Oral motor performance in spastic cerebral palsy individuals: are hydration and nutritional status associated?

Abstract

Previous studies reported alterations in salivary parameters in cerebral palsy (CP) individuals; however, none of these considered oral motor performance as possibly responsible for these conditions. The aim of this study was to investigate the influence of oral motor performance on the nutritional status and salivary parameters in individuals with CP. Forty-three individuals aged 11-19 years-old, with spastic CP were included in this study. Oral motor performance was evaluated using the Oral Motor Assessment Scale, which classified the individuals into two groups: subfunctional or functional. Unstimulated saliva was collected and the flow rate was calculated (ml/min). Salivary osmolality was measured using a freezing point depression osmometer. Blood samples were collected to evaluate complete blood count, total protein, albumin/globulin ratio and transferrin levels. The subfunctional (n = 21) and the functional group (n = 22) did not differ regarding sex (P = 0.193), however the functional group was older (P = 0.023) and had a higher mean BMI (P < 0.001). The subfunctional CP group presented a reduction in salivary flow rate (36.4%) (P < 0.01) and an increase in salivary osmolality (35.5%) (P < 0.001) compared to the functional group. Slightly lower values for red blood cells (millions/mm(3) ) (P < 0.001), hemoglobin (g/dl) (P < 0.009), hematocrit (%) (P = 0.001), number of platelets (N/mm(3) ), total protein (g/dl) and albumin/globulin ratio (P = 0.003 and P = 0.036, respectively) were determined for the subfunctional group, but within the normal range of normality. Cerebral palsy individuals appear to present impaired adequate hydration due to compromised oral motor performance.