Mei Cristina, Hodgson Madeleine, Reilly Sheena, Fern Bethany, Reddihough Dinah, Mensah Fiona, Pennington Lindsay, Losche Annabel, Morgan Angela
Murdoch Children's Research Institute, Melbourne, Australia.
University of Melbourne, Melbourne, Australia.
Disabil Rehabil. 2022 Mar;44(6):974-982. doi: 10.1080/09638288.2020.1788179. Epub 2020 Aug 3.
To explore the characteristics and associated factors of oromotor dysfunction in minimally verbal children with cerebral palsy (CP) aged five to six years, recruited from a population-based registry.
Twenty children with CP who were minimally verbal completed a standardised, observational oromotor assessment. Linear regression analyses examined the relationship between oromotor dysfunction and potential associated factors (e.g., fine and gross motor function, communication, and feeding).
Oromotor dysfunction affected every participant and was identified in all structures examined (i.e., face, jaw, lips, and tongue). Oromotor movements showed little dissociation among jaw, lip, and tongue movements. Oromotor dysfunction was univariately associated with the Manual Ability Classification System levels IV-V ( = 0.001), reduced communication skills ( = 0.002), and a prolonged eating duration (>45 min) ( = 0.006), even when non-verbal cognition served as a covariate.
Oromotor dysfunction was highly prevalent in our sample of minimally verbal children with CP, having significant functional impacts on feeding and communication. Findings suggest that fine motor function (i.e., Manual Ability Classification System levels IV-V) is a stronger predictor than gross motor function for identifying children with CP who are minimally verbal and at risk of oromotor dysfunction. IMPLICATIONS FOR REHABILITATIONOromotor dysfunction was highly prevalent in our sample of minimally verbal children with cerebral palsy.Severe fine motor impairment strongly predicted oromotor dysfunction, indicating that fine motor function may provide an early indicator of impaired oromotor function for this clinical population.Robust, standardised measures of motor speech-related oromotor development suitable for children with cerebral palsy who are minimally verbal are lacking.Until such a measure is developed, formal evaluation may be achieved via oral motor assessments standardised for typically developing children, with the caveat one must interpret the results with caution.
从基于人群的登记处招募5至6岁的轻度语言能力脑瘫（CP）儿童，探讨其口面部运动功能障碍的特征及相关因素。
20名轻度语言能力的CP儿童完成了标准化的口面部运动观察评估。线性回归分析检验了口面部运动功能障碍与潜在相关因素（如精细和粗大运动功能、沟通及进食）之间的关系。
口面部运动功能障碍影响了每一位参与者，且在所检查的所有结构（即面部、下颌、嘴唇和舌头）中均有发现。口面部运动在颌、唇和舌运动之间几乎没有分离。即使将非语言认知作为协变量，口面部运动功能障碍在单因素分析中仍与手动能力分类系统IV - V级（P = 0.001）、沟通技能下降（P = 0.002）以及进食时间延长（>45分钟）（P = 0.006）相关。
在我们的轻度语言能力CP儿童样本中，口面部运动功能障碍非常普遍，对进食和沟通有显著的功能影响。研究结果表明，精细运动功能（即手动能力分类系统IV - V级）比粗大运动功能更能预测轻度语言能力且有口面部运动功能障碍风险的CP儿童。
对康复的启示
在我们的轻度语言能力脑瘫儿童样本中，口面部运动功能障碍非常普遍。
严重的精细运动损伤强烈预测口面部运动功能障碍，表明精细运动功能可能为该临床人群的口面部运动功能受损提供早期指标。
缺乏适用于轻度语言能力脑瘫儿童的与运动性言语相关的口面部运动发育的可靠、标准化测量方法。
在开发出这样的测量方法之前，可通过针对正常发育儿童标准化的口腔运动评估进行正式评估，但必须谨慎解释结果。
