목적 : 본 연구의 목적은 발달장애 아동을 위한 태블릿 기반의 인지평가를 통해 세부 인지기능의 프로파일 을 비교함으로써 본 평가가 진단그룹에 따른 인지기능 상태를 평가하는데 변별력이 있는지 알아보고자 하였다.
연구방법 : 총 80명의 만 4~12세 아동이 본 연구에 참여하였다. 진단명별로 자폐 스펙트럼(Autism Spectrum Disorders; ASD) 24명, 지적장애(Intellectual Disability; ID) 20명, 주의력결핍 및 과잉행 동 장애(Attention-Deficit Hyperactivity Disorder; ADHD) 7명, 정상발달 아동 29명이 참여하였다. 태블릿으로 개발된 인지평가는 총 8개 항목으로 공간작업기억, 작업기억용량, 시각적 작업기억, 시지각 처리기술, 집행기능(계획), 집행기능(반응억제 및 주의력), 집행기능(억제)의 세부 인지항목으로 구성되 어 있다. 평가를 시행한 후 진단그룹에 따른 차이를 Kruskal-Wallis 검정을 통해 비교하였다. 통계분석 은 Jamovi 1.6.23 을 사용하였다.
결과 : 정상발달 아동에 비해 자폐 스펙트럼, 지적장애, ADHD 아동의 인지평가 총점이 통계적으로 유의 미하게 다른 것으로 나타났다(χ²= 22.41, p < .001). 정상발달 아동에 비해 자폐 스펙트럼 아동은 시각 처리기술 및 억제기능의 항목에서 유의미한 기능 저하를 보였고, 지적장애 아동은 작업기억 용량, 시각적 작업기억과 반응억제 및 주의력 항목에서 유의미한 기능 저하를 보이는 것으로 나타났다. 한편, ADHD 아동의 경우 정상발달 아동에 비해 통계적으로 유의미한 차이를 보이는 인지평가 항목이 없었다.
결론 : 본 연구에서 개발된 태블릿 기반의 인지평가는 정상발달 아동과 발달장애 아동의 인지기능의 상태 를 변별함으로써 치료의 기초자료로써 활용 가치가 있다.
Background: Research efforts to improve the pulmonary function of children with cerebral palsy (CP) need to focus on their decreased diaphragmatic ability compared to normal children. Real-time ultrasonography is appropriate for demonstrating diaphragmatic mechanisms.
Objects: This study aimed to compare diaphragm movement, pulmonary function, and pulmonary strength between normal children and children with CP by using ultrasonography M-mode. The correlation between general characteristics, diaphragm movement, pulmonary function, and pulmonary strength was also studied.
Methods: The subjects of this study were 25 normal and 25 CP children between five and 14 years of age. Diaphragm movement was measured using real-time ultrasonography during quiet and deep breathing. Pulmonary function (such as forced expiratory volume in one second; FEV1 and peak expiratory flow; PEF) and pulmonary strength (such as maximum inspiratory pressure; MIP and maximum expiratory pressure; MEP) were measured. A paired t-test and Spearman’s Rho test, with a significance level of .05, were used for statistical analysis.
Results: The between-group comparison revealed that normal children had significantly greater diaphragm movement, FEV1, PEF, MIP, and MEP (p<.05) than CP children. The results showed that general characteristics were significantly related to FEV1, PEF, MIP, and MEP (p<.05).
Conclusion: In clinical settings, clinicians need to concern decreased diaphragm movement, pulmonary function, and pulmonary strength in CP group compared to normal children.
Multi-sensory systems, including the visual, somatosensory, and vestibular ones, are involved in maintaining standing balance. The organization of these sensory systems is as important as the efficiency of each individual system in maintaining optimal balance. The purpose of the present experiment was to investigate the developmental changes in static standing balance and sensory organization under altered sensory conditions. This study involved 64 children (from 4 to 15 years of age) and 17 young adults. The children were divided into four age groups: 4~6, 7~9, 10~12, and 13~15 years. Static standing balance was assessed with the one-leg standing test under four different sensory conditions: the children stood on a firm surface with (1) eyes open or (2) closed, and they stood on a foam surface with eyes (3) open or (4) closed. In balancing ability, the age groups exhibited significant differences. The function of sensory organization for balance control was poorer for the children than for the young adults. The functional efficiency of the somatosensory system of the children aged 7~9 years was at the young adults' level, and the visual function of the children aged 10~12 years had also reached the young adults' level. However, the functional efficiency of the vestibular system of children was significantly lower than that of the young adults, even at the age of 15 years. This may indicate that sensory organization and standing balance are still developing after the age of 15 years.
Although many children with cerebral palsy have problems with their eye movements available data on its intervention is minimal. The purpose of the study was to determine the effectiveness of the postural movement normalization and eye movement program on the oculomotor ability of children with cerebral palsy. Twenty-four children with cerebral palsy (12 male and 12 female), aged between 10 and 12, were invited to partake in this study. The subjects were randomly allocated to two groups: an experimental group received the postural movement normalization and eye movement program and a control group which received conventional therapy without the eye movement program. Each subject received intervention three times a week for twelve weeks. The final measurement was the ocular motor computerized test before and after treatment sessions through an independent assessor. Differences between the experimental group and control group were determined by assessing changes in oculomotor ability using analysis of covariance (ANCOVA). The changes of visual fixation (p<.01), saccadic eye movement (p<.01) and pursuit eye movement (p<.01) were significantly higher in the experimental group than in the control group. These results show that the postural movement normalization and eye movement program may be helpful to treat children with cerebral palsy who lose normal physical and eye movement.
목적 : 상자와 나무토막 검사는 손의 기능, 즉 조작능력을 평가하는 방법으로 보다 객관적이고 일상생활에서 많이 쓰는 손의 기능을 검사할 수 있는 가장 기본적이고 간단한 검사방법이다. 따라서 본 연구는 서울의 초등학생을 대상으로 일반적인 특성(성, 연령, 우세한 손)과 신체적인 특성(앉은키, 몸무게)에 따른 상자와 나무토막 검사의 정상아동 표준치를 제시하여서, 아동 치료에 기초가 되는 자료를 제공하고자 하였다.연구방법 : 연구 대상자는 서울에 위치한 한 초등학교에 다니는 남학생 85명(45.2%), 여학생 103명(54.8%)으로 전체 188명이였다. 자료는 8세에서 13세까지 6집단으로 나누고, 평균, 표준편차, 백분위 점수로 나타내었다.결과 : 상자와 나무토막 검사에서 평균값은 성별, 연령, 우세손에 따라 계산되었다(남자: 80.15, 여자: 75.68). 성별에 따라 점수를 비교했을 때, 남자 학생들의 점수가 왼손, 오른손 손 검사에서 모두 높은 점수를 얻었다(p<0.05).결론 : 본
Objective : The purpose of this study was to compare the sensory-based behaviors of young children with and without cerebral palsy as reported by their parents on the Short Sensory Profile.Method : Short Sensory Profile questionnaire was completed by parents of 59 children with cerebral palsy 1 through 9 years of age and parents of 129 children without cerebral palsy 1 through 6 years of age.Results : The performance of children with cerebral palsy was significantly different form that of children without cerebral palsy on 4 of 7 factors. Factors were difference found included Movement Sensitivity, Auditory Filtering, Low Energy/Weak, Visual/Auditory Sensitivity.
Conclusion : Finding from the study suggest that young children with cerebral palsy have probable deficit in a variety of sensory processing abilities as measured by the Short Sensory Profile. The Short Sensory Profile can provide information about the sensory processing skills of children with cerebral palsy to assist occupational therapist in assessing and planning inter-vention for these children.
Objectives : This study evaluated norms for fine motor dexterity skills on kindergarten and elementary school children.
Method : Participants were recruited from five kindergartens and two elementary schools in Seosan area. The sample consisted of 160 healthy students ranging in age from five to eight years. The Grooved Pegboard Test (GPT) was utilized to investigate fine motor dexterity.
Results : The GPT showed statistically significant differences in hand dominance based on the findings that the scores of nondominant hands were substantially lower than those of dominant hands (p<0.05). The GPT showed significant age group differences in which 8 year old group demonstrated substantially higher scores than those of all other younger age groups (p<0.05). The results indicated a positive relationship between age and GPT scores.
Conclusion : The results of this study support the results of previous studies that compared hand function between healthy children and abnormal children. These data will provide standard value of GPT for occupational therapists.
본 연구는 대전지역의 만3세부터, 7세까지의 유치원 아동들 중 1 ,455명을 대상으 로 영 ·유아 시기의 주변 환경 및 습관이 시력에 영향이 미칠 수 있는 요소들올 성 문하고 안과병원과 협조하여 단체 시력검사를 실시하였는데, 난시는 Spherical equivalent로 환산하여 정상 시력 군은 -0.75D - +0.75D 사이의 범위이면서 양안의 나 안시력이 0.65 이상을 모두 만족한 아동으로 하였고 나머지를 비정상 시력 군으로 구 분하였다. 단, 상기의 구분에서 정상 시력 군으로 판정이 되었어도 Spherical equivalent에 의한 양안의 차이가 2.00 D 이상일 경우는 비정상 시력 군으로 분류한 결과, 83.6% 의 비정상적 시력을 보였으며 연령별로 통계학적 유의성은 없었으며 출 생시 체중이 2.5Kg 미만 군에서 비정상 시력 군이 86.3%로 가장 많았으나 체중별 결 과도 유의하지 않았다. 수유와 관련한 사항에서는 모유와 분유와 이유식을 모두 먹은 군에서 정상 시력 군이 22.9%로 가장 많았으며 수유기간은 197~ 월 이상 동안 수유한 군에 서 정 상 시 력 군이 22.0% 로 가장 많았으나 역 시 유의 하지 않았고 초유의 음용 여부에서는 “모두 먹었다”는 군에서 정상 시력 군이 2 1.1%로 가장 많았고 통계학적 으로 유의함을 알 수 있었다 (P=O. OO6). 수유기간 동안 및 최근 기간동안에 수면 시 조명상태에서는 “등을 켜고 잔다”는 군에서 비정상의 시력 꾼이 각각 90.0%, 85.0% 로 가장 많았으나 통계학적 유의성은 없었으며, 부모의 시력교정 여부에 따른 사력검 사 결과에서 “부모 모두 교정하였다”의 군에서 비정상 시력 군이 89.2% 로 가장 많았 으나 유의하지 않았고 출생 후 질병의 유무와 임신기간별 사력검사 결과에서도 그 유의성을 찾을 수 없었다.
The purpose of this study is to find the standard value of hand width, of grip strength and of pinch strength by age, sex, and by left hand and right hand and also to find how the general characteristics influences grip strength and pinch strength.
Martin Vigorimeter (List No. 17-27-01) was used for measuring grip strength, and the pinch gauge (0∼30 lbs) of B&L engineering for measuring pinch strength.
The subjects of this study are the children at the age of three to seven years, who attending the babies' play room, kindergarten and the primary school in Seoul and the Kyungki province area. They all were normally developed without any significant neurology problem. wo hundred girls and two hundred boys were partifipated in this study. They were divided into ten subgroups according to the age of six month interval. Each group consisted of forty children of twenty boys and twenty girls.
Analysis of data presents the technical statistics upon the hand width of right and left hand and the grip strength and pinch strength according to the age and sex. Multiple regression analysis using mixed liner model was operated in order to find how the general characteristics (of the age, sex, and side of hand) influence hand width, grip strength, and pinch strength individually. Also, we calculated the correlation among hand width, grip strength and pinch strength under the
condition of controlling general characteristics; and to find correlation between the right hand and the left hand of the age and sex, we carried out paired t-test and came to the conclusion as follows:
1. Hand width is significantly increased with the increase of age (p<0.01). The increase of hand width according to age, boy is wider than that of girl significantly (p<0.01), and the right hand is wider than that of the left hand significantly (p<0.01).
2. Grip strength is significantly increased as the age and hand width increased (p<0.01). The increase of grip strength according to the age, boy is stronger than that of girl significantly (p<0.01), and grip strength of the right hand is stronger than that of the left hand(p<0.01).
3. Three-jaw pinch strength is increased as the age, hand width and grip strength are increased(p<0.01). But there is no significant difference of three-jaw pinch strength according to sex and the side of hand(p>0.05).
4. Tip pinch strength is significantly increased as the age and grip strength are increased(p<0.05). The increase of tip pinch strength according to the age, boy is stronger than that of girl significantly (p<0.05), but there is no significant difference between the right hand and the left hand(p>0.05).
5. Lateral pinch strength is significantly increased as the age and grip strength are increased(p<0.01). But the increase of lateral pinch strength, there is no significant difference according to the hand width, sex and the side of hand(p>0.05).
6. The test of correlation among hand width, grip strength and pinch strength showed the correlation between grip strength and pinch strength was stronger than the correlation between hand width and pinch strength(0.3<r<0.7). There was strong correlation between each pinch strength(0.3<r<0.7). Above all, the correlation of three-jaw pinch strength and tip pinch strength was strongest(0.7<r<1.0).
7. The test of hand width according to the age and sex, and the difference between the right hand and the left hand in grip strength and pinch strength showed that there was significant difference against all the test of hand width, of grip strength, and of pinch strength in the age group from seven years and six months to seven years and eleven months than the age group
under six years, specially in girls group(p<0.05).
Physiological Cost Index (PCI) of walking has been widely used to predict oxygen consumption in healthy subjects or patients. The purposes of this study were to evaluate the predictability of physiological cost index of upper extremity exercise with a sander for the amount of exercise and cardiac function and to find out most efficient speed of exercise. Upper extremity exercise was conducted in 67 healthy children (age 4 -12) for 2 minutes with a sander in two different speeds, such as self selected comfortable and self selected fast speeds. Speed of sander was
calculated, and heart rate were measured before and immediately after the exercise. Physiological Cost Index (PCI) of upper extremity exercise was calculated for statistical analysis.
The result were as follows;
1. Comfortable and fast speeds of the sander went up according to the increase of age, sander PCI during exercise by it, decreased as the age increased with significant difference in each group (p=0.00). The heart rate change during exercising by it, there was no significant difference.
2. The heart rate change during the exercise by sander increased as the speed of sander increased. Linear regression equation between the heart rate change during the exercise by sander and the speed of sander were 'Y (the heart rate change by sander) = 0.332X (the speed of sander) + 12.731' (R²= 0.154). Stepwise regression showed the speed of sander affected the change of heart rate positively, and the age affected negatively (R²= 0.242, p = 0.00).
3. The PCI during the exercise by sander decreased as the speed of sander increased. Linear regression equation between the PCI during the exercise by the sander and the speed of sander were 'Y (the PCI by sander) = -0.00495X (the speed of sander) + 2.091'(R²= 0.267), and statistic significant was recognized (p = 0.00).
4. The speed of exercise by sander it increased as the age increased. Linear regression equation between the speed of the sander and the age were 'Y (the speed of sander) = 2.481X (the age) -0.893(R²= 0.452), and statistic significant was recognized(p = 0.00).
5. The reliability analysis for the method of examining each PCI, showed high reliability coefficients and the value of alpha was 0.9337.
In conclusion, PCI of the upper extremity exercise with a sander could be thought to predict the energy consumption from the speed of sander as there was a linear relationship between the speed of sander exercise and heart rate change with exercise. PCI of the upper extremity exercise with the self selected fast speed was most efficient.
Further study with oxygen consumption analysis is recommended to apply PCI in upper extremities in patients with different pathologies in motion.
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.
Manual dextrity is frequently evaluated in rehabilitation to estimate hand function. The Box and Block Test(BBT) mearsures gross manual dextrity. The first goal of this study was to verify the test-retest reliability of the BBT for 4, 5 years old children. The second goal of this reserch was to develop normative data from 35 convenient sample of normal children. The results showed the test-retest reliability was high (Pearson product moment correlation coefficients of 0.71 to 0.82).
The purpose of this study was to investigate whether the function of the non-affected hand of hemiplegic children is comparable to the hand function with both normal hands. The subjects of the study were 19 hemiplegic children and 20 normal children, all six years of age. The hemiplegic children were treated at one of three facili- ties: Yonsei University Rehabilitation Hospital, Seoul Community Rehabilitation Center and Inchon Severance Hospital during in period March to April, 1996. The normal children were randomly selected from a kindergarten in Inchon City. All hand function was measured by Jebsen Hand Function Test. Subtest was analysed statistically using the basic statistic analysis, Mam-Whitney test and Pearson correlation test . The results were as follows: The normal children had faster right hand function than herniplegic children whose nonaffected hand was their right hand, for the small objects, simulated
feeding, checkers subtests. Normal children had faster left hand function than hemiplegic children whose nonaffected hand was their left hand, for the small objects, checkers, large light objects and large heavy objects. The unaffected hand function of the hemiplegic children had a negative correlation with time of diagnosis, and treatment durat ion. These results showed that the nonaffected hand function of hemiplegic children dif- fered from the respective hand of normal children. Therefore, when hemiplegic children are treated, both the affected and unaffected hand must be treated as this will affect the treatment result.
The purposes of this study were 1) to determine the relationship between antigravity control(supine flexion and prone extension) and postural control(static and dynamic balance) by age, 2) to determine the quality of antigravity and postural control, and 3) to determine whether sex difference correlates with differences in antigravity and postural control in young normal children. We tested 120 children aged 4 to 7 years. The study results showed a significant relationship between antigravity and postural control by age. Quality scale measurements(r=0.90) indicated that the children in this study had not yet developed full antigravity or postural control. The study results revealed differences between sexes(f>m in 5 of 7 tests) and a significant relationship by age in antigravity and postural control.