Authors (including presenting author) :
Leung RWC(1), Fung BKY(1), Chan MPY(1), Lam KY(1), SY Leung(2), Lau MY(2), Kwok KL(2), Ng KK(2), Li CM(1)
Affiliation :
(1)Physiotherapy Department, (2)Department of Paediatrics, Kwong Wah Hospital, Hong Kong
Introduction :
Drooling is defined as salivary incontinence or the involuntary spillage of saliva over the lower lip. The prevalence of drooling was reported to be 12 to 58% in children with cerebral palsy. The effects of orofacial myofunctional exercise using an oral cavity rehabilitation device were investigated on adults with mouth breathing and allergy, but the outcome on drooling was not reported. The efficacy of orofacial myofunctional exercise with an assistive device on drooling in neurological normal children has not been studied.
Objectives :
To investigate the efficacy of orofacial myofunctional (OMT) exercise with assistive device on drooling in neurological normal children.
Methodology :
It is a retrospective analysis of the effectiveness of the program for neurological normal children with drooling problem. Data were retrieved from July 2018 to October 2018. Inclusion criteria of drooling program included: 1) complaint of drooling at nighttime or daytime; 2) neurological normal children aged 4 to 18; 3) following command. Children with epilepsy/ swallowing problem were excluded from the program. The rehabilitation program for drooling lasted for 3 months with 5 sessions. Exercise class was conducted on OMT exercise with assistive device MyoMunchee which is a silicone rubber brace to promote lip seal with natural chewing movement for home exercise. Data were reported as median. Kendall’s W test was used for paired comparison with p<0.05 as significant.
Result & Outcome :
Five children (Female: 1, Male: 4) aged at median of 8. Mouth breather was converted to nose breather in 2 children. Number of children with day drooling decreased from 3 to 2, but 5 with night drooling. Drooling severity and frequency by Drooling Severity and Frequency Scale (DSFS) at daytime and nighttime improved from 4 to 2 and from 5 to 4 respectively. The burden of care and children’s quality of life by Drooling impact Scale (DIS) at daytime and nighttime improved from 13 to 10 and from 20 to 14.5 respectively. Maximal tongue elevation strength and lip closure strength in term of pressure (kPa) with IOPI equipment increased from 33 to 54 (p-value= 0.022) and from 16 to 24 (p-value= 0.034) respectively. Tongue elevation endurance and lip closure endurance in seconds with IOPI equipment increased from 6 to 11 and from 15 to 20 respectively. Subjective improvement reported in numeric global rate of change scale was 5 out of 10. Rehabilitation program for drooling provides a treatment option for drooling problem in neurological normal children.
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