Mastication in Patients with Spinal Muscular Atrophy Types 2 and 3 is Characterized by Abnormal Efficiency, Reduced Endurance, and Fatigue.
A M B van der Heul, R P A van Eijk, R I Wadman and 6 others
PMID 34392389WHAT IT FOUND
Non-ambulant patients with SMA types 2 and 3 chewed inefficiently, reported fatigue during a six-minute chewing test, and did not always report problems.
Ambulant patients chewed normally. Questionnaires alone may miss chewing problems.
Key findings
01Non-ambulant patients needed more chewing cycles, swallows, and time to finish a standardized cracker than healthy Dutch reference values (median z scores 1.8, 4.3, and 3.4).
02Five non-ambulant patients could not complete the six-minute chewing test because of jaw muscle fatigue, and fatigue scores were higher than healthy subjects after the test.
03Some patients did not report chewing difficulty despite abnormal measured chewing efficiency (three of 11).
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Only 27 patients were studied, and only three were ambulant, so results for ambulant patients are unstable. Participants were selected because they had bulbar problems, so this does not describe chewing in all patients with SMA types 2 and 3. The study did not test any treatment, so it cannot show that chewing exercises, stretching, or food changes improve outcomes. Swallows in the cracker test were counted by video observation, not objective swallow measurement. Muscle ultrasound was scored qualitatively, so it describes structure but does not prove a cause of chewing problems.
Declared interests
The study was funded by Prinses Beatrix Spierfonds, Stichting Spieren voor Spieren, and Vriendenloterij. No author conflicts of interest are stated in the supplied text.
The easy way to misread this
Do not conclude that all patients with SMA types 2 and 3 have inefficient chewing. The three ambulant patients performed similarly to healthy subjects on the cracker test.