Abstract
BackgroundFew studies demonstrate effectiveness of therapies for oral rehabilitation of patients with cerebral palsy (CP), given the difficulties in chewing, swallowing and speech, besides the intellectual, sensory and social limitations. Due to upper airway obstruction, they are also vulnerable to sleep disorders. This study aims to assess the sleep variables, through polysomnography, and masticatory dynamics, using electromiography, before and after neuromuscular electrical stimulation, associated or not with low power laser (Gallium Arsenide- Aluminun, =780 nm) and LED (= 660 nm) irradiation in CP patients.Methods/design50 patients with CP, both gender, aged between 19 and 60 years will be enrolled in this study. The inclusion criteria are: voluntary participation, patient with hemiparesis, quadriparesis or diparetic CP, with ability to understand and respond to verbal commands. The exclusion criteria are: patients undergoing/underwent orthodontic, functional maxillary orthopedic or botulinum toxin treatment. Polysomnographic and surface electromyographic exams on masseter, temporalis and suprahyoid will be carry out in all sample. Questionnaire assessing oral characteristics will be applied. The sample will be divided into 5 treatment groups: Group 1: neuromuscular electrical stimulation; Group 2: laser therapy; Group 3: LED therapy; Group 4: neuromuscular electrical stimulation and laser therapy and Group 5: neuromuscular electrical stimulation and LED therapy. All patients will be treated during 8 consecutive weeks. After treatment, polysomnographic and electromiographic exams will be collected again.DiscussionThis paper describes a five arm clinical trial assessing the examination of sleep quality and masticatory function in patients with CP under non-invasive therapies.Trial registrationThe protocol for this study is registered with the Brazilian Registry of Clinical Trials - ReBEC RBR-994XFSDescriptorsCerebral Palsy. Stomatognathic System. Electromyography. Transcutaneous Electric Nerve Stimulation. Phototherapy. Sleep Disorders. Polysomnography.
Highlights
Few studies demonstrate effectiveness of therapies for oral rehabilitation of patients with cerebral palsy (CP), given the difficulties in chewing, swallowing and speech, besides the intellectual, sensory and social limitations
This paper describes a five arm clinical trial assessing the examination of sleep quality and masticatory function in patients with CP under non-invasive therapies
Through Gross Motor Function Classification System (GMFCS) for CP [3], the classification is by age (0–2, 2–4, 4–6, e 6–12 years), in five functional levels
Summary
This study will evaluate the effects of lower power laser, neuromuscular electrical stimulation, LED therapy, as well as neuromuscular electrical stimulation plus LED therapy and neuromuscular electrical stimulation plus laser therapy on the masticatory muscles activity in adults with CP, by means of surface electromyography. Authors’ contributions All the authors contributed to the conception and design the study. LCG and MFG provided the idea for the study, established the hypothesis and wrote the original proposal. SRFB is a speech therapist of the patients and made a contribution to evaluate and collect the data of the oral motor function. LCG, MYM, CTH and CPG made a contribution to acquisition and interpretation of EMG data. IRS, EFO, and ISD made a contribution to acquisition and interpretation of PSG data. CSO, LVFO and MFG supervised this study, participated in its design and coordination and, revised the manuscript that led to the final approval of the current submission. All authors read and approved the final manuscript
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