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Journal of the Korean Academy of Rehabilitation Medicine 1991;15(2):22-32.
Predictive value of postural reactions and neurological examinations for early diagnosis of cerebral palsy.
Park, Chang Il , Shin, Jung Soon , Park, Eun Sook , Lee, Bum Suk , Namgung, Ran , Park, Kook In
Department of Rehabilitation Medicine, Yonsei University College of Medicine, *Department of Pediatrics, Yonsei University College of Medicine
뇌성마비 조기진단을 위한 자세반응검사 및 신경학적 검사의 진단적 가치
박창일, 신정순, 박은숙, 이범석, 남궁란*, 박국인*
연세대학교 의과대학 재활의학교실, *연세대학교 의과대학 소아과학교실
Abstract

The purpose of this study was to demonstrate the predictive value of Vojta's postural reaction and other neurological examinations for early diagnosis of cerebral palsy.

The subjects of this study were 148 infants with motor disturbance who visited the Department of Rehabilitation Medicine, Yonsei University College of Medicine from December, 1987 to October, 1990.

The results are follows:

1) The mean age at initial examination was 4.7 months and the largest group (61 children; 48.0%) was the 1∼3 month of age group.

2) At final examination, 82 children were norma, 47 children were confirmed as cerebral palsy and 21 children had a variety of other diagnosis.

3) Among 10 groups of risk factors the highest prevalence of cerebral palsy was 42.9% in the perinatal asphyxia group, 42.4% in the prematurity group and 40.0% in the seizure group.

4) In the postnatal 0∼6 month period, significant neurological examinations and signs to detect brain dysfunction were Vojta's postural reactions, developmental delay and change of muscle tone (p<0.001).

5) In the groups who showed very light central coordination disturbance at initial examination, only 4.4% were later confirmed as cerebral palsy, but in severe central coordination disturbance group, 92.0% were confirmed as cerebral palsy. The higher the grade of central coordination disturbance, the greater the tendency to be identified as cerebral palsy by the time of final evaluation (p<0.001).

6) The sensitivity of the method used to diagnose cerebral palsy in this study was 95.6% (100% after 4 months) and the specificity was 65.9%.

According to the above results, Vojta's postural reaction method was useful in the early diagnosis of infants younger than 1 year and especially those younger than 6 months of age.

Key Words: Vojta's method, Early diagnosis, Cerbral palsy


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