Mastication training in adult patients with mitochondrial diseases: an explorative study

Abstract

Background: Fatigued muscles during mastication is a frequently reported clinical symptom in patients with mitochondrial diseases (MD). In general, long-term training will improve exercise capacity and mitochondrial function. Currently, no disease specific training is available for mastication in this patient group.

Aim and research question: The aim is to explore the effect of low intensity mastication training on mastication related outcome measures. Research question: Is there an effect of low intensity mastication training using chewing gum on masticatory performance, bite force, efficiency and endurance in adult patients with MD?

Design: Quasi-experimental explorative study.

Method: Twenty participants cooperated: 10 in the intervention and 10 in the control group, matched on sex and age. The intervention consisted of an 8-weeks low intensity (3 times a day, 20 minutes each) mastication training at home, using sugar-free chewing gum. Examination took place at baseline and directly after the intervention. The following masticatory measures were used: (1) performance using bicolour chewing gum samples; (2) bite force using the VU Bite Force gauge (VU-BFG); (3) efficiency using the Test of Mastication and Swallowing of Solids (TOMASS); (4) endurance, using the 6 minutes mastication test (6MMT).

Results: In the intervention group, masticatory efficiency - number of masticatory cycles needed to eat a cracker - significantly changed. Masticatory performance, bite force and endurance did not change. In the control group, no significant changes were observed.

Conclusion: Mastication training using chewing gum in patients with MD improved masticatory efficiency. Findings contribute to developing a disease specific training program to reduce oral phase impairment.

Recommendations: Further research is recommended to investigate the optimal frequency and duration of mastication training, along with the long-term effects of training.