Gisel E G, Applegate-Ferrante T, Benson J, Bosma J F
School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.
Dysphagia. 1996 Winter;11(1):59-71. doi: 10.1007/BF00385801.
The purpose of this study was to determine the effect of oral sensorimotor treatment on oral-motor skills and measures of growth in moderately eating impaired children with cerebral palsy who were stratified by state of aspiration/nonaspiration. Twenty-seven children aged 2.5-10.0 years participated in this study (aspiration: n = 7, nonaspiration: n = 20). Weight and skinfold measures were taken. Children were observed at lunch time and six domains of feeding were examined: spoon feeding, biting, chewing, cup drinking, straw drinking, swallowing, and drooling. Children underwent 10 weeks of control and 10 weeks of sensorimotor treatment, 5-7 minutes/day, 5 days/week. Treatment compliance for the entire group was 67%. Children who aspirated had significantly poorer oral-motor skills in spoon feeding, biting, chewing, and swallowing than children who did not aspirate. There was significant improvement in eating: spoon feeding (fewer abnormal behaviors, p < 0.03), chewing (more normal behaviors, p < 0.003), and swallowing (more normal behaviors, p < 0.008). There were no significant changes in drinking skills. Children as a group maintained their pretreatment weight-age percentile but did not show any catch-up growth. Children showed adequate energy reserves as measured by skinfold thicknesses. Improvement in oral-motor skills may help these children to ingest food more competently (i.e., less spillage). However, their weight remains at the lowest level of age norms.
本研究的目的是确定口腔感觉运动治疗对患有脑瘫且存在中度进食障碍的儿童的口腔运动技能和生长指标的影响，这些儿童根据是否存在误吸情况进行了分层。27名年龄在2.5至10.0岁之间的儿童参与了本研究（误吸组：n = 7，无误吸组：n = 20）。测量了体重和皮褶厚度。在午餐时间对儿童进行观察，并检查进食的六个方面：用勺进食、咬、咀嚼、用杯喝、用吸管喝、吞咽和流口水。儿童接受了10周的对照期和10周的感觉运动治疗，每天5 - 7分钟，每周5天。整个组的治疗依从率为67%。与无误吸的儿童相比，有误吸的儿童在用勺进食、咬、咀嚼和吞咽方面的口腔运动技能明显较差。进食方面有显著改善：用勺进食（异常行为减少，p < 0.03）、咀嚼（正常行为增多，p < 0.003）和吞咽（正常行为增多，p < 0.008）。饮水技能没有显著变化。作为一个群体，儿童维持了治疗前的体重年龄百分位数，但没有显示出任何追赶生长。根据皮褶厚度测量，儿童显示出充足的能量储备。口腔运动技能的改善可能有助于这些儿童更有效地摄取食物（即减少食物溢出）。然而，他们的体重仍处于年龄规范的最低水平。
