Authors (including presenting author) :
Chan OM(1), Chan SL(1), Leung YY(1), Chui KW(1), Yuen PM(1), Chan ML(1), Tam CY(1), Leung KM(1)
Affiliation :
(1)Physiotherapy Department, Princess Margaret Hospital
Introduction :
Obstructive Sleep Apnoea (OSA) leads to hypoventilation during sleep and fragmented sleeps which affect a child’s arousal and concentration in daytime. This hinders one’s learning and development.
Apart from nocturnal ventilation support, dental orthoses and surgeries, Orofacial Myofunctional Therapy (OMT) is another treatment option for children suffering from OSA. It is a non-invasive intervention which includes neuromuscular re-education and strengthening of orofacial muscles, breathing and posture correction exercises led by physiotherapists (PT). It aims to strengthen tongue and orofacial muscles and thereby realign the intraoral position to improve upper airway obstruction during sleep. It is also applicable in children with postoperative residual OSA.
Objectives :
(1) To improve the strength and endurance of orofacial muscles in children with OSA; (2) To evaluate the effectiveness of OMT in paediatric OSA
Methodology :
Patients with OSA were referred to the program by paediatricians in Princess Margaret Hospital since June 2019. Baseline assessments consisted of subjective evaluations (Paediatric Sleep Questionnaire (PSQ) and self-reported percentage of time on oral breathing during sleep) and objective measurements (tongue strength, tongue endurance, Apnoea Hypopnoea Index (AHI) and body mass index). Patients underwent 3 sessions of OMT exercises led by trained PT. In response to the COVID-19 pandemic, onsite training was converted to “tele-training”. Patients were then followed up at 3-month, 6-month and 9-month after accomplishment of training. In each follow-up, baseline outcome measures (except AHI, which was assessed only upon completion of all follow-ups) were re-assessed. Self-reported exercise compliance and Numeric Global Rating of Change Scale were also rated.
Result & Outcome :
A total of 15 children (9 boys and 6 girls; mean age of 12.9 years old) with OSA were recruited. Due to the COVID-19 epidemic, only 2 cases have completed the program.
After OMT training, the orofacial musculature improved with the mean tongue strength increased from 35.5 kPa to 47.5 kPa and the mean tongue endurance increased from 11.5 seconds to 14.5 seconds. The signs and symptoms of OSA were lowered with the mean PSQ score dropped from 0.41 to 0.35. The percentage of time on oral breathing was similar. This preliminary result is encouraging and further data collection is in progress.
