Effect of Oropharyngeal Dysphagia and Quality of Life in Children with Cerebral Palsy

Abstract

Abstract Background Cerebral palsy (CP) is a common neuromotor disorder causing physical and developmental disability varying in severity but with common developmental features. Dysphagia is a common comorbidity, it compromises airway safety during swallowing, efficiency, or adequacy of nutritional intake. Untreated dysphagia can lead to achalasia, aspiration, dehydration, malnutrition and pneumonia. The aim of the present study was to determine the quality of life among children with CP and co-morbid dysphagia. Patient and method: This was a cross sectional study included pediatric patients with cerebral palsy and dysphagia who attended children's hospital, Faculty of Medicine, Ain Shams University, Cairo, Egypt. Between January 2020 to 0ctober 2023. Inclusion Criteria Children with cerebral palsy associated with oromotor dysfunction and Mild to moderate dysphagia according to ASHA scale. Exclusion criteria: patients with congenital anomalies of other systems (respiratory, cardiac systems). All patients were subjected to full medical history, and assessment of cerebral palsy severity using Gross Motor Function Classification System (GMFCS), Oropharyngeal examination: oral structures and functions, drooling, presence of abnormal reflexes, oral preparatory phase, oral phase, feeding intervention assessment according to functional oral intake scale (FOIS), assessment of dysphagia severity by The American Speech, Language and Hearing Association (ASHA`s) Scale. Standard CP quality of life questionnaire and adult carer QoL questionnaire, (Generic version III-Arabic language copy). Results Twenty-two CP children with dysphagia included 6 females (27.3%) and 16 males (72.7%). Their age was 33.90±12.63 months, their weight 10.18±2.14 kg, all children were with oropharyngeal dysphagia of ASHA score 4), 11children with FOIS 5 and 11was of 4 FOIS score. GMFCS 12 children had GMFCS score 5 and 10 had 4 GMFCS score. The quality of life of CP children with dysphagia is low due to disability and nutritional deficiency. The way they get along with people generally, with caregivers, with brothers and sisters, other children, children ability to play with toys, with other children was defective, and how they were accepted by others was poor. Their ability to participate in recreational activities, in sporting activities, in social events and in their communities, they had low score in communication. The caregivers were worried about their children's future, and their opportunities in life. Conclusion The quality of life is poor in families having children with cerebral palsy and co-morbid dysphagia and oromotor dysfunction.