Effects of oral motor therapy in children with cerebral palsy

Abstract

Aim:Oral motor dysfunction is a common issue in children with cerebral palsy (CP). Drooling, difficulties with sucking, swallowing, and chewing are some of the problems often seen. In this study, we aimed to research the effect of oral motor therapy on pediatric CP patients with feeding problems.Materials and Methods:Included in this single centered, randomized, prospective study were 81 children aged 12-42 months who had been diagnosed with CP, had oral motor dysfunction and were observed at the Pediatric Neurology outpatient clinic of the Children's Health and Diseases Department, Istanbul Medical Faculty, Istanbul University. Patients were randomized into two groups: The training group and the control group. One patient from the training group dropped out of the study because of not participating regularly. Following initial evaluation of all patients by a blinded physiotherapist and pedagogue, patients in the training group participated in 1 h oral motor training sessions with a different physiotherapist once a week for 6 months. All patients kept on routine physiotherapy by their own physiotherapists. Oral motor assessment form, functional feeding assessment (FFA) subscale of the multidisciplinary feeding profile (MFP) and the Bayley scales of infant development (BSID-II) were used to evaluate oral motor function, swallowing, chewing, the gag reflex, the asymmetrical tonic neck reflex, tongue, jaw, and mouth function, severity of drooling, aspiration, choking, independent feeding and tolerated food texture during the initial examination and 6 months later.Results:When the initial and post-therapy FFA and BSID-II scores received by patients in the training and the study group were compared, the training group showed a statistically significant improvement (P < 0.05).Conclusion:Oral motor therapy has a beneficial effect on feeding problems in children with CP.

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“…He concluded that the training had a significant effect on feeding, and positive influence on the eye-hand coordination if the position was correct. These positive effects are corroborated on the study by Gisel [ 44 ] and Sığan [ 40 ]. Later, Gisel et al asserted that oral-motor training did not have a significant effect on feeding and growth [ 45 ].…”

“…As to reducing drooling, we have found contradictory results too. While the study of Domaracki and Sisson did not find any treatment benefit [ 46 ], positive results were confirmed by the research of Sığan [ 40 ] and Yam [ 47 ]. Furthermore, Sığan et al discovered in 2013 significant improvements in the treatment group when it comes to chewing, swallowing, drooling and independent feeding.…”

“…As shown in Figure 14 , the scores of children with CP, regarding the execution of the games, are more irregular between them and for each child. This explains why it is so difficult to find big and homogeneous samples, in addition to the difficulty in generalizing the results of studies conducted in this population [ 40 ].…”

Therapeutic potential of human embryonic stem cell transplantation in patients with cerebral palsy

“…Although several therapies are available for the treatment of patients with CP, none have shown satisfactory outcomes. Rehabilitation [ 12 ], physical therapy [ 13 ], nutritional support for malnourished CP patients [ 14 ], and oral motor therapy for patients with difficulty in swallowing, drooling, chewing problems [ 15 ], and the use of botulinum toxin A [ 16 ] are few therapies available for the treatment of patients with CP. However; the use of botulinum toxin A in patients with CP is still conflicting.…”

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

“…We think that the reason for it is the sufficiency of functional levels and mental status of the individuals. Sığan et al 22 ) reported in a study that evaluated children with CP that 79.3% of them could not eat with spoon, 83.45% could not bite, 66.33% could not chew, 91.61% could not drink, and 74.73% could not swallow. Santos et al 20 ) reported difficulty in eating with a spoon, biting, chewing, drinking from a glass, drinking with a straw, and swallowing skills.…”