Gisel E G
School of Physical and Occupational Therapy, McGill University, Montreal, Québec, Canada.
Dysphagia. 1996 Winter;11(1):48-58. doi: 10.1007/BF00385800.
Thirty-five children with cerebral palsy and moderate eating impairment were studied to determine the effect of oral sensorimotor treatment (OST) on eating efficiency and measures of growth (weight gain). After taking effects of maturation into account, 11 children who received OST (group A) exceeded their expected centile line by 1.7 percentile points after 10 weeks of treatment. Chewing exercises alone (group B) had no effect on weight gain. Although small decreases occurred in the time needed to eat three standard textures of food (solid, viscous, puree) in groups A and B, these were not significant. Children maintained their weight-for-age percentile line although at the lower end of expected norms. These children will be at risk of growth failure because of the increased energy demands once they enter their teenage growth spurt. The clinical implications of these findings are that prolonged mealtime and oral-motor therapies may be adequate through the childhood years. Thereafter, children's growth must be monitored carefully, and oral caloric supplementation is suggested to provide the necessary energy for growth.
对35名患有脑瘫且存在中度进食障碍的儿童进行了研究,以确定口腔感觉运动治疗(OST)对进食效率和生长指标(体重增加)的影响。在考虑成熟因素的影响后,11名接受OST治疗的儿童(A组)在治疗10周后,其超出预期百分位线1.7个百分点。仅进行咀嚼练习的儿童(B组)体重增加无变化。虽然A组和B组进食三种标准质地食物(固体、粘性、泥状)所需时间均有小幅减少,但并不显著。儿童的年龄别体重百分位线虽维持在预期标准的下限,但一旦进入青少年生长突增期,由于能量需求增加,这些儿童将面临生长发育迟缓的风险。这些研究结果的临床意义在于,在儿童时期延长进餐时间和进行口腔运动疗法可能就足够了。此后,必须密切监测儿童的生长情况,并建议通过口服补充热量来提供生长所需的必要能量。