Impact of Oral Appliance Therapy: Are Oral Skills and Growth Maintained One Year after Termination of Therapy?

Abstract

To determine the impact of intraoral appliance (ISMAR) therapy on functional feeding skills and growth, children with cerebral palsy and moderate dysphagia were followed a full year after termination of one year of ISMAR therapy. Seventeen children, 6.6-15.4 years old (mean age = 10.2 +/- 3.0 years), were divided into two groups: group A (n = 9) continued to wear the appliance and group B (n = 8) no longer wore the appliance. Generalized estimating equations (GEE) were used to test differences between the two groups over time while accounting for the dependence for the repeated within-subject measurements. No significant differences were found in the 7 domains of functional feeding. Significant time x group interactions for weight (kg and z-score 0.01 < p < 0.05) were found. However, post hoc analyses showed that there were no significant differences in weight changes between the two groups at either 18 or 24 months of followup. These results suggest that during a one-year period of followup, maturation was equally effective as ISMAR therapy.

The effects of oral‐motor exercises on swallowing in children: an evidence‐based systematic review

“…Sixteen studies investigated the effects of OME on swallowing in children 14,25–39 . Eight studies examined the effects of OME on swallowing physiology (), six studies examined functional swallowing outcomes (), and five studies explored the effects of OME on drooling ().…”

“…ISMAR) to standard rehabilitation received at school. Gisel et al 31 . evaluated children who continued to wear the ISMAR for a second year compared with those who did not.…”

“…The group receiving standard rehabilitation at school demonstrated no significant changes on the chewing domain ( d =0.27), swallowing domain ( d =0.19), or the clearing domain ( d =0.15) of the FFA. Gisel et al 31 . continued to track these two groups for 12 months and re‐assessed their performance on the FFA.…”

Assessment of Ingestive and Oral Praxis Skills: Children with Cerebral Palsy vs. Controls

“…We have also found that the GVA is not sensitive to small changes in ingestive skills [10]; therefore, we use it strictly as a diagnostic tool to determine the severity of an eating impairment [14]. On the other hand, the FFAm has proven to be an excellent tool to measure change following oral-motor therapies [10,11,26,27].…”

The effect of a practical nutrition education programme on feeding skills of caregivers of children with cerebral palsy at Muhimbili National Hospital, in Tanzania

“…A number of studies have investigated feeding skills patterns and health outcomes in children with CP (Gisel, Alphonce, & Ramsay, ; Reilly, Skuse, & Plobete, ; Sullivan et al, ; Troughton & Hill, ; Vik, Skrove, Dollner, & Helland, ; Yousafzai et al, ). It has also been shown that with proper interventions on knowledge and caregiver support in the positioning and use of utensils, feeding skills and child–caregiver interactions during feeding can be improved (Adams et al, ; Bailey & Angell, ; Das, Zaman, Hasan, Barua, & Chowdhury, ; Gisel, Applegate‐Ferrante, Benson, & Bosma, ; Gisel, Applegate‐Ferrante, Benson, & Bosma, ; Gisel, Haberfellner, & Schwartz, ; Haberfellner, Schwartz, & Gisel, ; Johnson et al, ; Marchand & Motil, ; Vekerdy, ).…”