Is there a relationship between upper limb function and swallowing function in children with cerebral palsy? A cross-sectional study

Abstract

Objective: Despite the association between gross motor and swallowing functions in patients with cerebral palsy (CP), there have been no studies examining the relationship between upper limb functions and swallowing in detail. The aim of this study was to evaluate the relationship between upper extremity skills and swallowing function in children with CP. Methods: The study included a total of 71 patients with CP who were attending the rehabilitation clinic. Upper limb functions were assessed using the Bimanual Fine Motor Function (BFMF) scale, and swallowing function with the Functional Oral Intake Scale (FOIS). The Nine-hole peg test (NPHT) was used to assess manual hand dexterity. Grip strength was measured with a Jamar hand dynamometer and pinchmeter. Correlation analysis was applied to outcome parameters. Results: The BFMF classification was level 1 in 6 patients (8.5%), level 2 in 22 patients (31.0%), level 3 in 27 patients (38.0%), level 4 in 12 patients (16.9%) and level 5 in 4 patients (5.6%). Nutrition was provided through oral intake in 59 (83.1%) patients and 12 (16.9%) were tube dependent. While a negative correlation was determined between swallowing function and BFMF and NHPT, a positive correlation was determined between swallowing function and grip strength values. Conclusions: The findings of this study demonstrated that there is a relationship between swallowing functions and upper limb functions. These findings may help in predicting functional improvement in terms of swallowing and/or if the patient needs further intervention such as upper limb rehabilitation in addition to oral motor training to improve oral intake, and thereby nutritional intake.