REHABILITASI MEDIK DISFUNGSI OROMOTOR PADA CEREBRAL PALSY
Abstract
Palsi Serebral dideskripsikan sebagai gangguan gerak dan postur tubuh yang dikaitkan dengan lesi non-progresif pada perkembangan otak. Tanda dan gejala palsi serebral berbeda secara signifikan pada jenis keluhan gerakan, tingkat kemampuan fungsional yang berbeda dan restriksi serta bagian tubuh yang terkena. Paksi serebral merupakan kondisi neurologis yang mempengaruhi tonus otot, gerakan, dan keterampilan motorik anak yang terkena. Hal ini diakibatkan oleh kerusakan otak yang terjadi selama kehamilan, saat melahirkan, atau setelah melahirkan.1
Oral motor atau sering disebut dengan oromotor memegang peranan penting pada anak palsi serebral karena fungsi oromotor sangat diperlukan saat anak makan (feeding), untuk berbicara (speech) dan berperan dalam pernafasan. Gangguan pada palsi serebral mempengaruhi keterampilan motorik oral yang mengakibatkan keterlambatan bicara, drooling dan masalah dengan mengisap, menelan dan menggigit. Disfungsi oromotor pada kelompok palsi serebral ini mencerminkan defisit dalam waktu, disosiasi, koordinasi, jangkauan, dan kekuatan gerakan oral.2,3,4
Pada evaluasi fungsi oromotor dilakukan penilaian ada atau tidaknya abnormal pattern dari bibir, lidah, rahang dan pipi/ mukosa bucal saat makan, minum, ekspresi wajah dan bicara untuk menentukan kemampuan apa yang perlu ditingkatkan dan abnormal pattern apa yang perlu diinhibisi atau untuk melihat kompensasi apa yang dibutuhkan.2
Tujuan akhir dari terapi oromotor untuk memungkinkan keamanan dalam konsumsi makanan dan minuman untuk pertumbuhan dan nutrisi yang memadai dan/atau meningkatkan kejelasan bicara pada individu. Rehabilitasi pada disfungsi oromotor terdiri dari medikamentosa, stimulasi oromotor dan modalitas terapi dan perilaku. Stimulasi oromotor bersifat tailor-made dan intervensi yang diberikan ditentukan oleh pemeriksaan baseline yang pertama kali dilakukan.2,7
References
Ahmad S, Sharif F, Ahmad A, Gilani SA. Nature and Frequency of Feeding Problems and Oral Motor Dysfunction in Children with Cerebral Palsy. Pakistan Pediatric Journal. 2020;44(2):142-147.
Grogher ME, Crary MA. Dysphagia Clinical Management in Adults and Children. First ed. Falk K, editor. Missouri: Mosby Elsevier; 2010.
Mei C, Hodgson M, Reilly S, Fern B, Reddihough D, et al. (2020). Oromotor Dysfunction in Minimally Verbal Children with Cerebral Palsy: Characteristics and Associated Factors. Disability and Rehabilitation, 1–9.
Awan WA, Aftab A, Janjua UII, Ramzan R, Khan N. Effectiveness of Kinesio Taping with Oromotor Exercises in Improving Drooling Among Children with Cerebral Palsy. T Rehabili. J 2017:01(02);21-27.
Logemann JA. Evaluation and Treatment of Swallowing Disorders. Second ed. Texas: Pro Ed Inc; 1998.
Reilly S, Skuse D, Poblete X. Prevalence of feeding problems and oral motor dysfunction in children with cerebral palsy: A community survey. The Journal of Pediatrics. 1996:877-81.
Dan B, Mayston M, Paneth N, et al. (eds). Cerebral Palsy: Science and Clinical Practice. London: Mac Keith Press; 2014.
Bahr D. Could an Ad Hoc Committee Help Define Oral-Motor. 2007.
Driver L, Ayyangar R, Tubbergen MV. Language Development in Disorders of Communication and Oral Motor Functions. In: Alexander MA, Matthews Dj, editors. Pediatric Rehabilitation Principles and Practice. 4 ed. New York: Demos; 2010.
Spalding PM. Craniofacial Growth and Development: Current Understanding and Clinical Considerations. In: Miloro M, editor. Peterson's Principles of Oral and Maxillofacial Surgery. 2 ed. Ontario: BC Decker Inc; 2004. p. 1051-73.
Beckman D. Oral Motor Stimulation. www.beckmanoralmotor.com.
Moore KL, Dalley AF. Clinically Oriented Anatomy. 5 ed: Lippincott Williams & Wilkins; 2006.
Lippert LS. Temporomandibular Joint. Clinical Kinesiology and Anatomy. 4 ed. Philadelphia: F. A. Davis Company; 2006. p. 169-80.
Redstone F. Neurodevelopmental Treatment in Speech-Language Pathology: Theory, Practice, and Research. Communicative Disorders Review. 2007;1:119-31.
Manno CJ, Fox C, Eicher PS, Kerwin MLE. Early Oral-Motor Interventions for Pediatric Feeding Problems: What, When and How. Journal of Early and Intensive Behavior Intervention 2005;2(3):145-59.
New York State Department of Health DoFH, Bureau of Early Intervention. Clinical Practice Guideline: Report of The Recommendations Motor Disorders Assessment and Intervention for Young Children (Age 0-3Years). 2000.
Sellers D, Mandy A, Pennington L. Development and Reliability of a System to Classify the eating and Drinking Ability of People with Cerebral Palsy Journal of Developmental Medicine and Child Neurology. 2014;56:245-51.
Levitt S, Addison A. Treatment of Cerebral Palsy and Motor Delay 6th Edition. Hoboken, NJ: Wiley-Blackwell; 2019.
Yoshida M, Nakajima I, Uchida A, Yamaguchi T, Nonaka T, Yoshida H, et al. Characteristics of lower-jaw-position sensation with respect to oral-jaw functions in patients with cerebral palsy. Pediatric Dental Journal. 2004;14(1): 23-8.’
Santos MTBR, Felipe Scalco Manzano, Chamlian TR, Masiero D, Jardim JR. Effect of spastic cerebral palsy on jaw-closing muscles during clenching. Special Care Dentistry. 2010;30:163-67.
Arvedson J, Clark H, Lazarus C. The Effects of Oral-Motor Exercise on Swallowing in Children: an Evidence-Based Systemic Review Journal of Developmental Medicine and Child Neurology. 2010;52:1000-13.
Sigan SN, Uzunhan TA, Aydinli N. Effects of Oral Motor Theraphy in Children with Cerebral Palsy. Annals of Indian Academy of Neurology Journal. 2013;16(3):342-6
Michael A, Alexander DJ, Matthews. Pediatric Rehabilitation Principles and Practice Fifth Edition. (eds). Demos Medical Publishing: New York; 2015.
Miller F, Bachrach S, Lennon N, et al. (eds.). Cerebral Palsy Second Edition. Switzerland : Springer Nature AG; 2020.
Senner JE, Logemann J, Zecker S, Gaebler-Spira D. Drooling, saliva production, and swallowing in Cerebral Palsy. Developmental Medicine and Child Neurology. 2004;46:801-6.
Chen C-L, Lin K-C, Chen C-H, Chen CC. Factors Associated with Motor Speech Control in Children with Spastic Cerebral Palsy. Chang Gung Medicine Journal. 2009;33:415-22.
Sungkar E, Wahyuni LK. Drooling pada Palsi Serebral. In: Wahyuni LK, Tulaar ABM, editors. Kedokteran Fisik dan Rehabilitasi pada Tumbuh Kembang anak. Jakarta: PERDOSRI; 2014.
Oliveira CAGR, Paula VACd, Portela MB, Primo LSGa, Castro GF. Case Report Bruxism Control in a Child with Cerebral Palsy. International Scholarly Research Network Dentistry. 2011.
Wahyuni LK, Hamzah Z, Ugahary M. Palsi Serebral. In: Wahyuni LK, Tulaar ABM, editors. Kedokteran Fisik dan Rehabilitasi pada Tumbuh Kembang Anak. Jakarta: PERDOSRI; 2014.
Pope JEC, Curzon MEJ. The dental status of cerebral palsied children. The American Academy of Pediatric Dentistry. 1991;13,:156-62.
Dentists SAoI. Cerebral Palsy a Review For Dental Professionals. Self-Study Course Module 4.
Sara Rosenfeld-Johnson's Approach to Oral-Motor Feeding and Speech Therapy.
Korth K, Rendell L. Feeding Intervention. In: Case-Smith J, O'Brien JC, editors. Occupational Therapy for Children and Adolescents. 7 ed. Missouri: Elsevier; 2015. p. 389-41.
Gisel EG. Oral-Motor Skills Following Sensorimotor Intervention in The Moderately Eating-Impaired Child with Cerebral Palsy. Journal of Dysphagia. 1994;9:180-92.
Kumar S. Effects of Oral Motor Stimulation in The Treatment of Drooling in Cerebral Palsy Children.
Ganz SF. Decreasing Tongue Thrusting and Tonic Bite Reflex through Neuromotor and Sensory Facilitation Techniques. Physical and Occupational Therapy in Pediatrics. 1987;7:57-75.
Chen C-l, Chen H-c, Hong W-h, Yang F-pG. Oromotor variability in Children with Mild Spastic Cerebral Palsy: a Kinematic Study of Speech Motor Control. Journal of Neuroengineering and Rehabilitation. 2010;7
