Background: Cerebral palsy presents significant challenges in motor function for affected children. While conventional bottom-up approaches are common in physical therapy, there is increasing interest in the efficacy of the top-down approach. Objectives: To investigated the impact of applying the top-down approach in physical therapy for a child diagnosed with cerebral palsy, focusing on functional improvement and quality of life. Design: A single-case study. Methods: The patient was a 15-year-old boy with spastic diplegic cerebral palsy who was entering middle school. Cerebral palsy treatment approach of the top-down method (jumping rope) was used to guide and direct physical therapy. Results: The child improved in muscle strength of lower extremity, gross motor function, participation and self-esteem, but the pattern of his gait seemed to be more severe on tiptoe. When the child participated in a jumping rope class, he was able to do more than 10 jumps. Conclusion: The effectiveness of the top-down approach in enhancing functional outcomes and quality of life in children with cerebral palsy. It highlights the potential of this approach in pediatric physical therapy, warranting further research validation.

Background: Children with cerebral palsy face challenges in maintaining body stability because of structural and functional defects. Their ability for responsive balance control is diminished. While there exist various trunk stabilization exercises such as Kinetic Link training (KLT) and the Bird-dog posture, there is a notable dearth of research that applies KLT specifically to children with cerebral palsy. Objectives: To investigate the effects of KLT and Bird-dog exercise on gross motor function and balance in children with cerebral palsy. Design: Quaxi-experimental study. Methods: The study participants were randomly divided into two groups: 15 individuals in the KLT group and 15 in the Bird-dog group. General characteristics were examined, and initial measurements of Gross motor function measure (GMFM) and Pediatric balance scale (PBS) were taken prior to the intervention. Each group engaged in KLT exercises and Bird-dog exercises for 20 minutes, three times a week over an 8 week period. Following the completion of the 8 week intervention, secondary measurements of GMFM and PBS were conducted. Results: In the KLT group, both PBS and GMFM showed a significant increase after the intervention compared to before (P<.05). Similarly, in the Bird-dog group, both PBS and GMFM significantly increased after the intervention compared to before (P<.05). There was a significant difference observed in PBS when comparing the pre- and post-intervention changes between the two groups (P<.05), whereas no significant difference was found in GMFM between the groups when comparing the pre- and post-intervention changes (P>.05). Conclusion: The interventions involving KLT and Bird-dog exercises were observed to effectively enhance PBS and GMFM in children with cerebral palsy. Specifically, it was evident that KLT was more beneficial in improving balance abilities compared to Bird-dog exercise.

Cerebral palsy (CP) is a prevalent neurodevelopmental disorder characterized by motor and postural impairments caused by central nervous system dysfunction. It significantly impacts children’s daily functioning and quality of life. Physical therapy is a crucial intervention for children with CP that aims to improve motor skills and functional abilities. This study aimed to provide a comprehensive overview of holistic physical therapy approaches methods specifically designed for children with CP and examine recent research trends and their implications for optimizing outcomes in this population. This study employed a narrative review approach, conducting a comprehensive examination of the current literature pertaining to physical therapy methods for children with CP. The review encompassed studies exploring assessment techniques, evidence-based interventions, and innovative approaches in the field. It was discerned that encompassing physical therapy strategies, which encompass individualized treatment plans, evidence-based interventions, and the integration of innovative techniques, yield a favorable influence on the motor skills and functional capacities of children with CP. This review synthesizes the current knowledge on effective physical therapeutic strategies for children with CP. Furthermore, this review highlights the need for continued research and innovation in the field of pediatric physical therapy for CP.

목적 : 본 연구의 목적은 뇌성마비 아동 및 청소년에게 보조공학을 사용한 글씨쓰기에 관한 연구를 분석하여 글씨쓰기 연 구에서 활용되고 있는 보조공학과 중재 프로그램의 효과를 알아보고자 하였다. 연구방법 : 2011년부터 1월부터 2023년 7월까지 DBpia, Kiss, earticle, ScienceDirect, EBSCOhost, PubMed, 구글 스칼라를 이용하여 뇌성마비 아동 및 청소년에게 보조공학을 사용한 글씨쓰기 중재에 대한 논문을 검색하였으며, 1차 검색 된 2,886편의 논문 중 선정기준 및 배제기준에 따라 6편의 논문을 최종 선택하여 분석하였다. 결과 : 선정된 6편의 논문 중 무작위 대조군 연구 1편, 비무작위 비교연구 2편으로 근거수준 1-2단계에 해당하는 연구가 3편이었다. 글씨쓰기 연구에 사용된 보조공학의 종류는 컴퓨터 접근장치가 4편(키보드 변형 3편, 스위치와 포인팅 기기, 소프트웨어 프로그램 사용 1편), 3차원의 반복적인 움직임을 통해 글씨쓰기를 연습하는 보조로봇 1편, 이축 연필(biaxial pencil) 등 변형된 필기도구를 사용한 연구가 1편이었다. 컴퓨터 보조공학 중재와 보조로봇을 적용한 5편의 연구에서 작업치 료사가 글씨쓰기 중재를 제공하였다. 컴퓨터 보조공학 중재 결과 종속변인인 문자입력 속도와 정확도가 향상되었으며, 부모만 족도와 목표달성 정도가 높게 나타났다. 결론 : 뇌성마비 아동 및 청소년에게 글씨쓰기에 사용되고 있는 보조공학과 효과적인 중재방법과 치료 효과를 확인했다는 데 의의가 있다.

Background: Despite the fact that aquatic exercise is one of the most popular alternative treatment methods for children with cerebral palsy (CP), there are few research regarding its effectiveness. Objects: The purpose of this study was to examine the effects of aquatic exercise on upper extremity function and postural control during reaching in children with CP. Methods: Ten participants (eight males and two females; 4–10 years; Gross Motor Function Classification System levels II–IV) with spastic diplegia were recruited to this study. The aquatic exercise program consisted of four modified movements that were selected from the Halliwick 10-point program to enhance upper extremity and trunk movements. The participants attended treatment two times a week for 6 weeks, averaging 35 minutes each session. The Box and Block Test (BBT), transferring pennies in the Bruininks-Oseretsky Test (BOT), and pediatric reaching test (PRT) scores were used as clinical measures. Three-dimensional motion analysis system was used to collect and analyze kinematic data. Differences in BBT and BOT values among pre-treatment, post-treatment, and retention (after 3 weeks) were analyzed using a Friedman test. In addition, the PRT scores and variables (movement time, hand velocity, straightness ratio, and number of movement units) from the three-dimensional motion analysis were tested using a Wilcoxon signed-rank test. The significance level was established at p < 0.05. When the results appeared to be statistically significant, a post-hoc test for multiple comparisons was performed with the Wilcoxon signed-rank test. Results: All clinical measures, which included BBT, transferring pennies of BOT, and PRT, were significantly increased between pre-intervention and post-intervention scores and between pre-intervention and retention scores after treatment (p = 0.001). Three-dimensional motion analysis mostly were significantly improved after treatment (p = 0.001). Conclusion: Aquatic exercise may help to improve body function, activity, and participation in children with varying types of physical disabilities.

목적 : 본 연구는 구강운동촉진기술(Oral Motor Facilitation Technique; OMFT)이 뇌성마비의 섭식기능 증진에 미치는 효과를 확인하기 위한 목적으로 시행되었다. 연구방법 : 평균 연령 5.88 ± 1.98세(범위 3~10세) 연하장애를 동반한 21명의 뇌성마비를 대상으로 하 였다. 주 1회, 30분, 16주(16회) OMFT를 제공하였다. OMFT가 섭식기능에 미치는 효과 확인을 위해 먹기와 마시기 기능 분류 체계(Eating and Drinking Ability Classification System; EDACS)로 측정 하였다. OMFT를 개발한 연구자 1인이 평가를 포함한 전체 과정을 진행하였으며 아동의 섭식기능에 따 라 개별적인 접근이 적용되었다. OMFT 치료 전, 8주, 16주 총 3회 EDACS 평가를 통해 치료 기간별 치료 효과 차이를 프리드만 검정과 윌콕슨 부호 검정을 통해 검정 및 사후 검정을 진행하였다. 결과 : 16주의 OMFT 중재 후 뇌성마비 아동의 섭식기능(EDACS 단계)은 유의미하게 향상되었다. 16주 의 치료 기간이 8주에 비하여 섭식기능 향상에 효과적이었다. 반면 독립적인 먹기(EDACS 도움 단계) 는 변화가 없었다. 연령, Gross Motor Function Classification System(GMFCS) 단계, 뇌성마비 분류 등 요인별 사후검정 결과 EDACS 단계에서는 7~8세, GMFCS Ⅲ단계, 무정위형을 제외한 모든 변인에 서 치료 기간에 따라 유의미한 차이를 보였다. 그러나 EDACS 도움 단계에서의 유의미한 차이는 없었 다. 결론 : OMFT는 뇌성마비의 섭식기능 향상에 효과적인 구강운동치료법으로 확인되었다. 적정 기간의 OMFT 적용을 통해 임상에서 다양한 연령, 운동기능 상태, 병변 부위의 뇌성마비 아동의 섭식기능 향상 을 위한 종합적인 구강운동치료 활용하는데 도움이 될 것으로 기대된다.

본 연구의 목적은 뇌성마비 아동에게 다감각스토리텔링에 기반한 활동중심중재를 적용하고 사회적 상호작용에 미 치는 영향에 대해 알아보는 것이다. 유사실험연구로 단일눈가림, 두 집단 사전-사후검사로 설계하였고, 경직형 뇌성마 비로 진단받고, 대동작기능분류체계(GMFCS) Ⅰ~Ⅲ단계에 속하는 7~8세 아동 24명을 대상으로 하였다. 실험군과 대조군에 12명씩 무작위 배정하고 아동과 보호자는 집단이 어디에 속하는지 알 수 없도록 하였다. 집단별 프로그램은 회기당 60분, 주 2회, 8주간, 총 16회기 동안 진행되었고, 실험군은 다감각스토리텔링에 기반한 활동중심중재를 하였 고, 대조군은 구조화된 신체활동을 실시하였다. 아동의 중재 전과 후에 사회적 상호작용의 변화정도를 확인하기 위해 또래관계기술척도를 사용하여 측정하였다. 수집된 자료는 SPSS 25.0 for windows (IBM Corp, USA) 프로그램을 이 용하여 분석하였고, 통계적 검증을 위한 유의수준(α)은 0.05로 하였다. 실험군과 대조군의 또래관계기술의 집단 내 변 화는 윌콕슨부호순위검정(Wilcoxon Signed-Rank test)으로 확인하고, 두 집단 간 변화량 차이의 비교는 맨휘트니검정 (Mann-Whitney U test)으로 분석하였다. 연구결과 또래관계기술의 집단 내 변화에서 또래관계기술의 전체 값과 하위 평가의 협동과 공감영역에서 실험군과 대조군 모두 유의한 차이가 있었고, 주도성 영역에서는 실험군은 유의한 차이 를 나타냈으나 대조군은 유의한 차이가 없었다. 두 집단 간 변화량 차이에서 또래관계기술의 하위평가의 주도성영역 과 전체 값에서 유의한 차이를 나타냈고, 협동과 공감 영역에서는 유의한 차이가 없었다. 본 연구에서는 뇌성마비 아 동을 대상으로 다감각스토리텔링에 기반한 활동중심중재를 적용하여 또래관계기술에 유의한 향상을 확인하였다. 다감 각스토리텔링에 기반한 활동중심중재는 뇌성마비 아동의 사회적 상호작용에 효과적인 중재방법으로 제안할 수 있다.

Background: The International Classification of Functioning, Disability, and Health-Child and Youth version (ICF-CY) is designed to record the characteristics of developing children and examine the influence of a child’s environment on their health. Objects: This study was designed to determine the relationship between the clinically extracted ICF-CY items and The Pediatric Evaluation of Disability Inventory (PEDI) and Gross Motor Function Measure (GMFM) items. Methods: Thirty patients (17 males and 13 females) who were hospitalized in a pediatric and youth patient unit of a rehabilitation hospital were included in the study. Four health professionals (two physical therapists and two occupational therapists) working independently linked the PEDI and GMFM-66 items to the activity and participation domains of the ICF-CY. Results: There were strong negative correlations between the ICF-CY subdomains and the PEDI subdomains (r = 0.76–0.95; p < 0.05). There were positive strong correlations between the ICF-CY subdomains and the GMFM-66 (r = 0.76–0.95; p < 0.05). Conclusion: The extracted ICF codes were a valid tool for evaluating the mobility and selfcare conditions of cerebral palsy in the pediatric rehabilitation area.

목적 : 본 연구는 뇌성마비를 대상으로 (Cognitive Orientation to daily Occupatonal Performance(CO-OP)중재에 대하여 체계적으로 고찰하고자 한다. 연구방법 : 본 연구는 2010년 1월부터 2020년 11월까지 데이터베이스 PubMed, SCOPUS, Embase, 학술연구정보서비스(Research Information Sharing Service; RISS)에 게재된 문헌들을 대상으로 하였다. 검색어는 (‘Cognitive orientation to daily occupational performance’ OR ‘Cognitive orientation’ OR ‘Cognitive approach’ OR ‘CO-OP’) AND cerebral palsy이었다. 검색된 260편의 논문 중 선정기준 및 배제기준에 따라 뇌성마비를 대상으로 CO-OP실험 중재를 실시한 7편의 논문을 최종 선택하여 대상자 특성, 중재목표 활동, 중재효과, 측정도구, 중재 회기와 중재시간 등을 분석하였다. 결과 : 분석대상 문헌은 무작위 대조 실험 연구는 3편, 개별실험연구 3편, 비 무작위 두 집단 연구는 1편 으로 전반적으로 근거 수준이 비교적 높은 것으로 나타났다. 대상자는 연령별로는 아동, 기능적으로는 Gross Motor Function Classification System(GMFCS) Ⅰ등급, Manual Ablilty Classification System(MACS) Ⅱ등급이 가장 많았다. 대상자가 원하는 중재활동의 영역은 일상생활동작, 놀이, 교육 영역이었다. 중재효과로는 작업수행, 운동영역, 심리영역에 긍정적인 효과를 보였으며 CO-OP의 효과를 측정도구로는 캐나다작업수행측정을 가장 많이 사용하였다. 적용 회기는 대부분이 10회, 1시간으로 진행 되었다. 결론 : 본 연구는 CO-OP를 적용한 뇌성마비 대상자의 특성과 목표 활동, 중재효과, 결과측정도구, 회기를 제시함으로써 뇌성마비를 대상으로 CO-OP중재 기법을 적용할 때 도움이 될 것으로 확인된다.

목적 : 본 연구에서는 문헌 고찰을 통해 뇌성마비 아동을 대상으로 한 행동관찰중재의 특성, 평가도구에 대해 분석하였다. 연구방법 : Pubmed, CINAHL을 사용하여 2020년 5월까지 출판된 논문을 검색하였다. 주요 검색어는 ‘Cerebral palsy’, ‘Action observation’, ‘Motion observation’을 사용하였고 총 10편의 국내외 논문을 선정했다. 결과 : 연구에서 실험군의 연령은 5세-10세까지 전 학령기부터 초기학령기 뇌성마비 아동을 대상으로 하였으며 행동관찰중재 적용 방법이 다양하였다. 사용된 평가도구는 수행기반 평가도구가 많았으며 Assisting Hand Assessment(AHA), Melbourne Assessment of Unilateral Upper Limb Function(MUUL)과 a measure of manual ability in children with cerebral palsy(ABILHAND-Kids)의 사용빈도가 가장 높았다. 결론 : 본 연구에서는 뇌성마비 아동을 대상으로 행동관찰중재방식의 다양성을 확인하였으나 프로그램의 일관성을 위해 가이드라인의 필요성을 제시하고 있으며, Action Observation Therapy(AOT) 임상증거 마련 및 추후 연구를 위한 기초자료로 활용할 수 있을 것이다.

This study examined the effects of group exercise program on health conditions and quality of life in cerebral palsy. Adults with cerebral palsy in their 20’s who participated in the evaluation of measurement tools prior to and following the experiment. The control group was engaged in manual exercise for the range of joint movement and extension exercise for arms, legs and trunk, and experimental group performed group exercise program including boccia exercise. The health condition and quality of life of the experimental group were significantly increased after intervention (.05<). There was a slight increase in the control group, however it was not statistically significant. As a result of comparing the health condition and quality of life of the two groups, the value of the experimental group was significantly higher than that of the control group. The results of this study suggest that exercise programs for patients with cerebral palsy in the twenties are considered as beneficial interventions to improve health conditions and quality of life.

This study was conducted to examine the effects of the application of familycentered training over the 12-week period by the pediatric physiotherapist on functional balance and activities of daily living in children with cerebral palsy. Among the 26 children with cerebral palsy as the subjects were allocated to the experimental and control group. Both groups were subjected to neurodevelopmental treatment by the pediatric physiotherapist. The experimental group, participated in family-centered training program 3 times a week over a period of 12 weeks for the total of 36 sessions, functional balance and activities of daily living were verified through intergroup comparison. There was no significant difference between the outcomes prior to training and after 6 weeks of training, (p>.05) Pediatric Berg's Balance Scale(PBS) and Functional Independence Measure for children(Wee-FIM) increased significantly from those measures after 6 weeks to those after 12 weeks of training (p<.05). Therefore, these results suggest that on family-centered training on children with cerebral palsy has beneficial effects on functional movements and physical activities.

목적 : 본 연구의 목적은 수행-기초 실행기능 그룹 프로그램이 학령전기 뇌성마비 아동들의 실행기능을 증진시키는지 알아보는 것이다. 연구방법 : 만 6세 학령전기 뇌성마비 아동 17명이 본 연구에 참가하였다. 사전-사후검사 통제집단 설계 (pretest-posttest control group design)를 사용하였고 수행 실행기능을 포함하는 만들기 활동과 기초 실행기능을 포함하는 게임 활동으로 구성된 그룹 중재 프로그램을 고안하여 치료군 아동에게 제공하였다. 치료 전･후 아동의 수행 실행기능은 운동처리기술평가(Assessment of Motor and Process Skills; AMPS)로 측정하였고 기초 실행기능은 해-달 과제, 8개 상자 과제, 아동 색 선로 과제 2(Children's Color Trails Test 2; CCTT-2)를 사용하여 측정하였다. 대기 명단의 대조군 아동들에게는 사전 사후 실행기능 평가만을 시행하였다. 결과 : 치료군은 AMPS 처리 기술, 해-달 과제, 8개 상자 과제, 아동 색 선로검사에서 사전검사 점수보다 높은 사후검사 점수를 보였다. 대조군은 AMPS 처리와 CCTT-2에서만 사전검사 점수보다 높은 사후검사 점수를 보였다. 치료군은 대조군보다 모든 실행기능 측정치에서 더 큰 향상을 나타냈다. 결론 : 본 연구는 수행-기초 실행기능 그룹 프로그램을 소개하였고, 이 중재 방법이 학령전기 뇌성마비 아동의 실행기능 향상에 효과가 있음을 보여주었다.

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.

The purpose of this study was to effects of hippotherapy on functional ability of children with cerebral palsy (CP). Fifty-seven children with CP participated were randomly divided into two groups. All of the groups received thirty minutes of conventional physical therapy program for three times a week per twelve weeks, however experimental group received additional fifteen minutes of the hippotherapy. Gross Motor Function Measure(GMFM) was used to compare the effects of hippotherapy. The results were as followings: GMFM score in dimensions A and B significantly increased in the control group after intervention. All dimensions of GMFM was significantly increased in experimental group after intervention. All dimensions of GMFM were significantly different between experimental group and control group. These results suggest that hippotherapy can be considered as a therapeutic method for physical therapy for the children with CP to improve the functional movements.

Background:Children with cerebral palsy (CP) have impaired postural control, but critically require the control of stability. Consequently, therapeutic interventions for enhancing postural control in children with CP have undergone extensive research. One intervention is sensorimotor training (SMT) using a Flexi-bar, but this has not previously been studied with respect to targeting trunk control in children with CP.Objects:This study was conducted to determine the effect of SMT using a Flexi-bar on postural balance and gait performance in children with CP.Methods:Three children with ambulatory spastic diplegia (SD) participated in the SMT program by using a Flexi-bar for forty minutes per day, three times a week, for six weeks. Outcome variables included the pediatric balance scale (PBS), trunk control movement scale (TCMS), 10 meter walking test (10MWT), and 3-dimensional movement coordination measurement.Results:The SMT provided no statistically significant improvement in PBS, TCMS, 10MWT, or 3-dimensional movement coordination measurement. However, positive changes were observed in individual outcomes, as balance and trunk control movement were improved.Conclusion:SMT using a Flexi-bar may be considered by clinicians as a potential intervention for increasing postural balance and performance in children with SD. Future studies are necessary to confirm the efficacy of Flexi-bar exercise in improving the functional activity of subjects with SD.

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

Background: The Pediatric Balance Scale (PBS) was developed to assess of balance ability in children with balance problem. The PBS was translated into Korean and its reliability had been studied. However, it had need to be verified using psychometric characteristics including item fit and rating scale. Objects: The purpose of this study was to investigate the item fit, item difficulty, and rating scale of the Korean version of PBS using Rasch analysis. Methods: In total, 40 children with cerebral palsy (CP) (boy=17, girl=23) who were diagnosed with level 1 or 2 according to the Gross Motor Function Classification System participated in this study. The PBS was performed, and was verified regarding the item fit, item difficulty, rating scale, and separation index and reliability using Rasch analysis. Results: In this study, the ‘transfer’, and ‘turning to look behind left and right shoulders while standing still’ item showed misfit statistics. in total 40 children with CP. Also, ‘transfer’, ‘standing unsupported with feet together’ and ‘standing with one foot in front’ items showed misfit statistics in diplegia CP group. Regardless of the classification of CP, the most difficult item was ‘standing on one foot’, whereas the easiest item was ‘sitting with back unsupported and feet supported on the floor’. The 4 rating scale categories of PBS were acceptable with all criteria. Both item and person separation indices and reliability showed acceptable values. Conclusion: The PBS has been proven reliable, valid and is an appropriate tool, but it needs to modify the items of PBS according to CP classification.

Background: The Pediatric Balance Scale (PBS) and the Fullerton Advanced Balance (FAB) scale were used to assess balance function in patients with balance problem. These multidimensional clinical balance scales provide information about potential risk factors for falls. Objects: The purpose of this study was to investigate and compare the predictive properties of the PBS and FAB scales relative to fall risk in children with cerebral palsy (CP) using a receiver operating characteristic analysis. Methods: In total, 49 children with CP (boy=21, girl=28) who were diagnosed with level 1 or 2 according to the Gross Motor Function Classification System participated in this study. The PBS and FAB were performed, and verified cut-off score, sensitivity, specificity, and the area of under the curve (AUC). Results: In this study, the PBS scale was as a predictive measure of fall risk, but the FAB was not significant in children with CP. A cut-off score of 45.5 points provided optimal sensitivity of .90 and specificity of .69 on the PBS, and a cut-off score of 21.5 points provided optimal sensitivity of .90 and specificity of .62 on the FAB. Both scales showed moderately accurate of AUC with .79 and .76, respectively. Conclusion: The PBS is a useful screening tool for predicting fall risk in children with cerebral palsy, and those who score 45.5 or lower indicate a high risk for falls and are in need of balance intervention.

Background: The International Classification of Functioning, Disability, and Health-core set (ICF-core set) for children and youth (CY) with cerebral palsy (CP) provides a useful conceptual framework and a guide for health care planning and measuring the changes brought by interventions across a multitude of dimensions from body functions to personal activities, social participation, and environmental factors for them. Objects: This single case study was reported to illustrate the use of a goal directed approach in applying the ICF-core set for CY with CP from a physical therapist perspective. Methods: An eleven year old boy with spastic CP, Gross Motor Function Classification System (GMFCS) level V, and his mother participated in an evaluation of his functioning state. The intervention goal was set through an interview using the ICF-core set, Canadian Occupational Performance Measure (COPM) and Goal Attainment Scale (GAS). Physical therapy was carried out on an outpatient basis using a goal directed approach for 30 min, 1 time/week during 12 weeks and the boy’s gross motor function was assessed using the Gross Motor Function Measure (GMFM)-66 version (item set 2) before and after the intervention. Results: As measured by the boy’s mother, the COPM score showed a meaningful clinical change (performance=mean 3.5, satisfaction=mean 2.5) and the T-score of GAS changed 34.4 after the goal directed approach. The GMFM-66 (item set 2) score changed from 31.8 to 38.7 and evaluation using the ICF-core set displayed improvement in 6 items of activity level between before and after the intervention. Conclusion: The ICF-core set for CY with CP is useful for understanding the overall functioning of CY with this condition and provides an opportunity to share and integrate information and opinions from different disciplines. We consider it as a useful tool in the universal language for the therapy and education of CY with CP.