Benfer Katherine A, Weir Kelly A, Bell Kristie L, Ware Robert S, Davies Peter S W, Boyd Roslyn N
Queensland Cerebral Palsy and Rehabilitation Research Centre, Discipline of Paediatrics and Child Health, School of Medicine, The University of Queensland, Brisbane, Australia.
BMJ Open. 2012 Aug 13;2(4). doi: 10.1136/bmjopen-2012-001460. Print 2012.
The prevalence of oropharyngeal dysphagia (OPD) in children with cerebral palsy (CP) is estimated to be between 19% and 99%. OPD can impact on children's growth, nutrition and overall health. Despite the growing recognition of the extent and significance of health issues relating to OPD in children with CP, lack of knowledge of its profile in this subpopulation remains. This study aims to investigate the relationship between OPD, attainment of gross motor skills, growth and nutritional status in young children with CP at and between two crucial age points, 18-24 and 36 months, corrected age.
This prospective longitudinal population-based study aims to recruit a total of 200 children with CP born in Queensland, Australia between 1 September 2006 and 31 December 2009 (60 per birth-year). Outcomes include clinically assessed OPD (Schedule for Oral Motor Assessment, Dysphagia Disorders Survey, Pre-Speech Assessment Scale, signs suggestive of pharyngeal phase impairment, Thomas-Stonell and Greenberg Saliva Severity Scale), parent-reported OPD on a feeding questionnaire, gross motor skills (Gross Motor Function Measure, Gross Motor Function Classification System and motor type), growth and nutritional status (linear growth and body composition) and dietary intake (3 day food record). The strength of relationship between outcome and exposure variables will be analysed using regression modelling with ORs and relative risk ratios.
This protocol describes a study that provides the first large population-based study of OPD in a representative sample of preschool children with CP, using direct clinical assessment. Ethics has been obtained through the University of Queensland Medical Research Ethics Committee, the Children's Health Services District Ethics Committee, and at other regional and organisational ethics committees. Results are planned to be disseminated in six papers submitted to peer reviewed journals, and presentations at relevant international conferences.
据估计，脑瘫（CP）患儿口咽吞咽困难（OPD）的患病率在19%至99%之间。OPD会影响儿童的生长、营养和整体健康。尽管人们越来越认识到与CP患儿OPD相关的健康问题的程度和重要性，但对该亚人群中OPD情况的了解仍然不足。本研究旨在调查18 - 24个月和36个月（矫正年龄）这两个关键年龄点及两点之间CP幼儿的OPD、大运动技能获得情况、生长和营养状况之间的关系。
这项基于人群的前瞻性纵向研究旨在招募200名2006年9月1日至2009年12月31日在澳大利亚昆士兰州出生的CP患儿（每年出生队列60名）。研究结果包括临床评估的OPD（口腔运动评估量表、吞咽障碍调查、言语前评估量表、提示咽期受损的体征、托马斯 - 斯托内尔和格林伯格唾液严重程度量表）、家长在喂养问卷上报告的OPD、大运动技能（大运动功能测量、大运动功能分类系统和运动类型）、生长和营养状况（线性生长和身体成分）以及饮食摄入（3天食物记录）。将使用带有比值比（ORs）和相对风险比的回归模型分析结果变量与暴露变量之间关系的强度。
本方案描述了一项研究，该研究首次对具有代表性的CP学龄前儿童样本进行基于人群的OPD大型研究，并采用直接临床评估。伦理审批已通过昆士兰大学医学研究伦理委员会、儿童健康服务区伦理委员会以及其他地区和组织伦理委员会获得。计划将研究结果发表在六篇提交给同行评审期刊的论文中，并在相关国际会议上进行展示。
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