Background: In cerebral palsy (CP), parents’ quality of life and rearing attitude are considered possible factors that influence patients’ quality of life, function level, and performance in daily activities. Despite these facts, little attention has been given to demonstrate a relation between these factors. Objects: This study aimed to demonstrate the relationship between parents’ quality of life, functional level, and performance in daily activities, the quality of life of school-aged children with spastic CP. Methods: This study included 24 parents of school-aged children with spastic CP. The KIDSCREEN-52 and World Health Organization quality of life (WHOQOL)-BREF questionnaires (including physical, psychological, social, and environmental domains) were used as research tools to assess the quality-of-life profiles of the children with spastic CP and those of their parents, respectively. In addition, the function levels and performance in daily activities of the children with CP were assessed by using the gross motor function measure (GMFM) and modified Barthel index (MBI). Correlation and multiple regression analyses were performed to clarify the determinants of the quality of life of the children with CP. Results: The KIDSCREEN-52 score correlated with the total score (r=.735, p<.01) and all domains of the WHOQOL-BREF questionnaire (physical: r=.542, p<.01; psychological: r=.690, p<.01; social: r=.568, p<.01; and environmental: r=.783, p<.01). In addition, significant correlation was found between the KIDSCREEN-52 and MBI scores (r=.411, p<.05), and between the MBI and GMFM scores (r=.427, p<.05). After controlling for age, gender, paralytic type, GMFM, and MBI, the WHOQOL-BREF score (R2=.621), particularly in the environmental domain (R2=.699), remained independently related to the quality of life of the children. Conclusion: These findings suggest that the quality of life of school-aged children with spastic CP can be influenced by the quality of life of their parents. This study provides useful information for future studies to investigate the quality of life of children with CP

The purpose of this study was to investigate the immediate effect of fabric ankle-foot orthosis on spatiotemporal gait parameters, compared to a barefoot condition in children with spastic cerebral palsy. Eleven children with spastic cerebral palsy participated in this study. Spatiotemporal gait parameters were measured with the GAITRite system. Fabric ankle-foot orthosis significantly improved Timed Up and Go test time and gait velocity. There was no significant difference in cadence. The step time significantly improved in both the more and less affected foot compared to the barefoot condition. The step length of the affected foot also significantly improved, but there was no significant difference in the step length of the less affected foot. There was significant improvement in the stride length of both the affected and less affected foot, but no significant difference in single stance or double stance. The fabric ankle-foot orthosis could improve stability, and selective control of the joint and promote better walking in children with cerebral palsy. Consequently, the fabric ankle-foot orthosis might be an alternative assistive device for neurological populations as a primary role instead of the typical ankle-foot orthosis.

The aim of the current study was to assess the effectiveness of backward gait training on the treadmill in patients with spastic diplegic cerebral palsy (CP). Twelve patients with spastic diplegic CP participated in the study. An 8-week course of backward gait training was administered to the subjects for 3 days per week. Pre-intervention and post-intervention assessments of temporal-spatial gait parameters, the symmetry of the bilateral lower extremity weight bearing, and gross motor function were analyzed using motion analysis system, force plate, and Gross Motor Function Measurement (GMFM). There were significant improvements (p<.05) in the measures of both step length and right stance phase time. Joint kinematics showed increase in right hip abduction in initial contact and terminal swing, right hip external rotation and knee flexion in mid-swing, left ankle dorsiflexion in initial contact and terminal swing (p<.05). The symmetry of the bilateral lower extremity weight bearing and GMFM also significantly increased (p<.05). These findings indicate that backward gait training using a treadmill is beneficial for patients with spastic diplegic CP.

목적 : 만성 경직성 편마비 환자에서 보툴리눔 독소 근 주입 후 상지 운동기능 개선을 알아보고자 하였다. 연구방법 : 뇌졸중 발병 후 12개월 이상이 경과된 만성기 편마비 환자 18명을 대상으로 환측 상지의 요측수근굴근, 척측수근굴근, 심지굴근, 천지굴근에 보툴리눔 독소를 각각 25 단위 주사하였다. 평가는 주사 전, 주사 2주 후와 8 주 후의 상지 기능 변화 및 동작 분석을 시행하였다. 상지의 경우 수정 에쉬워스 척도와 도수 근력 평가, 뇌졸중 상 지 기능 평가, 수지의 파악력 및 측면 집기력을 평가하였고 정량 분석을 위하여 3차원 동작 분석기를 이용하여 손 목관절의 최대 굴곡-최대 신전, 손바닥 두드리기, 검지 두드리기, 30cm 추적운동의 동작을 분석하였다. 결과 : 보툴리눔 독소를 주사 후 마비측 수지의 파악력, 측면 집기력에서는 유의한 변화가 없었으나 손목관절의 신 전, 수지의 신전 근력, 뇌졸중 상지 기능 평가에서 유의한 호전이 관찰되었다(p<.05). 3차원 동작 분석기를 이용한 상지 기능의 평가에서 손목관절 최대 굴곡-손목관절 신전 동작의 관절운동범위에서 유의한 호전이 관찰되었으며 손목관절 최대 굴곡-손목관절 신전 동작 및 손바닥 두드리기와 검지 두드리기 동작에서 진동수의 유의한 증가와 변이도의 유의한 감소는 관찰되지 않았으나 진폭의 유의한 증가가 관찰 되었다(p<.05). 결론 : 만성 경직성 편마비 환자에서 환측 상지에 대한 보툴리눔 독소 치료는 상지 운동기능 개선에 유의한 효과를 보였다.

목적 : 본 연구는 등쪽 손목 스프린트(dorsal wrist splint) 적용이 경직성 편마비형 뇌성마비 아동의 손 기능에 미치는 영향을 알아보기 위한 것이다. 연구방법 : 연구 대상은 만 8세 5개월 된 경직성 편마비형 뇌성마비 여자 아동이었으며 개별실험 연구방법(single-subject experimental research design) 중 ABA 설계를 사용하였다. 등쪽 손목 스프린트는 12주 동안 매일 하루 평균 4시간 동안 착용 하도록 하였고, 스프린트를 착용한 상태에서 1시간씩 주 3회 환측 손으로 작업치료를 받도록 하였다. 대상자의 손 기능은 기초선 과정(5회)과 치료 과정(12회), 기초선 회귀 과정(3회) 동안 상자와 나무토막 검사(Box & Block Test)와 수직선 그리기 검사(Vertical Line Drawing Test)를 사용하여 측정하였다. 결과 : 대상자의 손 기능은 기초선 기간보다 치료 기간 동안 향상되었으며 이 향상은 기초선 회귀 과정 동안에도 계속 지속되었다. 결론 : 등쪽 손목 스프린트는 경직성 편마비형 뇌성마비 아동의 환측 손 기능을 향상시키는데 효과적이며, 손목의 외부적 지지를 통해 손가락 움직임의 조절을 향상시키는 것으로 나타났다.

본 연구의 목적은 관절계 댐핑특성을 상용 에르고미터(BIODEX)의 등속운동을 이용하여 파악할 수 있는지를 평가하는 것이다. 제안된 방법은 등속운동을 유지하기 위해 인가한 외부토크와 하퇴의 관성토크의 차로부터 슬관절의 댐핑토크를 계산하는 것이다. 댐핑토크는 여러 가지 관절각속도에서 산출되었고, 이로부터 댐핑특성을 유도하였다. 실험장치는 BIODEX 시스템과 별도의 힘센서 및 Labview 시스템으로 구성되었다. 댐핑특성의 해석에는 Matlab을 사용하였다. 실험결과로부터 등속운동의 기동 및 종료를 위한 크랭크 암의 가속 및 감속으로 인한 미세한 각속도의 변화가 댐핑토크의 영향보다 큰 관성토크를 유발하는 것을 알 수 있었다. 따라서, 현재의 등속운동장비로는 댐핑특성을 추정하기가 어렵다고 보여진다.

In children with cerebral palsy, bone density is decreased by disturbance of bone remodelling due to lack of normal weight bearing and muscle contraction through physical activity. Loss of bone density cause fracture, delays treatment with immobilization, and leads to functional limitation. The purpose of this study was to investigate bone mineral density of lumbar spine in children with spastic quadriplegia and diplegia. Six spastic quadriplegia and 14 spastic diplegia were evaluated in this study. QDR 4500 X-ray densitometer was used to measure bone density at lumbar spine (L1~L4). Children with cerebral palsy showed lower bone density than that of normal children. Bone density in children with spastic quadriplegia and diplegia was , , respectively. However, there was no significant differences in bone density between children with spastic quadriplegia and diplegia. There was no significant difference in bone density relation to motor development level, height, and weight. Further study is needed to find the appropriate interventions for preventing loss of bone density in children with cerebral palsy.

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.

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.