1.Effect of Botulinum Toxin Injection in Hip Adductor Muscles on Gross Motor Function in Low-Functioning Children with Spastic Cerebral Palsy
Jun Min CHA ; Jehyun YOO ; Juntaek HONG ; Jeuhee LEE ; Yebin CHO ; Dong-Wook RHA
Yonsei Medical Journal 2026;67(1):56-61
Purpose:
Botulinum toxin type A (BoNT-A) injections are used to manage spasticity in children with low-functioning cerebral palsy (CP), particularly in cases involving the hip adductor muscles. Despite their widespread use, research on the impact of BoNT-A injections on gross motor function in children with CP within Gross Motor Function Classification System (GMFCS) levels III–V remains limited, prompting us to evaluate their effectiveness in this population.
Materials and Methods:
This retrospective study included 100 preschool children (mean age, 3.9 years) with CP (GMFCS levels III–V) who received BoNT-A injections targeting the adductor muscles at a tertiary hospital (2006–2024). Gross motor function was assessed using the Gross Motor Function Measure (GMFM) within 1 month before injection and between 3 weeks and 4 months post-injection. Subgroup analyses were conducted by GMFCS level and by injection site. Pre- and post-injection assessments were compared using the Wilcoxon signed-rank test.
Results:
GMFM scores improved significantly across all GMFCS levels (p<0.05). Children at GMFCS levels III and IV demonstrated improvements across all domains (A–E), whereas those at GMFCS level V showed significant gains in domains A, B, and C (p<0.05).Further analyses showed significant improvements in all three groups: adductors alone, adductors and hamstrings, and adductors and distal muscles (p<0.05).
Conclusion
BoNT-A injections into hip adductor muscles improved gross motor function in children with low-functioning CP, affecting both overall and specific functional domains. This effect was observed in children who received injections into the adductors alone, as well as in combination with injections into the hamstrings or distal muscles.
2.A Study of the Reliability and Validity of the Korean Version of DSM-5 Symptom Measure–Inattention and Anger for Parent and Guardian of Child Age 6 to 17
Shin MIN-SUP ; Bung-Nyun KIM ; Minji CHO ; Mirae JANG ; Hanbyul SHIN ; Ryemi DO ; Hyungseo PARK ; Narae YOON ; Gahye NOH ; Jae-Won SONG ; Yebin AHN ; Jiyoon SHIN ; Soomin JANG ; Eunjung NOH ; Eunhwa LEE
Journal of the Korean Academy of Child and Adolescent Psychiatry 2023;34(1):59-59
3.A Study of the Reliability and Validity of the Korean Version of DSM-5 Symptom Measure–Inattention and Anger for Parent and Guardian of Child Age 6 to 17
Min-Sup SHIN ; Bung-Nyun KIM ; Minji CHO ; Mirae JANG ; Hanbyul SHIN ; Ryemi DO ; Hyungseo PARK ; Narae YOON ; Gahye NOH ; Jae-Won SONG ; Yebin AHN ; Jiyoon SHIN ; Soomin JANG ; Eunjung NOH ; Eunhwa LEE
Journal of the Korean Academy of Child and Adolescent Psychiatry 2021;32(2):71-78
Objectives:
This study was conducted to investigate the reliability and validity of the Korean version of the DSM-5 Level 2 Cross-Cutting Symptom Measure–inattention [Swanson, Nolan and Pelham, version IV (SNAP-IV)] and anger [Patient-Reported Outcome Measurement Information System (PROMIS) Anger] for parents and guardians of children aged 6–17 years.
Methods:
We included 104 children and adolescents diagnosed with attention-deficit/hyperactivity disorder (ADHD), ADHD with anxiety and depression, depressive disorder, anxiety disorder, and tic disorder with somatic symptoms (ADHD=41, depression=9, anxiety=14, ADHD+anxious depression=11, tic+somatic symptoms=29). Their ages ranged from 8 years to 15 years. The participants’ mothers completed the SNAP-IV, PROMIS Anger scale, Korean version of the IOWA Conners Rating Scale (K-IOWA), and Korean ADHD Rating Scale (K-ARS) so that the reliability and validity of the SNAP-IV and PROMIS Anger scales, which are DSM-5 scales for assessing inattention and anger of children and adolescents, could be examined.
Results:
The reliability coefficient of SNAP-IV (Cronbach’s α) was 0.94. The correlation coefficients between SNAP-IV, K-IOWA inattention, and K-ARS inattention scores ranged from 0.73 to 0.86. The mean SNAP-IV scores of the ADHD and the ADHD+anxious depression groups were significantly higher than those of the anxiety and the tic+somatic symptoms groups. The reliability coefficient of the PROMIS Anger was 0.91. The correlation coefficient between PROMIS Anger and K-IOWA oppositional/defiant scores was 0.75.The PROMIS Anger mean score of the ADHD+anxious depression group tended to be higher than that of the other groups.
Conclusion
These results suggest that the Korean version of the DSM-5 Level 2 Cross-Cutting Symptom Measure–inattention and anger for parent and guardian of child age 6–17 might be a reliable and valid test and may be useful for screening children and adolescents with ADHD.
4.A Study of the Reliability and Validity of the Korean Version of DSM-5 Symptom Measure–Inattention and Anger for Parent and Guardian of Child Age 6 to 17
Min-Sup SHIN ; Bung-Nyun KIM ; Minji CHO ; Mirae JANG ; Hanbyul SHIN ; Ryemi DO ; Hyungseo PARK ; Narae YOON ; Gahye NOH ; Jae-Won SONG ; Yebin AHN ; Jiyoon SHIN ; Soomin JANG ; Eunjung NOH ; Eunhwa LEE
Journal of the Korean Academy of Child and Adolescent Psychiatry 2021;32(2):71-78
Objectives:
This study was conducted to investigate the reliability and validity of the Korean version of the DSM-5 Level 2 Cross-Cutting Symptom Measure–inattention [Swanson, Nolan and Pelham, version IV (SNAP-IV)] and anger [Patient-Reported Outcome Measurement Information System (PROMIS) Anger] for parents and guardians of children aged 6–17 years.
Methods:
We included 104 children and adolescents diagnosed with attention-deficit/hyperactivity disorder (ADHD), ADHD with anxiety and depression, depressive disorder, anxiety disorder, and tic disorder with somatic symptoms (ADHD=41, depression=9, anxiety=14, ADHD+anxious depression=11, tic+somatic symptoms=29). Their ages ranged from 8 years to 15 years. The participants’ mothers completed the SNAP-IV, PROMIS Anger scale, Korean version of the IOWA Conners Rating Scale (K-IOWA), and Korean ADHD Rating Scale (K-ARS) so that the reliability and validity of the SNAP-IV and PROMIS Anger scales, which are DSM-5 scales for assessing inattention and anger of children and adolescents, could be examined.
Results:
The reliability coefficient of SNAP-IV (Cronbach’s α) was 0.94. The correlation coefficients between SNAP-IV, K-IOWA inattention, and K-ARS inattention scores ranged from 0.73 to 0.86. The mean SNAP-IV scores of the ADHD and the ADHD+anxious depression groups were significantly higher than those of the anxiety and the tic+somatic symptoms groups. The reliability coefficient of the PROMIS Anger was 0.91. The correlation coefficient between PROMIS Anger and K-IOWA oppositional/defiant scores was 0.75.The PROMIS Anger mean score of the ADHD+anxious depression group tended to be higher than that of the other groups.
Conclusion
These results suggest that the Korean version of the DSM-5 Level 2 Cross-Cutting Symptom Measure–inattention and anger for parent and guardian of child age 6–17 might be a reliable and valid test and may be useful for screening children and adolescents with ADHD.

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