Article

There is paucity of research investigating oropharyngeal dysphagia (OPD)
in young children with cerebral palsy (CP), and most studies explore OPD in
high-resource countries.
This study aimed at determining the proportion and
severity of OPD in preschool children with CP in Bangladesh, compared to
Australia. METHOD: Cross-sectional, comparison of two cohorts. Two hundred and
eleven children with CP aged 18-36 months, 81 in Bangladesh (mean = 27.6 months,
61.7% males), and 130 in Australia (mean = 27.4 months, 62.3% males). The
Dysphagia Disorders Survey (DDS) - Part 2 was the primary OPD outcome for
proportion and severity of OPD. Gross motor skills were classified using the
Gross Motor Function Classification System (GMFCS), motor type/distribution.
RESULTS: (i) Bangladesh sample: proportion OPD = 68.1%; severity = 10.4 SD = 7.9.
Australia sample: proportion OPD = 55.7%; severity = 7.0 SD = 7.5. (ii) There
were no differences in the proportion or severity of OPD between samples when
stratified for GMFCS (OR = 2.4, p = 0.051 and beta = 1.2, p = 0.08,
respectively). CONCLUSIONS: Despite overall differences in patterns of OPD
between Bangladesh and Australia, proportion and severity of OPD (when adjusted
for the functional gross motor severity of the samples) were equivalent. This
provides support for the robust association between functional motor severity and
OPD proportion/severity in children with CP, regardless of the resource context.
Implications for Rehabilitation The proportion and severity of OPD according to
gross motor function level were equivalent between high- and low-resource
countries (LCs). Literature from high-resource countries may be usefully
interpreted by rehabilitation professionals for low-resource contexts using the
GMFCS as a framework. The GMFCS is a useful classification in LCs to improve
earlier detection of children at risk of OPD and streamline management pathways
for optimal nutritional outcomes. Rehabilitation professionals working in LCs are
likely to have a caseload weighted towards GMFCS III-V, with less compensatory
OPD management options available (such as non-oral nutrition through tubes).

Langue : ANGLAIS