Fighting Against Disuse of the Masticatory System in Duchenne Muscular Dystrophy

Abstract

Duchenne muscular dystrophy patients report masticatory problems. The aim was to determine the efficacy of mastication training in Duchenne muscular dystrophy using chewing gum for 4 weeks. In all, 17 patients and 17 healthy age-matched males participated. The masticatory performance was assessed using a mixing ability test and measuring anterior bite force before, shortly after and 1 month after the training. In the patient group the masticatory performance improved and remained after 1-month follow-up, no significant changes in anterior maximum bite force was observed after mastication training. In the healthy subject the bite force increased and remained at the 1-month follow-up; no significant differences in masticatory performance were observed. Mastication training by using sugar-free chewing gum in Duchenne muscular dystrophy patients improved their masticatory performance. Since bite force did not improve, the working mechanism of the improvement in chewing may relate to changes of the neuromuscular function and coordination, resulting in improvement of skills in performing mastication.

Effects of gum chewing exercise on maximum bite force according to facial morphology

“…The gum chewing exercise has been used previously to improve bite force and masticatory function (Kiliaridis et al, 1995; Masumoto et al, 2009; Nakagawa et al, 2017; Ohira et al, 2012; van Bruggen et al, 2015). In this study, the mean MBF value of all subjects increased from 468 to 574 N after 4‐week chewing exercise.…”

“…Therefore, masticatory exercise seems important in improving masticatory disturbance and deficiency. It has been reported that gum chewing exercise is helpful in enhancing bite force and masticatory function (Kiliaridis, Tzakis, & Carlsson, 1995; Masumoto, Yamaguchi, & Fujimoto, 2009; Nakagawa et al, 2017; Ohira, Ono, Yano, & Takagi, 2012; van Bruggen et al, 2015). Kiliaridis et al (1995) reported that 4‐week training with hard chewing gum influenced the functional capacity of the masticatory muscles and increased their strength.…”

“…Kiliaridis et al (1995) reported that 4‐week training with hard chewing gum influenced the functional capacity of the masticatory muscles and increased their strength. Moreover, gum chewing exercise for 4 weeks in Duchenne muscular dystrophy patients improved their masticatory performance (van Bruggen et al, 2015). To our knowledge, however, the effectiveness of the gum chewing exercise on MBF based on craniofacial morphology has never been examined in the past.…”

206th ENMC International Workshop: Care for a novel group of patients – adults with Duchenne muscular dystrophy Naarden, The Netherlands, 23–25 May 2014

“…Also, negative correlation with the width and depth of the palate with tongue pressure in 11 patients with DMD was described [23]. A study by means of quantitative ultrasound of the oral muscles, sEMG, anterior tongue pressure, and videofluoroscopic swallowing (VFSS) showed progressive involvement of the muscles and swallowing problems with the first sign in the geniohyoid muscle during the ambulatory phase (ultrasound), tongue hypertrophy during the early and late non-ambulatory phase (ultrasound), increasing problems with solid food (VFSS), progressive decrease in tongue pressure, and lowest sEMG measurements in late nonambulatory phase [24].…”

“…35 patients from the cohort are still alive (aged 22-31 years); 18 died (aged [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30]. Patients were ventilated by NIV (29/53) or IV (33/53).…”