본 연구는 강직성 편측 뇌성마비 환자의 보행 기시(gait initiation)의 특성을 파악하고, 동적 단하지 보조기(dynamic ankle foot orthosis : DAFO)가 이런 환자들의 보행 기시에 미치는 영향을 알아보기 위하여 실시하였다. 연구대상자는 19세 선천성 강직성 우측 뇌성마비를 가진 여자 대학생이었다. 연구대상자는 4개의 다른 보행 기시 조건에서 각 조건당 7회의 보행 기시를 하였는데, 각각의 보행 기시 조건은: 1) 보조기

The purpose of this study were to evaluate the effect of program in visual perception on eye-hand coordination in a child with cerebral palsy. The results were as follows. 1)　Eye-hand coordination were increased significantly compared to doing without pretreatment with the program in visual perception with time-dependent fashion with a cerebral palsy child 2)　A most increased part of eye-hand coordination activities was a large heavy objects and a least increased part of those was a writing. From the above results, it is suggested that program in visual perception is a most useful therapy for a child with cerebral palsy having incomplete eye-hand coordination activity functionally.

The purpose of this study was to investigate the relation between components of population, maternal health, need for health care, maternal lifestyle and environment from a conceptual model for cerebral palsy, and the occurrence of cerebral palsy with spastic quadriplegic. This study was a case-control design. The subjects consisted of 53 children with quadriplegic cerebral palsy as a case who were receiving treatment after a diagnosis for cerebral palsy at 3 university hospitals and 3 rehabilitation facilities, and 186 children as a control who were visiting well baby clinics and pediatric departments after screening at the same hospitals in Seoul. The data were collected by a structured questionnaire survey from October, 1998 to February, 1999. The odds ratios of risk factor was produced by χ2 and simple logistic analysiss. The unconditional logistic analysis was done by modeling the data, after adjusting for gestational age. Statistically associated with an increase the risks for spastic quadriplegia were asphyxia(OR=221.89, 95% CI 15.8-999.0) and maternal history of admission during the pregnancy (OR=10.55, 95% CI 2.2-50.4). The result suggested that the improvement of obstetric and neonatal care is necessary to prevent cerebral palsy with spastic quadriplegia.

The purpose of this study was to find a more effective balance training method. The subjects of this study were 14 children with cerebral palsy (7 males, 7 females) being treated at Seran Pediatric Developmental Research Center in Taegu. Two groups of children with cerebral palsy (everyday trained group, every-other-day trained group) were evaluated with visual & auditory feedback. Evaluation and training device was Balance Performance Monitor (BPM) Dataprint Software Version 5.3. There was statistically significant difference of the balance score between the pre-and the post-training in both group (p<.05), but there was no difference of the balance score between two groups (p<.05). In conclusion, it is likely that the visual and auditory feedback in children with cerebral palsy was effective in improving standing balance, but there was no difference between everyday trained group and every-other-day trained group.

The purpose of this study was to compare the effects of anterior walker and posterior walker on gait parameters and body alignment of children with cerebral palsy. The intraclass correlation coefficient was .99 for intertester reliability. Intratester reliability was between .96 and .99. The use of posterior walker increased gait velocity and facilitated more upright posture. The measurement of joint angle program was found to be reliable to measure range of motion. This study has a limitation of generalizing the results to all children with cerebral palsy. Research is required to investigate the effect of posterior walker on energy efficiency.

The purposes of this study were to research the current state of evaluation of children with delayed development and cerebral palsy and determine pediatric physical therapists' knowledge of assessment tools and their use. The subjects were 130 pediatric physical therapists (general hospitals, university-related hospitals, rehabilitation centers, etc.). Data was obtained from August 24, 1999 to October 18, 1999 by means of a survey questionnaire. The results were as follows: 1. The current state of pediatric physical therapist evaluation of children with delayed development and cerebral palsy. 1) Tools used to assess functional areas of children with cerebral palsy were: subjective description format-128 (47.1%); the GMFM-58 (21.3%); facility-generated tool-51 (18.8%); and DDST-15 (5.5%). 2) Tools used to assess developmentally delayed children were: subjective description format-121 (50.6%); the GMFM-43 (18.0%); facility-generated tool-41 (17.2%); and DDS T-14 (5.9%). 3) After their college or university study, therapists who had attended lectures on evaluation were 113 (86.9%); 13 (10.0%) therapists had not attended any lectures on evaluation 2. Test scores of physical therapists' professional knowledge of evaluation procedures: high (more than 36 points)-74 (56.9%); moderate (18~35 points)-39 (30.0%); and low (below 17 points)-none. 1) For therapists treating cerebral palsied children, 73 (65.2%) were in the high range, 39 (34.8%) were in the moderate range and none were in the low range. 2) For therapists treating children with delayed development, 71 (65.7%) were in the high range, 37 (34.3%) were in the moderate range and none were in the low range. Although the general degree of professional knowledge of evaluation was quite high, there was a lack of variety in the assessment tools used With a large number of therapists depending on subjective description. Possible reasons for the low rate of objective asses sment tool use: 1) Poor clinical environment: too many clients and lirnited treatment time. 2) Lack of any medical insurance fee category for specific assessment tools. 3) Lack of continuing education opportunities in pediatric evaluation skills during or after either college-based (3 year) or university-based (4 year) education programs. Based on the study results, provision of more extended educational opportunities would promote the use of a greater variety of objective assessment tools by pediatric physical therapists.

이 연구의 목적은 Motor-Free Visual Perception Test (MVPT)와 Mariannene Frostig Developmental Test of Visual Perception (DTVP)을 사용하여 뇌성마비 아동과 정상아동의 시 지각 능력의 차이를 알아보고, 뇌성마비의 사지마비군과 양하지마비군, 그리고 정상아동군에서 두 평가도구의 결과에서 제시한 시 지각능력의 차이를 비교하기 위한 것이다. 뇌성마비 아동 21명(사지마비 11명,

The purpose of this study was to know whether the performance of activities of daily living(ADL) affect the depression level of disable people or not. In this study, the ADL item was divided into two category as basic ADL and instrumental ADL. The particip- ants were 67 persons with cerebral palsy(aged 16 to 49). Over 80% of the subjects had independent ability to perform the basic ADL, but, in instrumental ADL items, 50% of them needed assistance. Each of basic and instrument ADL item were signific- antly correlated to the depression level(p<0.01). The Spearman correlation coefficients of basic and instrumental ADL item were 0.336 and 0.416 respectively. As before, ins-trumental ADL item score was more correlated to depression level than basic ADL item score.

The purpose of this study was to compare and evaluate various hand functions in three hip flexion postures(70°, 90°, 110°)in persons with spastic diplegic cerebral palsy using by Jebsen Hand Function Test. 14 children with mild or moderate spastic diplegia were chosen in the Rehabilitation Hospital, Yonsei University Medical Center. Both hands were tested 3 times by ten intervals in three hip flexion postures (70°, 90°, 110°). Data Collected were analysed using nonparame-tric test, Friedman's Test. Results were as follows: 1. The right hand mean score of Jensen Hand Function Test showed no significant difference in any of the three hip flexion postures. 2. The left hand mean score of Jensen Hand Function Test showed no significant di- fference in any of the three hip flexion postures. The results showed that the hand function of children with spastic diplegia was not affected in three hip flexion postures, but it is necessary to maintain well supported pelvic posture for good hand function.

Many children with physical disability have feeding difficulties. In cases of children with cerebral palsy, feeding difficulties can be seen in abnormal oral motor activity and defective swallowing coo rdination. These problems originate from neurological lesions. The purpose of this study was to i nvestigate the effect of trunk and neck position on the following aspects of swallowing: stages of oral preparation, pharyngeal swallowing reflex, pharyngeal clearing and aspiration. Sixteen subjects with quadriplegic cerebral palsy were examined to assess their swal-lowing abil ity using videofluoroscopy(VFS). Subjects were evaluated in four different positions 1) trunk erect with the neck flexed 30°2) trunk reclined 30°posteriorly with the eck positioned neutrally 3) trunk re clined 30°posteriorly with the neck flexed 30° 4) trunk in supine with the neck flexed 30°. Friedman's test was used to analyze the effect of posi tion of the neck and trunk on swallowing. The results were as follows: 1. Ability of oral preparation was significantly better with the subject's trunk recli-ned 30°poste riorly and the neck flexed 30°than with the trunk erect and the neck flexed 30°(p < 0.05). 2. Ability of pharyngeal clearing was significantly better with the subject's trunk er-ect and the neck flexed 30° than in supine with the neck flexed 30°(p < 0.05). 3. Incidence of swallowing reflex was not significantly different among the four posi- tions (p > 0.05). 4. Prevention of aspiration was significantly better with the subject's trunk reclined 30°posteriorl y and the neck flexed 30° than with the trunk reclined 30°posteriorly and the neck neutrally positi oned or in supine with the neck flexed 30°(p < 0.05). These results suggest that positions of both the neck and the trunk have an effect on swallowi ng in children with cerebral palsy. The position with the trunk reclined 30°posteriorly and the n eck flexed 30°was found to be optimal for oral preparation and prevention of aspiration. Further r esearch to study swallowing ability in conjunc- tion with respiratory function is indicated.

Paralytic shellfish poison threatens public health most seriously from April to early May every year and gives adverse effects on export of these products. Major shellfish products exported were canned oyster, Crassostrea gigas and blue mussel, Mytilus edulis. Toxicities of canned shellfishes with toxin of low levels were mostly inactivated during the processing; in contrast, residual toxicity was of great concern with canned products from highly toxic shellfishes. This study was to provide basic data to establish food safety measure by evaluating the changes of toxicity during 2 year storage of canned products with toxic blue mussel and oyster. Any significant difference was not observed between two samples. Boiled can and smoked can showed inactivation of toxicity to some extent, whereas acidified can did not show reduction of toxicity even after 2 year storage. In case the initial toxicity of shellfish was high long term storage could not inactivate the toxicity of the canned product.

The purpose of this study focused how to show physiological responses comparing exercise group and non exercise group for progressive maximal wheelchair ergometer exercise loading in complete paraplegia. It also examined the various factors which would be influenced physiological responses. Sixteen subjects have been investigated in this study, and the subjects are divided into two groups as follows: 1) exercise group (7 subjects) 2) non exercise group (9 subjects). Each test was terminated by physical exhaustion and/or an inability to maintain a flywheel velocity. The results were as follows: 1) No difference was noted in pulmonary function test between two groups. 2) Emax value during maximal exercise was significantly different between the groups (p<0.05). The mean Emax of exercise group was , non exercise group was . 3) () value during maximal exercise was significantly different between the groups (p<0.05). The mean () of exercise group was , non exercise group was . 4) max(ml/kg/min) value during maximal exercise was significantly different between the groups (p<0.05). The mean () of exercise group was , non exercise group was . 5) Maximal heart rate(HRmax) value during maximal exercise was significantly different between the groups (p<0.05). The mean HRmax of exercise group was 180.43 beats/min, non exercise group was 175.00 beats/min. 6) value during maximal exercise was not significantly different between the groups (p>0.05). The mean of exercise group was , non exercise group was . Considering the results which explore the exercise group with paraplegia has shown the maximal aerobic power compared with non exercise group, regular and consistent physical training is highly assumed as a main factor to improve cardiopulmonary fitness.

Recently the researches to enhance the hand function of brain injured clients are increased. One of those aspects is related to in-hand manipluation. In-hand manipulation is divided to four types: that is finger-to-palm translation. palm-to-finger translation, shift, and rotation. The purpose of this study was to find type of in-hand manipulation in normal adults in six activities and to differentiate the pattern of in-hand manipulation between normal adults and children with cerebral palsy. The participants were consist of twenty normal adults and twenty cerebral palsy. children. As a results, cerebral palsy children significantly used at lower frequence than normal adults in 3 activities. Also, in the other items, there are some pattern to differenciate between normal adults and cerebral palsy children but that was not significant statistically. The development of in-hand manipulation skills involves improvement in the dimension of activities of daily living skills training and more detailed evaluation method will be needed.

마비성패류독(Paralytic shellfish poison, PSP)에 의하여 독화된 패류의 유효이용에 대한 자료를 제공하고자 독화된 진주담치의 중장선 균질육, 0.1N HCl로 추출한 조독소 용액, 중장선으로부터 정제한 gonyautoxin(GTX) group과 saxitoxin(STX) group 등 4가지 형태의 PSP 독소에 대한 내열성을 조사하였다. 독화된 진주담치의 중장선육 균질액, 산추출 조독소액, GTX group, STX group 등 4 종류의 반응속도상수는 120℃에서 3.28×10^(-2), 1.20×10^(-2), 5.88×10^(-2), 2.58×10^(-2)이었으며 4 종류의 독소 중 0.1 N HCl 추출한 조독소용액의 D-value가 가장 높았다. 반응속도상수를 이용한 살균온도 산정에 있어서, 초 독력이 200 /100g인 독화된 진주담치육의 경우, 독력을 마비성패류독 규제치인 80 ㎍/100g으로 감소시키는데에는 90℃에서는 약 129분, 100℃에서는 약 82분, 110℃에서는 약 48분, 120℃에서는 약 28분이 걸렸다. 이러한 결과는 최초 독력이 200 ㎍/100g인 패류의 경우, 통조림 살균공정 후 잔존 독력이 규제치인 80㎍/100g이하로 감소시키는데에는 현재의 살균조건(115℃, 70분)으로는 충분하다는 것을 입증한다

The purpose of this case study was to introduce botulinum toxin A injection in cerebral palsy. Spasticity can be managed using a variety of methods. Eliminating aggravating sources, promoting stretching and bracing, and positioning are the least invasive methods of treatment. Botulinum toxin A injection is a relatively recent method of spasticity management in children with cerebral palsy. A 3-year old boy was evaluated for possible botulinum toxin injection to promote left side function. The patient had left hemiparetic cerebral palsy. He walked with bilateral intoning, much worse on the left than on the right and with excessive plantar flexion on the left. Botulinum toxin A was injected into the left medial gastrocnemius, with the goals of improving quality of gait. Finally, botulinum toxin treatment of would improve the motor function and ambulatory status in cerebral palsy by hypertonicity, spasticity, dynamic contracture and athetoid movement.

Hand skills are important to interaction with environment. Hands are the tools most often used to accomplish work, to play, to express and communicate. This study observed the grasp patterns of spastic cerebral palsied(39) and athetoid cerebral palsied children(l3). They were asked by occupational therapist that wrote their name with pencil and colored a circle with crayon. Their grasp patterns were recorded on the basis of which fingers were used to grasp the object, the surface areas of the fingers in contact with the object, and the position of the joints of the fingers. This paper will present the skill acquisition and the activities of daily living for the fine motor skill and self care to the child who has a disability affecting hand skills.

An A-B-A-C single subject research design was used to assess the effectiveness of transcutaneous electrical nerve stimulation(TENS) and inhibitive techniques on spasticity in a 10-year-old girl with cerebral palsy. Stimulation electrodes were placed over the sural nerve of the right leg. The standard method of cutaneous stimulation, TENS with impulse frequency of 100 Hz, was applied. Inhibitive techniques including stretch, antagonist contraction, and weight bearing were used. The tonus of the leg muscle was measured by means of a surface-EMG biofeedback unit. Visual analysis of data indicate that the child showed clinically significant reduction of spasticity in passive ankle movement following 30 minutes of TENS and inhibitive techniques application, respectively. The effect of TENS on spasticity inhibition was similar to that of inhibitive techniques. This result suggests that for this child with cerebral palsy, the application of TENS to the sural nerve may induce short-term post-stimulation inhibitory effects on the spasticity of cerebral palsy. Replication of this study with a more complex single-subject design involving more subjects is recommended to confirm this result.

The purpose of this investigation was to examine the influence of head and neck(HN) position in the transverse plane on the static production of elbow extension force in the involved(paretic) upper extremity of patients with hemiparesis. On this study, thirty patients who had experienced a cerebrovascular accident were matched with neurologically intact subjects. Force of static elbow extension was tested with a hand-held dynamometer, twice with the HN rotated toward the paretic side and twice with the HN rotated toward the non-paretic side. Elbow extension force differed significantly with the HN in the two position in patients with hemiparesis but not in normal persons(=0.05). Results of this study support the conclusion that HN position in the transverse plane influences the production of static elbow extension force on the paretic side in patients with hemiparesis.

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.

The purpose of this study was to compare and evaluate various hand functions in the most common positions (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 patients. For this study, 27 children with 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 stringing and card sorting activities. Collected data was analysed using univariate, and MANOVA. Results were as follows: 1. The scores of children who walked showed no significant difference in any of the three postures. 2. The highest test scores in children who walked with assistance (aid /other person) were in the Box and Block Test for the nondominant hand, and in bead stringing for bilateral hand function. These scores occurred with the children in the chair sitting posture(p(0.05). 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 varia- tions allowed for relevance to the chosen position of the hand activity being performed.