Spatial Characteristics of Jaw Movements During Chewing in Children with Cerebral Palsy: A Pilot Study

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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Acknowledgements

We would like to thank the participants and their families for their participation as well as Sara Benjamin, Katherine Bristow, Anne Coleman, Lauren Coyne, Julie Cunningham, Erica J. Greenberg, Brennan Hefner, Adeena Homampour, David Kremp, Anne Merkel, Stefanie Opdycke, Frances Ramos, Casey Rockmore, Grace Sitton, and Carina Valdivieso for their assistance with data collection and analysis. We would also like to thank Dr. Meg Simione for her comments and suggestions.

Funding

This study was funded by the NIH-NIDCD R03 DC012135, 3R01DC013547-04S1, and the American Speech-Language-Hearing Foundation.

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Correspondence to Ignatius S. B. Nip.

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Nip, I.S.B., Wilson, E.M. & Kearney, L. Spatial Characteristics of Jaw Movements During Chewing in Children with Cerebral Palsy: A Pilot Study. Dysphagia 33, 33–40 (2018). https://doi.org/10.1007/s00455-017-9830-2

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Keywords

  • Deglutition
  • Deglutition disorders
  • Chewing
  • Kinematics
  • Cerebral palsy
  • Children