Dysphagia in stroke: Development of a standard method to examine swallowing recovery
Journal of rehabilitation research and development
This study began development of a standard method that uses the videofluoroscopic swallow study for evaluation of swallowing recovery after stroke based on a definition of dysphagia derived from three domains: bolus timing, bolus direction, and bolus clearance. Two experiments were conducted: one that defined normal versus disordered swallowing based on the range of scores in a sample of healthy adults (n = 13), and one that applied these thresholds to nine stroke patients to identify the
... identify the presence of dysphagia. Results indicate that acute and protracted dysphagia may be more accurately detected by identifying abnormalities on multiple objective measures of swallowing rather than on laryngeal penetration or aspiration alone. Results indicate that our selected measures and use of healthy control subjects to establish normal thresholds may eventually contribute to the definition and differentiation of dysphagic and nondysphagic patients. Further research with a broader sample of healthy controls and stroke patients is mandatory. Abbreviations: MRI = magnetic resonance imaging, OTT = oral transit time, P-A = Penetration-Aspiration, PTT = pharyngeal transit time, SD = standard deviation, STD = stage transition duration, UES = upper esophageal sphincter, VAMC = Department of Veterans Affairs medical center, VSS = videofluoroscopic swallow study. * Indicates >2 SD above control group mean. OTT = oral transit time, P-A = Penetration-Aspiration, PS = pyriform sinus, PTT = pharyngeal transit time, SD = standard deviation, STD = stage transit duration.