Efficacy of Passive Oral Motor Therapy on Drooling in Children With Multiple Disabilities
Condition: Multiple Disabilities
MeSH terms: Sialorrhea
Study type: Interventional

Summary: 
      This study was formulated to determine the efficacy of passive oral motor regimen for
      drooling in children with multiple disabilities. Seven subjects aged 7-19yrs were taken in
      the study. All the subjects received passive treatment which included light touch, stroking,
      vibration, tapping, pressure and stretch. All the techniques have been proved to be effective
      in treating drooling. Relative sterility and hygiene was maintained throughout the procedure
      as sterilized gloves and napkins were used. The measurement protocol was designed to check
      effectiveness on drooling in children. The protocol was given for 4 weeks with treatment
      sessions given 3 times per week and the treatment duration was 30min. Twelve sessions of oral
      motor stimulation therapy given during the 4 weeks. Thirteen after 4 weeks of treatment,
      improvement was found in terms of the severity as well. Primary outcome measure taken was
      Drooling Frequency and Severity rating scale and secondary outcome measure being taken was
      drool quotient. Pre and post intervention scores of Drooling Frequency and Severity rating
      scale and drool quotient were taken and data was analyzed using wilcoxon signed rank test .
    

Detailed description: 
      Title To formulate and see efficacy of passive oral motor regimen for drooling in children
      with multiple disabilities Background Drooling ranges from mild embarrassment and discomfort
      for the intellectually intact patient with minimal drooling to gross emotional and physical
      impairment for the severely affected individual. Drooling produces an unhygienic condition
      that may be associated with a disagreeable odour. Drooling affects the social and physical
      wellbeing of children and may represent problems for caregivers. Many persons with severe and
      profound disabilities exhibit chronic and excessive drooling, which can have unfavourable
      effects on their socialization and health. Studies have suggested that various treatments
      like medication, surgery, behaviour modification, myofunctional therapy and oral motor
      therapy are effective in treating drooling but there is no single protocol developed to treat
      drooling in children with multiple disabilities. Passive treatment protocol is needed
      specifically designed for children who are not able to follow commands and on whom various
      treatment techniques like behaviour modification, over-correction can't be applied. Present
      study aims to formulate and see the efficacy of passive oral motor regimen for drooling in
      children with multiple disabilities.

      Methodology Seven subjects of age group between 07-19 years were selected out of accessible
      population.

      Informed consent taken from the parents/caregivers.Severity and frequency of drooling
      accessed (For each subject prior to the study) and Drool Quotient was calculated (For each
      subject prior to the study). Patient was in sitting position with back fully supported and
      head in neutral position in their own home. Therapist in standing position in front of the
      patient.Therapist wore sterilised gloves to ensure that no infection occurs along with change
      of gloves for every subject. Light touch applied to mid line of lips (3 times, for 5 sec).
      Maintained pressure applied around lips (3 times for 3 sec). Gentle tapping to the cheeks
      applied with index finger (8 times each cheek). Quick, gentle stretch applied outward with
      index and middle finger on middle of upper lip and lower lip (8 times on each lip). Gentle
      stroke to the cheek applied with index finger from base of nose towards ear. Then returned
      back to corner of lips (8 times each cheek), repeat on the other side. Gentle stroking
      applied to area around the lips in a circular manner, from the corner towards the center and
      to the other corner, then reverse. (4 times each lip). Vibration slowly applied for 10-15 sec
      each of a) orbicularis oris b) Both sides of larynx from chin to sternal notch c) Under the
      chin from ear to ear.Quick stretch applied to the masseter muscles (3 times on each side).
      Stretch pressure applied to vibrated areas, on a) orbicularis oris b) Laryngopharyngeal
      muscles, both sides. Intra-orally applied light touch to roof of mouth, anteriorly for 3
      times. The protocol was given for 4 weeks with treatment sessions given 3 times per week.

      .
    

Intervention name(s): passive oral motor therapy for drooling
Intervention type(s): Device
Intervention description(s): 7 subjects aged 7-19 yrs were taken . All subjects received passive treatment which included light touch, stroking, vibration with (mechanical vibrator), tapping, pressure and stretch. All the techniques have been proved to be effective in treating drooling. Relative sterility and hygiene was maintained throughout the procedure as sterilized gloves and napkins were used. The measurement protocol was designed to check effectiveness on drooling in children. The protocol was given for 4 weeks with treatment sessions given 3 times per week and the treatment duration was 30min.12 sessions of oral motor stimulation therapy given during the 4 weeks..
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment