankle foot orthoses, eyeglasses, gender, and CP subtype (p<.05). The failure rate crossing horizontal obstacle was affected by CP subtype. These findings suggest that rehabilitation procedures should (1) consider the clinical characteristics of patients in order to prepare them to be more independent while performing daily activities, and (2) incorporate environmental conditions that patients encounter at home and in the community.