Proposed Topic (Most preferred): :
HA Young Investigators Session (Projects to be presented by HA staff who had joined HA for 10 years or less)
Proposed Topic (Second preferred): :
Research and Innovations (new projects / technology / innovations / service models)
Authors (including presenting author) :
Lam KY, Wong SS, Lam HT, Leung RWC, Law KM, Yip HS, Yeung YKA, Yeung CHJ, Fung BKY
Affiliation :
Physiotherapy Department, Kwong Wah Hospital
Introduction :
Orofacial myofunctional therapy (OMT) was proposed to reduce obstructive sleep apnea syndrome (OSAS) severity and associated symptoms in adults. Literature demonstrates that OMT promoted significant improvement in orofacial myofunctional status and sleep quality in adults with sleep disordered breathing (SDB). However, OMT as an adjunctive therapy for the treatment of sleep disordered breathing in adults is not commonly practised in Hong Kong.
Objectives :
To evaluate the application of orofacial myofunctional therapy to adult patients with sleep disordered breathing.
Methodology :
It was a retrospective analysis of the effectiveness of the program for adult patients with sleep disordered breathing. Data was retrieved from November 2020 to December 2023.Inclusion criteria: patient diagnosed as sleep disordered breathing.
The outcome measures:
1. Daytime sleepiness: Epworth Sleepiness Scale (ESS)
2. Sleep related quality of life: Short version of Functional Outcomes Sleep Questionnaire (FOSQ-10)
3. Mouth opening: Maximal interincisal opening (MIO)
4. Tongue movement: Mouth opening tongue tip to incisive papilla (MOTTIP), Tongue range of motion ratio (TRMR)
5. Tongue strength and endurance: measured by Iowa Oral Performance Instrument (IOPI) machine
6. Severity of OSAS: belun Apnea and Hypopnea Index (bAHI)
The 16-week OMT program consisted of 5 sessions training in orofacial exercise, breathing and postural re-education. Data was analysed by Wilcoxon Signed Rank test for paired comparison on mean, p<0.05 as significant at baseline and 1-month after completion of program.
Result & Outcome :
Sixty-five SDB adults (Female: 25, Male: 40) aged 57.5±13.0 with body mass index (BMI) 26.3±4.4 were recruited. All subjects completed post 1-month evaluation without significant change in BMI and MIO.
MOTTIP increased significantly from 32.1±7.8 mm to 33.3±7.3 mm (p=0.034); TRMR increased significantly from 67.5±18.8% to 69.8±16.7% (p=0.024).
Tongue strength significantly improved from 40.6±12.5kPa to 46.3±12.4kPa (p<0.001). (norm: male 35.2±9kPa; female: 34.5±6.9kPa). Tongue endurance significantly improved from 11.4±9.3 seconds to 19.2±12.6 seconds (p<0.001) (norm: male 15.8±6.7 seconds; female: 17.9±8.1 seconds).
bAHI decreased significantly from 16.6±10.5 to 12.7±7.0 (p=0.03).
ESS significantly improved from 8.5±4.9 to 7.1±4.1 (p=0.002).
FOSQ-10 significantly improved from 80.0±16.1% to 84.7±12.5% (p=0.012).
Conclusion
OMT improves OSAS symptoms and orofacial myofunctional status in adult patients with SDB as reflected in improvement in ESS, FOSQ-10, MOTTIP, TRMR, bAHI, tongue strength and tongue endurance which promote nose breathing pattern. Physiotherapy also play an important role in weight reduction and postural re-education which are important component in SDB rehabilitation. Larger sample size is required to establish its effectiveness in local population.
