Effect of A Clinician-Delivered Chewing Program on Masticatory Function in Children with Cerebral Palsy

Abstract

Objectives: Studies documenting the training effect of the Functional Chewing Training (FCT) program using objective methods are limited. The present study attempts to evaluate the effect of FCT on chewing dynamics by comparing the pre-, post-treatment and follow-up scores in children with cerebral palsy (CP). Study design: A time series design was employed to study the treatment effects. Methods: Six children with a confirmed diagnosis of oral dysphagia secondary to CP in the age range of 3 to 8 years formed the participant group. Chewing performance was assessed using Mastication Observation Evaluation (MOE, Remijn et al., 2014) and quantified using surface electromyography (sEMG) for the masseter muscle. Subsequently, 20 sessions of intensive chewing training was carried out. The assessments were repeated after intervention and at 4 weeks post-discharge, during which no intervention or home training was provided. Results: Friedman’s Two-Way Analysis of Variance revealed that there was a significant improvement in jaw, lip, and tongue scores for chewing as well as for the sEMG parameters. Wilcoxon Signed Rank test revealed that there was a significant difference in the pre- versus post-therapy and pre- versus follow-up conditions for all the parameters (p<0.017). Conclusions: The study revealed that FCT leads to improvements in lip seal, jaw stability and tongue lateralization aiding in effective masticatory performance. The continued improvement post-discharge indicates the effect of better management and progression of food textures. The present study is one of the first to elucidate the efficacy of the FCT program by illustrating the changes with respect to instrumental measures.