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脑瘫患儿咀嚼时下颌运动的空间特征:一项初步研究。

Spatial Characteristics of Jaw Movements During Chewing in Children with Cerebral Palsy: A Pilot Study.

作者信息

Nip Ignatius S B, Wilson Erin M, Kearney Lucia

机构信息

School of Speech, Language and Hearing Sciences, San Diego State University, San Diego, CA, USA.

Speech and Feeding Disorders Laboratoray, MGH Institute of Health Professions, Boston, MA, USA.

出版信息

Dysphagia. 2018 Feb;33(1):33-40. doi: 10.1007/s00455-017-9830-2. Epub 2017 Aug 9.

Abstract

This study compared jaw motion between children with cerebral palsy (CP) and their typically-developing (TD) peers during chewing. The jaw movements of 11 children with spastic CP (GMFCS levels II-V) all of whom were exclusively oral feeders with no reported clinical issues with feeding [mean age = 7.49 (2.30) years; 7 males, 4 females] and 11 age- and sex-matched TD peers [mean age = 7.54 (2.35) years] were recorded using optical motion capture. Participants chewed five trials of three different consistencies, including puree, mechanical soft, and solid. For each chewing sequence, the path distance (total amount of distance traveled by the jaw), average jaw speed, and working space (total 3-dimensional size of the jaw movements during chewing) were calculated. The CP group had greater path distances for mechanical soft and solids (p < 0.001) and larger working spaces (p < 0.001) than the TD group. Consistency differences were also found with path distances increasing for both groups with increased bolus consistency (p < 0.001). Puree was chewed most slowly for both groups (p = 0.05) and was associated with smaller working space than the other consistencies for both groups (p < 0.001). The TD group demonstrated slower speeds for mechanical soft as compared to solids (p = 0.05), a finding which was not observed in the CP group. The results suggest children with CP showed jaw movement differences during chewing despite being exclusive oral eaters with no reports of clinical feeding or deglutition disorders. Food consistency also influenced jaw movements in both children with CP and their TD peers.

摘要

本研究比较了脑瘫(CP)儿童与其发育正常(TD)的同龄人在咀嚼过程中的下颌运动。记录了11名痉挛型CP儿童(GMFCS水平为II - V级)的下颌运动,他们均为完全经口喂养且无喂养方面的临床问题报告[平均年龄 = 7.49(2.30)岁;7名男性,4名女性],以及11名年龄和性别匹配的TD同龄人[平均年龄 = 7.54(2.35)岁],采用光学动作捕捉技术。参与者对三种不同质地的食物各咀嚼五次,包括泥状、软食和固体食物。对于每个咀嚼序列,计算路径距离(下颌移动的总距离)、平均下颌速度和工作空间(咀嚼过程中下颌运动的三维总体大小)。与TD组相比,CP组在咀嚼软食和固体食物时路径距离更长(p < 0.001),工作空间更大(p < 0.001)。还发现随着食物团质地变稠,两组的路径距离均增加(p < 0.001),存在质地差异。两组咀嚼泥状食物的速度最慢(p = 0.05),且与其他质地食物相比,两组咀嚼泥状食物时的工作空间更小(p < 0.001)。与固体食物相比,TD组咀嚼软食的速度较慢(p = 0.05),而CP组未观察到这一现象。结果表明,尽管CP儿童均为完全经口进食且无临床喂养或吞咽障碍报告,但他们在咀嚼过程中仍表现出下颌运动差异。食物质地也影响了CP儿童及其TD同龄人在咀嚼时的下颌运动。

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