The purpose of this study will be to compare the effect between kinesiotaping and neuromuscular electrical stimulation on dysphagia in children with bilateral spastic cerebral palsy.
Children ages will be ranged from 3 to 7 years old.
They scored ≤10 on an initial evaluation of Oral Motor Assessment scale.
They scored from 5 to 7 in accordance to dysphagia severity scale.
Sufficient cognition to follow simple verbal instructions.
Congenital problems of mouth and soft plate (e.g: cleft lip and plate).
Jaw anomalies.
Gum and/or dental problems.
Chest infection or unstable cardiopulmonary conditions.
Parallel
Structured Oromotor Exercises
Other interventionThe structured oromotor exercises will include cheek massage, gum massage, cheek Stretch, and lip stretch.
Kinesio Taping
Other interventionKinesio taping will be applied on the suprahyoid and infrahyoid muscle in Y-shape.
Neuromuscular Electrical Stimulation
Other interventionNeuromuscular electrical stimulation will be applied on the suprahyoid and infrahyoid muscles with frequency of 80 HZ of 300 milliseconds with 1-second interval.
Oral Motor Skills
Oral Motor Assessment Scale will be used to assess oral motor skills. It is a reliable scale consists of seven items compromising oral-motor skills (Mouth closure, Lip closure onto the utensil, lip closure during degluition, control of the food during degluition, straw suction, contol of liquids during degluition, and mastication) that are scored from 0 to 3 (0-passive, 1-sub-functional, 2-semi-functional, and 3-functional).
Swallowing Function
Pediatric Eating Assessment Tool (PEDIEAT-10) will be used to assess swallowing function. It is an eating screener tool include 10-items (gags with smooth food like pudding, insists on being fed by the same person(s), has to be reminded to chew food, shows more stress during meals than during non-meal times (whines, cries, gets angry, tantrums), refuses to eat, is willing to feed self (if younger in age, holds cup, feeds self crackers), throws up during mealtime, arches back during or after meals, gets tired from eating and is not able to finish, and gags when it is time to eat (for example, when they see food or when placed in high chair)) that scored from never to always (never, almost never, sometimes, often, almost always, and always).
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