Role of chewing exercise on cervical hypermobility in patients with Pierre Robin Syndrome

Objective: To determine the effects of chewing exercises in addition to routine physical therapy on cervical hypermobility in patients with Pierre Robin syndrome (PRS). Methodology: This randomized controlled trial was conducted at Rising Sun Institute for Special Children and Children’s Hospital, Lahore. Patients with PRS and Stickler syndrome of both gender and age between 4-12 years were included. Those with any other syndrome or epilepsy were excluded. A total of 10 children were randomly divided in 2 groups. Group A received routine physical therapy and chewing exercise while Group B received only routine physical therapy. Generalized hypermobility was measured by Beighton Hypermobility Scoring (BHS) system. Children having BHS of more than 5 out of 9 were considered in this study. Twelve sessions were given for consecutive 4 weeks. Results: Cervical range of motion (ROM) in cervical side flexion values (p=0.003), flexion (p=0.006) and Extension (p=0.004) decreased within group showed significant improvement in cervical stability. While in cervical rotation, there was no significant reduction (p=0.682). Between groups, p value showed significant decrease in ROM in cervical side flexion (p=0.016) flexion (p=0.032) and extension (p=0.008), respectively and showed marked improvement in cervical stability. Conclusion: Chewing exercise with routine physical therapy was more effective in cervical hypermobility by decreasing cervical ROM in different cervical positions for cervical stability in patients with PRS.