Scoring of Norms of the Gross Motor Function Measure (GMFM) in Normal Children

OBJECTIVE: We performed to obtain the normal values of Gross Motor Function Measure (GMFM) in normally developed children. We designed this study to inform the degree of gross motor functional disability or delay in children with cerebral palsy, comparing with score values of GMFM in normal children. METHOD: One hundred-sixteen normally developed children who were in the age of 12 to 47 months were recruited. Their GMFM tests were performed by a pediatric physical therapist. They were grouped by age of 6 months and the scores were compared with all of each groups. Results: The GMFM scores in normal children increased with ages. The rates of increment in scores were fast till 35 months of age and inter-individual differences of GMFM scores were greater in younger age groups (less than 36 months of age) than older groups. Even the means of GMFM scores were higher in the girls than boys, the differences between sexes were insignificant statistically. CONCLUSION: Norms of GMFM obtained in normally developed children who were in the age of 12 to 47 months. It would be helpful to assess the degree of motor functional disabilities or delay in children with physical disabilities.

Interval between Initial Hospital Arrival and Start of Rehabilitation Therapy in Sroke Patients of Tertiary Medical Center

The rehabilitation therapy as well as the initial medical management for stroke patients should be started early to be effective. However, a little attention has been paid to the interval between the onset of stroke and rehabilitation therapy. We studied the delay from the onset of stroke to the start of rehabilitatioin therapy and its impact on outcomes. This study was performed retrospectively on 807 acute stroke patients who were admitted to Asan Medical Center to evaluate the interval between ictus of stroke and hospital arrival or rehabilitation therapy and to compare in the ischemic and hemorrhagic groups. Forty seven percents of the stroke patients arrived after 24 hours of the onset of stroke and 70% of stroke patients started their rehabilitation therapy 1 week later. Hemorrhagic patients started their rehabilitation therapy significantly earlier than the ischemic patients. This delay in hospital arrival may be attributed to the lack of awareness about the symptoms and early signs of stroke by the patients, general public, and even medical personnels. The delay in rehabilitation therapy from the onset of stroke can be prevented by the public compaigns emphasizing the better outcome with earlier rehabilitation treatment.

Cardiovascular Instabilities Accompanying Acute Spinal Cord Injured Patients

Traumatic spinal injury causes profound changes in blood pressure, pulse rate and cardiac rhythm. Because the cardiovascular system is highly dependent on autonomic influences, acute spinal cord trauma might interfere wit h the complex mechanisms involved in cardiovascular homeostasis. These abnormalities has been generally attributed to autonomic instability. However, relatively little attention has been paid to the acute aspects of autonomic dysfunction in humans. Therefore, this study was performed retrospectively on 62 patients with acute spinal cord injuries to evaluate incidence, time course and severity for cardiovascular instability. In this study, the incidence of persistent bradycardia and hypotension in the cervical injury group was significantly higher than that of the thoracolumbar injury group. These signs occurred earlier in the cervical group than the thoracolumbar group and also lasted longer in the cervical group. This study suggests that there is a direct correlation between the level of spinal cord injury and the incidence of cardiovascular problems.