• Journal of the Korean Society of Physical Medicine
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• v.16 no.3
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• pp.123-130
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• 2021

PURPOSE: Robotic gait training is being used increasingly to improve the gross motor performance and gait speed. The present study examined the effectiveness of a novel end-effector type of robotic gait training (RGT) system on standing, walking, running, and jumping functions, as well as the gait speed in children with spastic cerebral palsy. METHODS: Eleven children with spastic cerebral palsy Gross Motor Function Classification System (GMFCS) levels I-III (6 males; age range, 15.09 ± 1.44 years) were examined. They underwent 24 sessions (30 minutes/sessions, one time/day, three days/week for eight consecutive weeks) of RGT. The Gross Motor Function Measure-88 D domain (GMFM D), and GMFM E were assessed with a pretest and posttest of RGT. The setting was a one-group pretest-posttest design. RESULTS: A comparison of the pre-test and post-test show that the outcomes in post-test of GMFM D (p < .01), GMFM E (p < .05), and 10MWT were improved significantly after RGT intervention. CONCLUSION: The present study provided the first evidence on the effects of an eight-weeks RGT intervention in participants with spastic CP. The outcomes of this clinical study showed that standing performance, locomotion function, and gait speed increased in after 24 sessions of the end-effector RGT system in children with spastic cerebral palsy.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.4
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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.

• Journal of Korean Physical Therapy Science
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• v.5 no.3
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• pp.651-658
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• 1998

Cerebral palsy is a neurodevelopmental impairment caused by a nonprogressive defect or lesion in single or multiple locations in the immature brain. The defect or lesion can occur in utero or during or shortly after birth and produces sensory-motor impairment that are usually evident in early infancy. The causes of cerebral palsy are not completely understood, certain prenatal, perinatal, and postnatal factors have been associated with cerebral palsy. This study was analysed the clinical features of 50 children with cerebral palsy (29 males and 21 females) in National Rehabilitation Hospital from March 17 to June 27, 1998. The time of initial visit was over than 12 months in 74%, and their cheif complains were delayed developments (78%). The preterm infants were 40% and the infants with low birth weight were 36%. The maternal age at childbirth was over than 30 years old in 52%. The most common type of cerebral palsy was spastic (54%), mixed (22%), athetosis and hypotonia (10% each), ataxia (4%). The cerebral palsy with preterm infants and low birth weight were more likely to have spastic type (P=0.002, P=0.023 each). The most preterm infants were born between 30 and 35 years old of maternal age, and there were statistical significance in difference (P=0.031).

• Journal of The Korean Society of Integrative Medicine
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• v.3 no.1
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• pp.11-21
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• 2015

Purpose: This study intends to investigate if visual perception training program has influence on writing intelligibility and visual perception ability of the children who have spastic cerebral palsy. Methods: The subjects were 12 children of 4-8 years old. Classifying them into 2 groups - cerebral palsy children group(6) and normal children group(6), visual perception training program was conducted to the cerebral palsy children group twice a week for 4 weeks. Korean alphabet writing test and Korean-version development test on visual perception(DTVP-2) were used for the test. Result: First, the cerebral palsy children group had significantly lower scores on visual perception than the normal children group. Second, Two groups didn't show significantly difference between before and after the visual perception training program. Third, The normal children group significantly increased at three parts without the visual perception training program. Forth, The cerebral palsy children group significantly increased at the only a part after the visual perception training program Conclusion: For the visual perception ability improvement of cerebral palsy children, it is necessary to systematic and continued intervention. And the study about the effect of the visual perception training program application according to by type characteristic of the cerebral palsy child wishes to proceed.

• 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.

• Phonetics and Speech Sciences
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• v.9 no.4
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• pp.129-136
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• 2017

This study investigates the effect of voice quality on speech intelligibility and the relationship between voice quality and intelligibility for children with spastic CP. We recruited 36 children with spastic CP (mean age 10.43 year, 17 girls, 19 boys, spastic type 34, mixed 2) from a special school and a rehabilitation hospital. Voice samples for the perceptual analysis of voice quality were extracted from a sustained vowel /a/ and were rated on the GRBAS scales by two experienced speech language pathologists. Ten adult subjects with no hearing problems evaluated speech intelligibility for the 37 words listed in the Assessment of Phonology and Articulation for Children on a 7-point interval scale. The children with spastic CP were divided into three groups according to the rated G scores on the GRBAS scales (G1(n)=10, G2(n)=13, G3(n)=13). Analyses of ANCOVA and Pearson correlation showed that there was a significant difference in speech intelligibility among three groups. There was also a significant correlation in G scale (grade), A scale (asthenia), B scale (breathy) score, and speech intelligibility. These findings suggest that poor speech intelligibility of spastic CP might be related to asthenia and breathiness. Vocal intensity should be increased and vocal functioning should be improved for speech therapy to improve speech intelligibility of the children with spastic CP.

• Phonetics and Speech Sciences
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• v.2 no.4
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• pp.193-212
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• 2010

The purpose of our study was to provide effective speech evaluation items examining the variables of speech that successfully predict the speech intelligibility in CP children. The subjects were 55 children with spastic type cerebral palsy. As for the speech evaluation, we performed a speech subsystem evaluation and a speech intelligibility test. The results of the study are as follows. The evaluation task for the speech subsystems consisted of 48 task items within an observational evaluation stage and three levels of severity. The levels showed correlations with gross motor functions, fine motor functions, and age. Second, the evaluation items for the speech subsystems were rearranged into seven factors. Third, 34 out of 48 task items that positively correlated with the syllable intelligibility rating were as follows. There were four items in the observational evaluation stage. Among the nonverbal articulatory function evaluation items, there were 11 items in level one. There were 12 items in level two. In level three there were eight items. Fourth, there were 23 items among the 48 evaluation tasks that correlated with the sentence intelligibility rating. There was one item in the observational evaluation stage which was in the articulatory structure evaluation task. In level one there were six items. In level two, there were eight items. In level three, there was a total number of eight items. Fifth, there was a total number of 14 items that influenced the syllable intelligibility rating. Sixth, there was a total number of 13 items that influenced the syllable intelligibility rating. According to the results above, the variables that influenced the speech intelligibility of CP children among the articulatory function tasks were in the respiratory function task, phonatory function task, and lip and chin related tasks. We did not find any correlation for the tongue function. The results of our study could be applied to speech evaluation, setting therapy goals, and evaluating the degree of progression in children with CP. We only studied children with the spastic type of cerebral palsy, and there were a small number of severe degree CP children compared to those with a moderate degree of CP. Therefore, when evaluating children with other degrees of severity, we may have to take their characteristics more into account. Further study on speech evaluation variables in relation to the severity of the speech intelligibility and different types of cerebral palsy may be necessary.

• The Korean Journal of Rehabilitation Nursing
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• v.7 no.1
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• pp.96-104
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• 2004

Purpose: The aim of this study is to evaluate the general status and prevalence of cerebral palsy, the complication and the activity of daily living in patients with cerebral palsy in Holt Ilsan Home. Methods: Cross-sectional study was performed on 113 cerebral palsy patients in Holt Ilsan Home with the medical records review, the physical examination, and the Modified Barthel index for the independency of activities of daily living. Results: The mean age of subjects was $28.1{\pm}12.7$ years and the duration of residence was $22.9{\pm}12.8$ years. The most common type of cerebral palsy according to the muscle tone abnormality was spastic type(53.1%). The most frequent condition in which extremities are involved were quadriplegia in 46.0%. The score of Modified Barthel index was significantly lower in mixed type for $16.9{\pm}24.0$ and quadriplegic type for $14.8{\pm}25.5$ compared with others. Conclusion: This study indicates that cerebral palsy patients in rehabilitation facility have severe medical problems such as musculoskeletal complications, visual and language problems, epilepsy and dependency in activities of daily living. Therefore more medical attention like long-term follow-up study and social supports is needed.

• Physical Therapy Korea
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• v.22 no.4
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• pp.79-86
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• 2015

This study examined the effects of trunk stabilization exercise on balance and trunk control in children with spastic diplegia. Four children with ambulatory spastic diplegia participated in the trunk stabilization exercise program using a Both Sides Utilized (BOSU) ball, 30 minutes a day, two times a week for eight weeks. Outcome variables included the pediatric balance scale, trunk control movement scale and multifidus thickness using ultrasound image. After trunk stabilization exercise, there was statistically no significant improvement in pediatric balance scale, trunk control movement scale and multifidus thickness. However, individual outcomes were observed with some positive changes. Balance, trunk control movement, and thickness of multifidus were found to be improved. Trunk stabilization exercise using a BOSU ball could improve trunk control and increase the thickness of multifidus in children with spastic diplegia. Further investigation is needed to evaluate subjects according to type of cerebral palsy and to understand the relationship between postural control and gait.

• Phonetics and Speech Sciences
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• v.5 no.2
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• pp.3-10
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• 2013

The purpose of this study is to analyze the acoustic characteristics of Korean alveolar sibilant sounds of children with cerebral palsy by acoustic analysis. Thirteen children with spastic cerebral palsy aging from 6 to 10 years old, were selected by an articulation test, and compared with a control group of thirty children. The meaningless monosyllable CV, disyllable VCV(/asa/) and frame sentence including target syllables CV were measured. C was from the /s, s'/, and V was from the set /a, i, u, ${\varepsilon}$, o, ɯ, ʌ/. Multi-Speech was used for data recording and analysis. As a result, the frication duration of lenis-glottalized alveolar sibilant of children with cerebral palsy was significantly shorter than that of the control group in CV, VCV and frame sentence. The vowel duration in the following lenis-glottalized alveolar sibilant of children with cerebral palsy was significantly longer than that of the control group in CV, VCV and frame sentence. The children with cerebral palsy showed frequency and intensity of friction intervals which were significantly lower than in the control group in CV, VCV and frame sentence. In the comparison of the lenis-glottalized alveolar sibilant by the children with cerebral palsy group's phonation types, the frication duration showed a significant difference between the phonation types in CV, VCV and between the phonetic contexts. The glottalized-sibilant was longer than the lenis-sibilant in all the phonetic contexts. The subsequent vowel duration showed a significant difference between the phonation types in VCV and between the phonetic contexts(p<.05). The vowel duration in the following glottalized-sibilant was longer than the vowel duration in the following lenis-sibilant in all the phonetic contexts. In the frequency there was a significant difference between the phonation types in CV, and in the intensity there was a significant difference between the phonation type in CV and VCV. The children with spastic cerebral palsy had difficulty in articulating the alveolar sibilant due to poor control ability in laryngeal, respiration and articulatory movements which require fine motor coordination. This study quantitatively analyzes the acoustic parameters of the alveolar sibilant in various phonetic contexts. Therefore, the results are expected to help provide fundamental data for an intervention of articulation treatment for children with cerebral palsy.