Relationship between Gross Motor Function, Oromotor Function and Nutritional Status in Children with Cerebral Palsy

OBJECTIVE: To investigate the non-speech mechanism function in relation with functional status and find out the relationship between nutritional status and non-speech mechanism function in children with cerebral palsy (CP). METHOD: Eighty four children with CP were participated in this study. Non-speech mechanism function was investigated with a simple scale of oral motor status (OMS) and a feeding-swallowing evaluaton protocol for children (FEP-C). Higher score represents more severe in dysfunction in both tests. As well, Gross motor function classification system (GMFCS), the nutritional status based on body mass index were assessed in these subjects. GMFCS level I to III were grouped into high functioning group while GMFCS level IV and V were grouped into low functioning group. RESULTS: Fifty seven (67.9%) individuals with CP showed dysphagia symptoms (OMS sore > or =1). The mean scores of non-speech mechanism function in low functioning group were higher than in high functioning group (p<0.05). The mean scores of both OMS and FEP-C were higher in individuals with underweight (p<0.05). Compared to high functioning individuals with CP, underweight was more prevalent along with higher scores in oral motor function in low functioning group. OMS scores were significantly correlated with the mean scores of non-speech mechanism in all subareas (p<0.05). CONCLUSION: Non-speech mechanism function was closely related with GMFCS level. As well, this study revealed that the oromotor function and nutritional status in these individuals with CP related with non-speech mechanism function.

Short-Term Effects of Combined Serial Casting and Botulinum Toxin Injection for Spastic Equinus in Ambulatory Children with Cerebral Palsy

PURPOSE: The purpose of this paper is to test the hypothesis that combination therapy of serial cast and botulinum toxin type A (BTX-A) injection can further enhance the effects of a BTX-A injection in ambulant children with cerebral palsy (CP) who have an equinus foot. MATERIALS AND METHODS: Children in group A (30 legs of 21 children) received a serial casting application after an injection of BTX-A, and children in group B (25 legs of 17 children) received only a BTX-A injection. Assessments were performed before the intervention and 1 month after the intervention. RESULTS: After the intervention, there were significant improvements in tone, dynamic spasticity, and passive range of motion (ROM) in both groups. However, the changes were greater in group A than in group B. Dimension D (standing) in Gross Motor Function Measure (GMFM)-66 was significantly improved in group A but not in group B. On the other hand, there were no significant changes in di-mension E (walking, running, jumping) in GMFM-66 in either group. CONCLUSION: The results of our study suggest that a serial casting application after BTX-A injection can enhance the benefits of BTX-A injection in children with cerebral palsy.