• A recent study analyzed whether people with type 2 and type 3 spinal muscular atrophy (SMA) had chewing problems that impacted their quality of life.
• Researchers concluded that people with SMA were more likely to take longer chewing their food and to experience pain and fatigue from chewing.
• Chewing difficulties may lead to choking or malnutrition risks.

SMA can impair a person’s ability to chew, potentially leading to choking or malnutrition, according to a new study published on Aug. 15 in the journal Dysphagia. Researchers also found that people with SMA who required walking assistance were more likely to experience chewing issues, including eating more slowly and experiencing pain or fatigue.

Researchers have long known that SMA can weaken the muscles people need to move and breathe. However, researchers have not thoroughly studied the chewing abilities of people living with SMA. When people experience chewing problems, they may be at risk of choking or of breathing food into their airways. They may also feel self-conscious about eating and want to avoid it. This can lead to problems with malnutrition; it can also affect a person’s desire to socialize with others over meals.

In the study, the authors analyzed chewing abilities in 27 people with SMA. Eighteen study participants had SMA type 2, and nine had SMA type 3. The participants were between the ages of 13 and 67. All participants reported that they had trouble chewing or swallowing food.

The authors performed several tests to measure chewing ability and muscle strength. They found that study participants who were ambulant (were able to walk around) often had similar chewing abilities compared to people without SMA. However, people with SMA who needed walking assistance were more likely to have chewing problems, including:

• Needing to chew and swallow additional times while eating
• Taking longer to eat
• Tending to chew at a slower rate
• Experiencing occasional pain and getting tired after chewing for several minutes

The authors also used an ultrasound imaging test to look at the tongue and jaw muscles used to chew food. They found that 9 out of 10 people with SMA had abnormal structure in these muscles. The authors also determined that people who had chewing problems often could not open their mouths very wide.

Study participants with chewing problems were more likely to alter their food habits to make eating easier. For example, they might cut their food into small pieces, puree food, or avoid certain hard-to-eat items. The researchers recommended that people with SMA continue to consume food they can still safely chew and eat to help maintain their jaw muscles.

Past research has shown that working with a speech-language pathologist may help people with SMA overcome swallowing muscle weakness. Supportive feeding methods, such as feeding tubes, can also help.