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The Effects of Neurodevelopmental Therapy on Feeding and Swallowing Activities in Children with Cerebral Palsy

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Abstract

This study investigated the effect of the structured Neurodevelopmental Therapy Method-Bobath (NDT-B) approach on the feeding and swallowing activity of patients with cerebral palsy (CP) and feeding difficulties. In addition to feeding and oral motor intervention strategies (OMIS), and nutrition-related caregiver training (NRCT), and the NDT-B, which was structured to increase trunk and postural control, was added to the therapy program. Forty patients with CP, with a mean age of 3.25 ± 0.927 years, were classified using the Gross Motor Function Classification System, Eating and Drinking Ability Classification System, and Mini-Manual Ability Classification System. The patients were randomly assigned into two groups as OMIS + NRCT (n = 20) and OMIS + NRCT + NDT-B (n = 20). The program was applied for 6 weeks, 2 days/week, for 45 min. The patients were evaluated using the Trunk Impairment Scale, Schedule for Oral Motor Assessment, and the Pediatric Quality of Life Inventory before and after 6 weeks. The trunk control of the OMIS + NRCT + NDT-B group was superior to the other group (P = 0.026). Although there was an improvement in the groups according to the subcategories of SOMA, the OMIS + NRCT + NDT-B group was superior in the trainer cup and puree subcategories of SOMA (P = 0.05). A significant correlation was observed between trunk control and oral motor functions in children with CP, and the eating function of children in the OMIS + NRCT + NDT-B group further improved. NDT-B-based neck and trunk stabilization exercises should be added to the treatment programs.

Trial Registration NCT04403113.

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Acknowledgements

We would like to express our sincere gratitude to the staff of Department of Pediatric Neurology, Istanbul Pendik Research and Education Hospital, Marmara University, who helped organize the interviews. We sincerely thank all research participants. We appreciate Onur AYDOĞDU and Zehra BETÜL KARAKOÇ for their statistical advice.

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Authors and Affiliations

  1. Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Marmara University, Basibuyuk, Basibuyuk Cd. No:9, Maltepe, Istanbul, 34854, Turkey

    Gönül Acar & Nasim Ejraei

  2. Department of Child Health and Diseases, Department of Pediatric Neurology, Marmara University Istanbul Pendik Training and Research Hospital, Istanbul, Turkey

    Dilşad Turkdoğan & Gülten Öztürk

  3. Department of Otolaryngology, Pendik Training and Research Hospital, Marmara University, Istanbul, Turkey

    Necati Enver

  4. Pediamer Child Therapy Center, Istanbul, Turkey

    Gülçin Aktaş

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  1. Gönül Acar
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Contributions

NE and GA were involved in the entire process from the beginning to the end of the study, designed the study, and drafted and revised the manuscript. NE was involved in the material preparation, data and resource collection and treatment of all cases. She did the English translation of the article. GA and NE wrote the first draft of the manuscript. GA was the supervisor of the study. DT and GO diagnosed and evaluated all cases. NE evaluated the cases with FEES. GA contributed to the initiation of the study and design of the treatment plan. All authors acknowledged and approved the final manuscript as submitted and agreed to be responsible for all aspects of the work.

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Correspondence to Nasim Ejraei.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and any subsequent amendments or comparable ethical standards. Ethical approval was obtained from the Marmara University Faculty of Medicine Clinical Research Ethics Committee (protocol code 09.2018.278).

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Acar, G., Ejraei, N., Turkdoğan, D. et al. The Effects of Neurodevelopmental Therapy on Feeding and Swallowing Activities in Children with Cerebral Palsy. Dysphagia 37, 800–811 (2022). https://doi.org/10.1007/s00455-021-10329-w

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