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MBGR Protocol of Orofacial Myofunctional Evaluation with Scores

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MBGR Protocol of Orofacial Myofunctional Evaluation with Scores Volume 38 Number 1 pp. 38-77 2012 Clinical Perspective MBGR Protocol of orofacial myofunctional evaluation with scores Irene Queiroz Marchesan (CEFAC, Sao Paulo, [email protected]) Giedre Berretin-Félix (University of Sao Paulo) Katia Flores Genaro (University of Sao Paulo) Follow this and additional works at: https://ijom.iaom.com/journal The journal in which this article appears is hosted on Digital Commons, an Elsevier platform. Suggested Citation Marchesan, I. Q., et al. (2012). MBGR Protocol of orofacial myofunctional evaluation with scores. International Journal of Orofacial Myology, 38(1), 38-77. DOI: https://doi.org/10.52010/ijom.2012.38.1.5 This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. The views expressed in this article are those of the authors and do not necessarily reflect the policies or positions of the International Association of Orofacial Myology (IAOM). Identification of specific oducts,pr programs, or equipment does not constitute or imply endorsement by the authors or the IAOM. International Journal of Orofacial Myology 2012, V38 MBGR PROTOCOL OF OROFACIAL MYOFUNCTIONAL EVALUATION WITH SCORES IRENE QUEIROZ MARCHESAN PHD, GIÉDRE BERRETIN-FÉLIX PHD, KÁTIA FLORES GENARO PHD ABSTRACT The MBGR Protocol with scores was first published in 2009. This protocol was widely administered by speech-language pathologists experienced in orofacial myology in different states from Brazil for four months. From the comments and suggestions of these professionals, the protocol was reviewed and modified. A consistent visual training materials program was prepared, and speech-language pathologists, experienced in orofacial myology from different states of Brazil, Venezuela, Peru, and Colombia were trained with the provided materials. These speech-language pathologists administered the protocol for two years. From the data collected by the speech-language pathologists, modifications were made, and a final version was designed. This final version was administered for two-months by the same speech-language pathologists from Brazil, Venezuela, Peru, and Colombia in order to re-test the final version of MBGR protocol. The aim of this study was to demonstrate the efficiency and effectiveness of the protocol to assess orofacial myofunctional alterations. The final version of the MBGR protocol with scores has proven to be efficient and effective in the identification of individuals experiencing orofacial myofunctional disorders. KEYWORDS: Protocol, validity, validation study, test reproducibility, orofacial myology INTRODUCTION Protocols are important in the providing From the administration of the original 2009 parameters for assessment, especially in a protocol, modifications were made, and a final specialty area such as orofacial myology version was designed. This version consisted (OM). In Brazil, until the 1980s, there was an of two parts: history and clinical examination. absence of structured protocols for the The history section focuses on collecting identification of orofacial myofunctional information about: general health problems; disorders (OMD). Since the 1980s short breathing; sleep; previous treatments; feeding; protocols to assess the OM alterations were chewing; swallowing; oral and postural habits; designed by different speech-language communication; education; speech; hearing; pathologists (Marchesan, 1997; Marchesan, and voice. The clinical examination section is 2003a; Marchesan, 2003b; Marchesan, composed of eight parts and focues on 2005a; Marchesan, 2005b; Marchesan 2005c; assessing: body posture; the face, mandibular Cattoni, 2006; Paskay, 2006; Felicio, Ferreira, and occlusion measurements; extra-oral and 2008; Rodrigues, Monção, Moreira, 2008; intra-oral examinations; mobility of lips, Cattoni, Fernandes, 2009; Tessitore, tongue, velum and jaw; pain; tone of lips, Paschoal, Pfeilsticker 2009; Whitaker, mentum, tongue and cheeks; orofacial Trindade, Genaro, 2009). functions including breathing, chewing, swallowing, speech, and voice. During 2007 and 2008, four speech-language pathologists, experienced in OM, decided that A scoring system was developed for the it was important to design a structured results obtained from administering the protocol. From the protocols in existence at protocol. Because of the different that time, a new model protocol was designed characteristics of each item assessed, the and published (Genaro, Berretin-Felix, scores range, from the maximum score Redher, Marchesan, 2009). considered as being reflective of the most 38 International Journal of Orofacial Myology 2012, V38 deficient results and 0 score considered the RESULTS best or normal performance. At the end of the MBGR protocol, a summary with scores of all The final version of MBGR protocol is items assessed is provided. Photos and video presented in Appendix A. In an attempt to recording are the types of documentation provide examples of some of the items suggested. This is primarily to compare the included in the MBGR protocol, Appendix B first evaluation to the re-evaluations. provides photographic samples of some of the items included on the MBGR to help the new The aim of this article is to demonstrate the clinician understand the characteristics efficiency and effectiveness of the protocol in important to conducting the clinical identifying orofacial myofunctional alterations. assessment. METHODS DISCUSSION The protocol published in 2009 was widely The new protocol permits the identification of administered by speech-language pathologists individuals experiencing orofacial experienced in orofacial myology in different myofunctional disorders, and also presents states from Brazil for four months. Following information on categories of problems. Insight the directions of the authors of the protocol, into the potential causes of an orofacial the speech-language pathologists myofunctional disorder, and potential future administering the protocol also photographed difficulties that the individual may experience, and recorded the patients during evaluation. is also possible for the properly trained The data was collected and the considerations evaluator. When a specific protocol is of the speech-language pathologists were sent administered by trained individuals, a to the authors, who analyzed all the cases, systematic and homogeneous analysis of the including the photographs and recordings. collected information is possible which may From the comments and suggestions of these justify the knowledge and beliefs currently held professionals, the protocol was reviewed and about orofacial myofunctional disorders. modified. As Hogikyan & Sethuraman (1999) and Understanding the importance of Gasparini & Behlau (2009) indicate in their administering the reviewed protocol, the studies on voice, subjective judgements may authors searched for speech-language be accurate or inaccurate. Informational data pathologists from Brazil, as well as Latin from a specific country on the disease America, to test the new version of MBGR incidence, etiology, prognosis, the most protocol. A consistent visual training materials frequent symptoms, for example, can only be package was prepared, and speech-language obtained from the use of a standard protocol. pathologists experienced in orofacial myology from different states of Brazil, Venezuela, When protocols are administered during all the Peru, and Colombia were trained in the use of treatment phases including evaluation before the materials, and administered the protocol and after treatment, the comparison of data during the following two years. reveals whether the therapeutic techniques are effective or not. If professionals from From the information collected by the speech- different places administer the same protocol, language pathologists, modifications were they can compare data from different patients made, and a final version was designed. This concerning diagnosis and treatment, and final version was administered for two-months potentially identify specific treatment by the same speech-language pathologists procedures for the various types of orofacial from Brazil, Venezuela, Peru, and Colombia myofunctional disorders, which could then be who administered the previous version in provided in an efficient and effective manner. order to re-test the final version of MBGR protocol. 39 International Journal of Orofacial Myology 2012, V38 CONCLUSIONS which has been developed and reviewed by knowledgeable specialists. The authors feel The MBGR is a two-part protocol composed of that this final version of the MBGR protocol is history and clinical examination with scores, an instrument that will not only help in the which allows the speech-language pathologist identification of individuals with orofacial to assess, diagnose and establish prognostic myofunctional disorders, but also permit information for orofacial myofunctional individuals interested in conducting future disorders. In order to be confident in the data research a protocol which will allow the collected, it is important to use a protocol accurate collection of data. CONTACT AUTHOR Irene Queiroz Marchesan PhD. Kátia Flores Genaro PhD. Speech-Language Pathologist from CEFAC Speech-Language Pathologist Post-Graduation in Health and Education Associate Lecturer CEFAC’ Professor and Board of Directors, Department of Speech Therapy Specialist in Orofacial Myology Faculty of Odontology Phone number: 55-11-3868.0818 University of Sao Paulo [email protected] Bauru, Brazil www.cefac.br
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