An investigation of the relationship of drooling with nutrition and head control in individuals with quadriparetic cerebral palsy

Abstract

[Purpose] The aim of the present study was to investigate the relationship of drooling, nutrition, and head control in individuals with quadriparetic cerebral palsy. [Subjects and Methods] Fifty-six individuals between the ages 2 and 15 diagnosed with spastic quadriparetic cerebral palsy and their families/caretakers were included in the study. Drooling severity and frequency of individuals was evaluated by using the scale developed by Thomas-Stonell and Greenberg (Drooling Severity and Frequency Scale). Individuals having a drooling severity value of 1 were included in the not drooling group (group 2) (n=27). Individuals having a drooling severity of 2, 3, 4, or 5 were included in the drooling group (group 1) (n=29). The evaluations were applied to both groups. [Results] There were significant differences between the two groups in terms of gestational age, nutrition behavior, eating abilities, head control, gagging, nutritional status (inadequate nutrition, normal nutrition, over weight-obese), and low weight. It was established that as head control increased, drooling severity diminished, and as drooling severity increased, BMI index decreased. Independence of eating ability was found to be greater in the group having better drooling control. [Conclusion] In the present study, it was determined that drooling control affected nutritional functions and that drooling control was affected by head control.

A Comparison of Prenatal, Natal, and Postnatal Histories in Children with Cerebral Palsy with and without Swallowing Disorder

“…Conversely, the lack of head control increases feeding/swallow- ing disorders and drooling problems, and changes the child's independence level. In a study, a negative relationship between head control and drooling problem was reported (19). It has also been reported that feeding/swallowing disorders and drooling problems are common in cwCP (20).…”

The Masticatory Structure and Function in Children with Cerebral Palsy—A Pilot Study

“…Thanks to this method, we had a continuation of the previous SCS technique on the scalene muscle [ 40 , 41 , 42 ]. Taş (2015) also found a significant difference between head control and drooling and that the intensity of producing salivation was higher in individuals with poorer head control ( p = 0.038) [ 18 ]. Moreover, the authors proved that when drooling severity increased, the BMI index decreased significantly ( p = 0.018).…”

“…According to Chávez (2008), Dias (2016) and Gerek (2005), intensified drooling may make it difficult to ingest food [ 4 , 5 , 6 ]. The lack of such information and the need for help during the feeding process for individuals may cause moderate to severe secondary malnutrition and limit hydration in patients with CP [ 18 , 19 ]. On the other hand, there are some reports about physiotherapy treatment causing decreased drooling in this group of patients.…”

Evaluation of the Effectiveness of Functional Chewing Training Compared with Standard Treatment in a Population of Children with Cerebral Palsy: A Systematic Review of Randomized Controlled Trials

“…It is related to oral phase dysfunction in addition to insufficient lip closure generally and to tongue movements that are impaired due to diminished oral and perioral sensory perception, upside-down posture, diminished swallowing frequency, and dysphagia. Some studies have also found that difficulties in swallowing saliva are related to postural abilities, such as head control [ 13 , 14 ]. Moreover, the inability to swallow saliva can lead to aspiration pneumonia [ 15 ].…”

“…Children with CP often have difficulty with bolus formation and effective chewing and have limited ability to manage age-appropriate food textures [ 9 ]. The specific nature and severity of the chewing dysfunction may differ in relation to sensorimotor impairment and gross and fine motor limitations [ 14 ]. The most affected aspects of chewing are food transportation from the front of the mouth to the molar area and food processing through masticatory cycles due to insufficient lateral and rotational tongue movements [ 16 ].…”