Tongue mobility in patients with cerebral palsy

Abstract

Background/Aim. In children with cerebral palsy speech is a big problem. Speech of these children is more or less understandable, depending on the degree of reduced mobility of articulatory organs. Reduced mobility is affected by inability to control facial grimacing and poor muscle strength when performing targeted movements. The aim of this study was to determine the mobility of tongue in patients with cerebral palsy. Methods. The study included a sample of 34 children - patients with cerebral palsy who had been treated in the Special Hospital for the Cerebral Palsy and Developmental Neurology in Belgrade. The patients were divided according to the determined diagnosis into two groups: Quadriparesis spastica (n = 11) and Morbus Little (n = 16). The children, aged 8-12 years, had preserved intelectual abilities, and all of them had preserved hearing. The study was conducted during the period from January to September 2009. The functional state of articulatory organs in both groups was tested by the C-test that examines the anatomic structure and mobility of the articulatory organs. Results. Our research showed that both groups of the patients had impaired functional state of the tongue - the most mobile articulatory organ. Also, the research showed that the functional state of the tongue was worse in children diagnosed with Quadriparesis spastica. A statistically significant correlation between the diagnosis and the functional state of the tongue, the tongue test performance and the retention of the tongue in a given position was found (r = 0.594, p lt 0.005; r = 0.816, p lt 0.01 and r = 0.738, p lt 0.001, respectively). Conclusion. A large percentage of children with cerebral palsy were not able to establish control over the position of articulatory organs, especially the tongue, and its retention in a given position, all of which affect the quality of speech.

Uvod/Cilj. Govor predstavlja veliki problem kod dece sa cerebralnom paralizom. Govor te dece je manje ili više razumljiv u zavisnosti od stepena redukovane pokretljivosti artikulacijskih organa. Na smanjenu pokretljivost jezika utiču i nemogućnost kontrole facijalnih grimasa i slaba mišićna snaga prilikom izvođenja ciljanih pokreta. Cilj ovog istraživanja bio je da se utvrdi pokretljivost jezika kod bolesnika sa cerebralnom paralizom. Metode. Ispitivanjem je bilo obuhvaćeno 34 dece sa cerebralnom paralizom koja su bila na lečenju u Specijalnoj bolnici za cerebralnu paralizu i razvojnu neurologiju u Beogradu. Deca, uzrasta 8-12 godina, imala su očuvane intelektualne sposobnosti i sluh. Deca su bila podeljena na dve grupe prema dijagnozi: Quadriparesis spastica bila je zastupljena kod 18 dece, a Morbus Little kod 16 dece. Ispitivanje je obavljeno u periodu od januara do septembra 2009. godine. Funkcionalno stanje artikulacijskih organa kod obe grupe bolesnika ispitano je C-testom, koji utvrđuje pokretljivost jezika. Rezultati. Naše istraživanje pokazalo je narušeno funkcionalno stanje jezika kao najpokretljivijeg artikulatora kod obe grupe bolesnika. Znatno više bila su ugrožena deca sa dijagnozom Quadriparesis spastica. Nađena je zna- čajna korelacija između funkcijskog stanja jezika i dijagnoze (r = 0,594; p lt 0,005), kao i između izvođenja proba jezikom i dijagnoze (r = 0,816; p lt 0,001). Takođe, nađena je značajna korelacija između dijagnoze i zadržavanja jezika u zadatom položaju (r = 0,738; p lt 0,001). Zaključak. Utvrđeno je da visok procenat dece sa cerebralnom paralizom nije u mogućnosti da uspostavi kontrolu položaja artikulacijskih organa, pre svega jezika, kao i njegovo zadržavanje u zadatom položaju, što sve skupa utiče na kvalitet govora.