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Spatial Characteristics of Jaw Movements During Chewing in Children with Cerebral Palsy: A Pilot Study
Ignatius S B Nip1, Erin M Wilson2,3, Lucia Kearney4
1School of Speech, Language and Hearing Sciences, San Diego State University, San Diego, CA, USA. inip@mail.sdsu.edu.
Insights
Children with cerebral palsy (CP) exhibit distinct jaw motion patterns during chewing compared to typically-developing (TD) peers, even without feeding issues. Food consistency significantly impacts jaw movements in both groups.
Area of Science:
- Biomedical Engineering
- Neuroscience
- Pediatric Dentistry
Background:
- Cerebral palsy (CP) can affect motor control, potentially impacting oral motor functions like chewing.
- Understanding jaw motion in children with CP is crucial for assessing oral function and developing targeted interventions.
- Previous research has not extensively detailed jaw kinematics during mastication in relation to food consistency for children with CP.
Purpose of the Study:
- To compare jaw motion parameters during chewing between children with spastic cerebral palsy (CP) and typically-developing (TD) peers.
- To investigate the influence of different food consistencies (puree, mechanical soft, solid) on jaw movements in both groups.
- To identify potential differences in chewing kinematics that may exist despite the absence of reported feeding or swallowing disorders in the CP cohort.
Main Methods:
- Utilized optical motion capture technology to record 3D jaw movements.
- Recruited 11 children with spastic CP (GMFCS levels II-V) and 11 age- and sex-matched TD children, all exclusively oral feeders.
- Assessed chewing of three food consistencies (puree, mechanical soft, solid) over five trials per consistency.
Main Results:
- Children with CP demonstrated significantly greater jaw path distances and larger working spaces for mechanical soft and solid foods compared to TD peers.
- Jaw path distances increased with greater food consistency in both groups.
- Pureed foods were associated with slower chewing speeds and smaller working spaces for both CP and TD groups.
Conclusions:
- Children with CP exhibit altered jaw movement patterns during chewing, characterized by increased path distance and working space, particularly with more complex food textures.
- These kinematic differences persist even in children with CP who are exclusively oral feeders and have no reported feeding or deglutition issues.
- Food consistency is a significant factor influencing jaw motion in both children with CP and their typically-developing counterparts, highlighting the importance of texture in oral motor function assessment.
Abstract:
This study compared jaw motion between children with cerebral palsy (CP) and their typically-developing (TD) peers during chewing. The jaw movements of 11 children with spastic CP (GMFCS levels II-V) all of whom were exclusively oral feeders with no reported clinical issues with feeding [mean age = 7.49 (2.30) years; 7 males, 4 females] and 11 age- and sex-matched TD peers [mean age = 7.54 (2.35) years] were recorded using optical motion capture. Participants chewed five trials of three different consistencies, including puree, mechanical soft, and solid. For each chewing sequence, the path distance (total amount of distance traveled by the jaw), average jaw speed, and working space (total 3-dimensional size of the jaw movements during chewing) were calculated. The CP group had greater path distances for mechanical soft and solids (p < 0.001) and larger working spaces (p < 0.001) than the TD group. Consistency differences were also found with path distances increasing for both groups with increased bolus consistency (p < 0.001). Puree was chewed most slowly for both groups (p = 0.05) and was associated with smaller working space than the other consistencies for both groups (p < 0.001). The TD group demonstrated slower speeds for mechanical soft as compared to solids (p = 0.05), a finding which was not observed in the CP group. The results suggest children with CP showed jaw movement differences during chewing despite being exclusive oral eaters with no reports of clinical feeding or deglutition disorders. Food consistency also influenced jaw movements in both children with CP and their TD peers.
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