BACKGROUND: Currently there is limited information to guide health professionals regarding the optimal time frame to initiate safe and effective oral feedings to preterm infants. The study aims to revise and validate a streamlined version of the Traditional Chinese-Preterm Oral Feeding Readiness Assessment Scale, the TC-POFRAS®, and evaluate its construct validity in the clinical decisions regarding feeding readiness of preterm infants. METHODS: Eighty-one clinically stable preterm infants were assessed using the TC-POFRAS for oral feeding readiness. Item-total correlation analysis was used to check if any item was inconsistent with the averaged TC-POFRAS scores. Cronbach’s α coefficient was used to evaluate the inter-item consistency. Exploratory factor analysis was used to determine the coherence of variables to reorganize assessment domains. The revised version of TC-POFRAS (TC-POFRAS®) was developed and a new cut-off score based on discriminant accuracy was established. RESULTS: Based on the results from statistical analysis, five items (“lips posture,” “tongue posture,” “biting reflex,” “gag reflex,” and “tongue cupping”) were deleted from the original TC-POFRAS to form the TC-POFRAS®. The TC-POFRAS®’s global accuracy was 92.1%. The cut-off value of 19 was the one that presented the most optimization of sensitivity based on specificity. The TC-POFRAS® was reconstructed into corrected gestational age and five behavioral domains. CONCLUSIONS: The TC-POFRAS® is considered a valid, safe, and accurate objective instrument to assist health professionals to initiate oral feeding of preterm infants.
Objective: Tongue muscles play critical roles in swallowing function. This study was designed to investigate the tongue function of healthy individuals without food intake and compose a tongue function database in Taiwan across age, gender, and two tongue bulb placement positions.Methods: Both tongue strength and tongue endurance were measured at the anterior and the posterior tongue position. A total of 214 participants (102 males and 112 females) across six age groups completed the tongue strength study. Only 203 participants (96 males and 107 females) completed the tongue endurance study.Results: Results of this study found no significant interaction effects between age and gender for all the tongue strength and endurance measures. Both anterior and posterior tongue strength were significantly lower in the older group (60+) compared with the middle-aged participants (31-40). Although no significant differences were found in younger age groups at either tongue positions on endurance measures, significantly lower tongue endurances were noticed in the 60+ age group. The tongue strength and tongue endurance measurements were greater at the anterior position than the posterior position, decrease in the 60+ age group. Conclusion:The tongue endurance duration was similar between males and females and remained relatively stable throughout life. In contrast, the impact of age and gender on the maximum tongue strength measurement was more obvious. Tongue strength and endurance level were observed to decline with advancing age at both the anterior and the posterior positions. These data could be one feasible reference indicator for oral function and swallowing state in Taiwanese population.
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