Khamis Amanda, Badawi Nadia, Morgan Catherine, Novak Iona
Cerebral Palsy Alliance Research Institute, Discipline of Child & Adolescent Health, Faculty of Medicine & Health, The University of Sydney, 88 Mallett Street, Camperdown, NSW 2050, Australia.
The Children's Hospital at Westmead, The Sydney Children's Hospitals Network, Sydney, NSW 2145, Australia.
J Clin Med. 2023 Apr 3;12(7):2677. doi: 10.3390/jcm12072677.
Cerebral palsy (CP), results in impairment of muscle function including the face, mouth, and throat, leading to oropharyngeal dysphagia (OPD), which affects 85% of children with CP. OPD increases risk of deficiencies in growth, neurological development, and aspiration pneumonia, a leading cause of death in CP. This pilot randomised controlled trial aimed to (i) assess feasibility and acceptability of a novel neuroplasticity and motor-learning feeding intervention program, Baby Intensive Early Active Treatment (babiEAT), and standard care, and (ii) explore preliminary efficacy of babiEAT on health and caregiver feeding-related quality of life (QoL). A total of 14 infants with both CP and OPD were randomly allocated to 12 weeks of babiEAT or standard care. Results indicate that babiEAT and standard care are equally feasible, and acceptable. Parents in the babiEAT group thought recommendations were significantly more effective than standard care parents, were more likely to recommend the program to a friend and reported higher QoL. babiEAT infants showed significantly greater efficiency in fluid intake, fewer compensatory strategies with cup drinking, consumption of more advanced food textures, and shorter mealtimes without impacting intake, aspiration risk, or weight. This small pilot study shows promise for babiEAT in infants with CP and OPD. Further research is needed to determine strength of its effects.
脑瘫(CP)会导致包括面部、口腔和喉咙在内的肌肉功能受损,进而引发口咽吞咽困难(OPD),85%的脑瘫儿童受其影响。OPD会增加生长发育缺陷、神经发育迟缓以及吸入性肺炎的风险,而吸入性肺炎是脑瘫患儿死亡的主要原因之一。这项初步随机对照试验旨在:(i)评估一种新型神经可塑性和运动学习喂养干预方案——婴儿强化早期主动治疗(babiEAT)以及标准护理的可行性和可接受性;(ii)探索babiEAT对健康状况以及照顾者与喂养相关的生活质量(QoL)的初步疗效。共有14名同时患有脑瘫和OPD的婴儿被随机分配接受为期12周的babiEAT或标准护理。结果表明,babiEAT和标准护理同样可行且可接受。babiEAT组的家长认为该方案的建议比标准护理组的家长更有效,更有可能向朋友推荐该方案,并且报告的生活质量更高。接受babiEAT治疗的婴儿在液体摄入方面效率显著更高,使用杯子饮水时的代偿策略更少,能食用更高级的食物质地,用餐时间更短,且不会影响摄入量、误吸风险或体重。这项小型初步研究表明babiEAT对患有脑瘫和OPD的婴儿具有前景。需要进一步研究以确定其效果的强度。