Cerebral palsy (CP) refers to disorders of motor development, rising from the primary brain injury, are permanent and changeable character, causing secondary musculoskeletal abnormalities and limitations in activities
. Recent studies estimate the prevalence of this condition in 2,4 per 1000 children, which means a significant number of people with this kind of disturbances
Currently, the children with CP are classified according to their functional independence in gross motor function. Through Gross Motor Function Classification System (GMFCS) for CP
, the classification is by age (0–2, 2–4, 4–6, e 6–12 years), in five functional levels. The system goal is to classify gross motor function with emphasis on the movements of "sit" and "walk"
[4–6]. Children who have motor function problems similar to those classified at level 1, can generally walk without restrictions but tend to be limited in some of the more advanced motor skills. Children classified at level 5, are usually very limited in their ability to move even with the use of assistive
It is known that the main alteration present in children with CP is the motor impairment, which causes several modifications rose from encephalopathy, with consequent changes in body biomechanics. In addition, the child may have intellectual disorders, sensitive, visual and hearing, which added to the motor changes, task constraints and the environment, have repercussions in different ways in their functional performance
Besides the difficulties in locomotion previously described, as a result of the lack of motor coordination, orofacial alterations are also common in these individuals. These disorders are followed by pain, joint noise and irregular or deviated jaw function
. Individuals with spastic muscles present severely compromised function due to a diminished range of motion, diminished voluntary strength, and increased joint stiffness
In general, important functions such as mastication, speech and swallowing are compromised, due to tongue thrusting, cheeks and lips incompetence, resulting in salivary incompetence, presence involuntary bite reflex, asymmetric positioning of the neck, making it difficult to maintain the posture of the head, as well as lack of dynamic balance of the masticatory muscles
[14–16]. Some therapies may be suggested to treat muscular alteration in CP, such as electrical stimulation, LED therapy and laser therapy
[17, 18]. Neuromuscular electrical stimulation has been proposed as a potentially useful modality for muscle strengthening in children with CP. The electrical neuromuscular stimulation, it is the application of electrical stimulation of sufficient intensity to produce a visible muscle contraction which is applied to the motor point of the muscle, in order to promote muscle strengthening. However, none study that analyzed and compared their effectiveness in adult patients with CP was found so far. Considering the relation between the function of masticatory muscles and the craniofacial complex, the electromyographyc analysis (EGM) is an important tool for the undestanding of muscular pattern when developmental and functional alterations are present
. Evaluating and treating patients with special needs requires a multidisciplinary approach. In this context, it is important to consider that individuals with CP are also predisposed to sleep-disordered breathing, such as obstructive sleep apnea (OSA), which is one of the most common respiratory disorders. Besides, it could occur oxyhemoglobin desaturation, altered sleep-wake cycle, insomnia, disruption of sleep architecture, thus, resulting in hypoxia events during sleep. Patients with CP have a higher prevalence ranging between 50–60% of sleep-disordered breathing, when compared to individuals without CP. Health professionals should then consider the obstruction of the upper airway during wakefulness and sleep in these patients, since in most cases, OSA is not diagnosed
[20–22]. In addition, sleep disorder leads to an impairment on mood, behavior, and neurocognitive function and, along with pre-existing problems in patients with PC, causes greater damage in their quality of life
. The measurement of sleep quality and the evaluation of sleep disorders in patients with PC are very important for the assessment of these individuals holistically, and should be added to the protocol for treating these patients. There is much to clarify about the physiology of the impact of sleep and its disorders, both in normal subjects and in patients with special needs. Forward studies are needed to search for an effective treatment protocol for improvement of quality of life of these individuals.