Oral support for patients with severe motor and intellectual disabilities

Abstract

Background Oral support during feeding was clinically provided to patients with severe motor and intellectual disabilities (SMID) for the prevention of dysphasia. The present study investigated the advantages of oral support anatomically and functionally. Methods A videofluoroscopic swallowing study was conducted on nine patients with SMID (age = 5–41 years; mean age = 15.0; four males, five females) and 24 healthy adults (age = 26–67 years; mean age = 44.3; 16 males, eight females). The movements of the hyoid bone and mandible during pharyngeal swallowing were tracked, and the pharyngeal residues were evaluated. The temporal and spatial features of the movements were compared between patients with and without oral support as well as healthy adults. Results The mandible moved downward earlier and showed larger displacement in the patients with SMID. The patients also had insufficient anterior displacement of the hyoid, which was associated with the pharyngeal residue. This displacement was enhanced, and the pharyngeal residue decreased with oral support. Conclusions Oral support to hold the mandible successfully improved hyoid excursion and reduced pharyngeal residue during swallowing, which is a simple and reliable strategy for the prevention of dysphasia in patients with SMID.

The anatomical and functional rationale for conducting dysphagia rehabilitation

“…Nakamura et al . through a videofluoroscopic swallowing study evaluated the sequential hyoid bone and mandibular movement in patients with SMID, with and without oral support, and healthy controls 6 . They found significantly earlier hyoid movement, larger mandibular displacement, and smaller anterior displacement of the hyoid bone in the patients with SMID.…”