Int J Med Sci 2019; 16(11):1447-1452. doi:10.7150/ijms.34850 This issue

Research Paper

Can muscle vibration be the future in the treatment of cerebral palsy-related drooling? A feasibility study.

Emanuele F. Russo1, Rocco S. Calabrò2✉, Patrizio Sale3, Filomena Vergura1, Maria C. De Cola1, Angela Militi4, Placido Bramanti2, Simona Portaro2, Serena Filoni1

1. Padre Pio Foundation and Rehabilitation Centers, San Giovanni Rotondo, Foggia, Italy;
2. IRCCS Centro Neurolesi Bonino-Pulejo, Messina, Italy;
3. Rehabilitation Unit, Department of Neurosciences, University of Padua;
4. Dipartimento di Scienze Biomediche odontoiatriche e delle immagini Morfologiche e Funzionali, University of Messina, Italy

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Russo EF, Calabrò RS, Sale P, Vergura F, De Cola MC, Militi A, Bramanti P, Portaro S, Filoni S. Can muscle vibration be the future in the treatment of cerebral palsy-related drooling? A feasibility study.. Int J Med Sci 2019; 16(11):1447-1452. doi:10.7150/ijms.34850. Available from

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Background: Drooling is an involuntary loss of saliva from the mouth, and it is a common problem for children with cerebral palsy (CP). The treatment may be pharmacological, surgical, or speech-related. Repeated Muscle Vibration (rMV) is a proprioceptive impulse that activates fibers Ia reaching the somatosensory and motor cortex. Aim: The aim of the study is to evaluate the effectiveness of rMV in the treatment of drooling in CP. Design, setting and population: This was a rater blinded prospective feasibility study, performed at the “Gli Angeli di Padre Pio” Foundation, Rehabilitation Centers (Foggia, Italy), involving twenty-two CP patients affected by drooling (aged 5-15, mean 9,28 ± 3,62). Children were evaluated at baseline (T0), 10 days (T1), 1 month (T2) and 3 months (T3) after the treatment. Methods: The degree and impact of drooling was assessed by using the Drooling Impact Scale (DIS), the Drooling Frequency and Severity Scale (DFSS), Visual Analogue Scale (VAS) and Drooling Quotient (DQ). An rMV stimulus under the chin symphysis was applied with a 30 min protocol for 3 consecutive days. Results: The statistical analysis shows that DIS, DFSS, VAS, DQ improved with significant differences in the multiple comparisons between T1 vs T2, T1 vs T3 and T1 vs T4 (p≤0.001). Conclusion This study demonstrates that rMV might be a safe and effective tool in reducing drooling in patients with CP. The vibrations can improve the swallowing mechanisms and favor the acquisition of the maturity of the oral motor control in children with CP.

Keywords: Muscle vibration, neurorehabilitation, developmental disorders, sialorrhea.