Abstract：
BACKGROUND: Orofacial myofunctional disorders (OMD) are often associated with limitations of oral ingestion of solid food. The Test of Masticating and Swallowing Solids (ToMaSS) is a simple diagnostic tool to assess and quantify oropharyngeal efficiency while eating a standardised cracker.
OBJECTIVE: The objective of this study was to investigate the applicability and clinical utility of the ToMaSS in children with OMD.
METHODS: In this case-control study, data were collected from 18 children between 4 and 11 years with confirmed OMD. Inter-rater reliability and age effects on the ToMaSS parameters were investigated and the specific performance profile of the OMD children was identified.
RESULTS: Inter-rater reliability was excellent for the ToMaSS parameters \'bites\' (ICC = .999), \'masticatory cycles\' (ICC = .961), \'time\'(ICC≧ .999) and good for \'number of swallows\' (ICC = .810). \'Masticatory cycles\' and \'time\' decreased as a function of age with a significant difference in the \'number of masticatory cycles\' between the youngest (4-6 years) and oldest (10-14 years) participants (p = .006, Z = -2.739). Deviations from normative data in at least one of the four ToMaSS parameters were found in 90% of the OMD children with \'bites\', and \'masticatory cycles\' predominantly corresponding to the performances expected in typically-developing children in younger age groups.
CONCLUSIONS: The ToMaSS is a reliable diagnostic instrument and clinically useful to detect limited efficiency of oral solid bolus intake and specific impairments in chewing function and duration of food intake in children with OMD. Our data suggest that OMD is associated with delayed development of efficient solid bolus preparation.
OBJECTIVE: The objective of this study was to investigate the applicability and clinical utility of the ToMaSS in children with OMD.
METHODS: In this case-control study, data were collected from 18 children between 4 and 11 years with confirmed OMD. Inter-rater reliability and age effects on the ToMaSS parameters were investigated and the specific performance profile of the OMD children was identified.
RESULTS: Inter-rater reliability was excellent for the ToMaSS parameters \'bites\' (ICC = .999), \'masticatory cycles\' (ICC = .961), \'time\'(ICC≧ .999) and good for \'number of swallows\' (ICC = .810). \'Masticatory cycles\' and \'time\' decreased as a function of age with a significant difference in the \'number of masticatory cycles\' between the youngest (4-6 years) and oldest (10-14 years) participants (p = .006, Z = -2.739). Deviations from normative data in at least one of the four ToMaSS parameters were found in 90% of the OMD children with \'bites\', and \'masticatory cycles\' predominantly corresponding to the performances expected in typically-developing children in younger age groups.
CONCLUSIONS: The ToMaSS is a reliable diagnostic instrument and clinically useful to detect limited efficiency of oral solid bolus intake and specific impairments in chewing function and duration of food intake in children with OMD. Our data suggest that OMD is associated with delayed development of efficient solid bolus preparation.
摘要：
背景：口腔肌功能障碍（OMD）通常与口服固体食物的局限性有关。咀嚼和吞咽固体测试（ToMaSS）是一种简单的诊断工具，可在食用标准化饼干时评估和量化口咽效率。
目的：本研究的目的是探讨ToMaSS在OMD患儿中的适用性和临床应用。
方法：在本病例对照研究中，收集了18名4~11岁确诊OMD儿童的数据.研究了评估者间的可靠性和对ToMaSS参数的年龄影响，并确定了OMD儿童的具体表现特征。
结果：对于ToMaSS参数“bites”（ICC=.999），评分者间的可靠性非常好，\'咀嚼周期\'（ICC=.961），\'时间\'（ICC≥.999）和有利于\'燕子数量\'（ICC=.810）。“咀嚼周期”和“时间”随着年龄的变化而减少，年龄最小（4-6岁）和年龄最大（10-14岁）参与者之间的“咀嚼周期数”存在显着差异（p=.006，Z=-2.739）。在90％的OMD儿童中发现了四个ToMaSS参数中至少一个与规范数据的偏差，和“咀嚼周期”主要对应于年轻年龄组中典型发育儿童的预期表现。
结论：ToMaSS是一种可靠的诊断工具，在临床上可用于检测OMD儿童口服固体推注摄入的有限效率以及咀嚼功能和食物摄入持续时间的特定损害。我们的数据表明，OMD与有效的固体丸剂制剂的延迟发展有关。
目的：本研究的目的是探讨ToMaSS在OMD患儿中的适用性和临床应用。
方法：在本病例对照研究中，收集了18名4~11岁确诊OMD儿童的数据.研究了评估者间的可靠性和对ToMaSS参数的年龄影响，并确定了OMD儿童的具体表现特征。
结果：对于ToMaSS参数“bites”（ICC=.999），评分者间的可靠性非常好，\'咀嚼周期\'（ICC=.961），\'时间\'（ICC≥.999）和有利于\'燕子数量\'（ICC=.810）。“咀嚼周期”和“时间”随着年龄的变化而减少，年龄最小（4-6岁）和年龄最大（10-14岁）参与者之间的“咀嚼周期数”存在显着差异（p=.006，Z=-2.739）。在90％的OMD儿童中发现了四个ToMaSS参数中至少一个与规范数据的偏差，和“咀嚼周期”主要对应于年轻年龄组中典型发育儿童的预期表现。
结论：ToMaSS是一种可靠的诊断工具，在临床上可用于检测OMD儿童口服固体推注摄入的有限效率以及咀嚼功能和食物摄入持续时间的特定损害。我们的数据表明，OMD与有效的固体丸剂制剂的延迟发展有关。
