Effect of a new treatment protocol called Functional Chewing Training on chewing function in children with cerebral palsy: a double‐blind randomised controlled trial

Abstract

Cerebral palsy (CP) is a group of permanent sensorimotor impairments. Children with CP have various feeding difficulties including chewing disorder, which may affect their nutritional status. Functional Chewing Training (FuCT) was designed as a holistic approach to improve chewing function by providing postural alignment, sensory and motor training, and food and environmental adjustments. This study aimed to investigate the effect of FuCT on chewing function in children with CP. This study was designed as a double-blind, randomised controlled trial. Eighty CP children with chewing disorder were randomised and split between the FuCT group (31 males, 19 females; mean age 3·5 ± 1·9 years) and the control group (16 males, 14 females; 3·4 ± 2·3 years) receiving traditional oral motor exercises. Each group received the training programme for 12 weeks with weekly follow-up and with two evaluations at baseline and end of 12 weeks. Chewing function was evaluated by analysing video recordings and scored with the Karaduman Chewing Performance Scale (KCPS). The Behavioral Pediatrics Feeding Assessment Scale (BPFAS) was used to evaluate feeding behaviours of children. A significant improvement was observed in KCPS scores at 12 weeks after training in the FuCT group (P < 0·001), but no change was found in the control group (P = 0·07). A significant improvement was detected in all parameters of BPFAS at 12 weeks after training in the FuCT group (P < 0·001) and in four parameters of BPFAS in the control group (P = 0·02, P = 0·02). FuCT is an effective method to improve chewing function compared with traditional oral motor exercises.

Effect of Functional Chewing Training on tongue thrust and drooling in children with cerebral palsy: a randomised controlled trial

“…Our study indicated that the FuCT is more effective approach to reduce chewing dysfunction, tongue thrust and drooling severity in children with CP comparing classical oral motor exercises. Our result related to the effect of the FuCT on chewing dysfunction is consistent with a previous study (17). The additional finding, in other words the main aim of our study, is the effect of the FuCT on tongue thrust and drooling.…”

“…According to our clinical experiences, we developed a method called Functional Chewing Training (FuCT) to improve chewing function in children with CP. Functional training of chewing refers to train the related oral motor function and continuing practising that function in everyday living . The FuCT included positioning the child and food, sensory stimulation, and motor training of the function, thereby aiming to restore and improve tongue function .…”

“…Functional training of chewing refers to train the related oral motor function and continuing practising that function in everyday living . The FuCT included positioning the child and food, sensory stimulation, and motor training of the function, thereby aiming to restore and improve tongue function . Therefore, it may also be used to reduce tongue thrust in CP children.…”

Chewing Function in Children with Repaired Esophageal Atresia–Tracheoesophageal Fistula

“…This distribution is clinically important because the nature of the problem helps clinicians plan the appropriate chewing training. 11 In our study, half of the children with chewing disorders had difficulties in the foodprocessing stage, which is the series of masticatory cycles needed to comminute and soften the food, 20 while the remaining had problems in both the food-transportation stage, which is the transportation food from the front of the mouth to the occlusal surfaces of the postcanine teeth by tongue, 20 and the food-processing stage. Namely, the chewing disorders in children with EA-TEF may disperse in a broad range from the completion of the chewing with problems in efficient grinding to more complicated problems including initiation, grinding, and completion of the chewing function.…”

“…1,3,9,10 However, the characteristics of the chewing function in EA-TEF need further studies to be able to address the problem appropriately. 11 Thus, we aimed to perform a prospective study to evaluate the chewing function in children with EA-TEF.…”