咀嚼功能训练治疗脑瘫儿童口腔运动功能障碍的前瞻性随机对照研究

Clinical effect of functional chewing training in treatment of oral motor dysfunction in children with cerebral palsy:a prospective randomized controlled clinical trial

目的观察咀嚼功能训练(FuCT)对脑瘫儿童咀嚼功能、舌尖推力严重程度、流涎严重程度及流涎频率的影响。方法前瞻性选择2019年1月至2020年1月诊断为口腔运动功能障碍的脑瘫儿童48例为研究对象,随机分为FuCT组(n=24)和口腔运动训练组(n=24)。每组均接受12周训练,评估两组儿童咀嚼功能、舌尖推力严重程度、流涎严重程度和流涎频率的变化情况。结果两组儿童训练前咀嚼功能、舌尖推力严重程度、流涎严重程度及流涎频率比较差异无统计学意义(P>0.05)。训练12周后,FuCT组咀嚼功能、舌尖推力严重程度、流涎严重程度均有改善(P<0.05),但流涎频率无明显改善(P>0.05);口腔运动训练组咀嚼功能、舌尖推力严重程度、流涎严重程度及流涎频率均无明显改善(P>0.05)。训练12周后,FuCT组舌尖推力严重程度、流涎严重程度及流涎频率均优于口腔运动训练组(P<0.05)。结论 FuCT是改善脑瘫儿童咀嚼功能、舌尖推力严重程度、流涎严重程度及流涎频率的有效方法。

Objective To study the effect of functional chewing training(FuCT)on masticatory function,the severity of tongue thrust,and the severity and frequency of drooling in children with cerebral palsy.Methods A prospective study was performed for 48 children who were diagnosed with oral motor dysfunction from January 2019 to January 2020,and they were randomly divided into an FuCT group and an oral motor training group,with 24 children in each group.Both groups received FuCT or oral motor training for 12 weeks,and then they were evaluated in terms of the changes in the masticatory function,the severity of tongue thrust,and the severity and frequency of drooling.Results There were no significant differences between the two groups in the masticatory function,the severity of tongue thrust,and the severity and frequency of drooling before treatment(P>0.05).After the 12-week training,the FuCT group showed significant improvements in the masticatory function and the severity of tongue thrust and drooling(P<0.05),but with no improvement in the frequency of drooling(P>0.05),while the oral motor training group had no improvements in the masticatory function,the severity of tongue thrust,and the severity and frequency of drooling(P>0.05).After the 12-week training,the FuCT group had more significantly improvements in the severity of tongue thrust and the severity and frequency of drooling than the oral motor training group(P<0.05).Conclusions FuCT can effectively improve the masticatory function,the severity of tongue thrust,and the severity and frequency of drooling in children with cerebral palsy.