Assessment of swallowing and referral to speech and language therapists in acute stroke

Hinds, Nicole; Wiles, C. M.

doi:10.1093/qjmed/91.12.829

Cited by 101 publications

(79 citation statements)

References 2 publications

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“…49,50 Generally, data were complete for all enrolled patients with 2 exceptions. 41,47 Of all 24 studies, only 1 study 34 reported investigator reliability of diagnostic interpretations, and 6 studies 30,34,35,37,38,44 declared blinding for outcome assessments. The characteristics of enrolled patients varied among selected studies.…”

Section: Methodological Quality and Characteristics Of Included Studiesmentioning

confidence: 99%

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Dysphagia After Stroke

Martino

Foley²,

Bhogal³

et al. 2005

Stroke

1,574

592

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Objective-To determine the incidence of dysphagia and associated pulmonary compromise in stroke patients through a systematic review of the published literature. Methods-Databases were searched (1966 through May 2005) using terms "cerebrovascular disorders," "deglutition disorders," and limited to "humans" for original articles addressing the frequency of dysphagia or pneumonia. Data sources included Medline, Embase, Pascal, relevant Internet addresses, and extensive hand searching of bibliographies of identified articles. Selected articles were reviewed for quality, diagnostic methods, and patient characteristics.Comparisons were made of reported dysphagia and pneumonia frequencies. The relative risks (RRs) of developing pneumonia were calculated in patients with dysphagia and confirmed aspiration. Results-Of the 277 sources identified, 104 were original, peer-reviewed articles that focused on adult stroke patients with dysphagia. Of these, 24 articles met inclusion criteria and were evaluated. The reported incidence of dysphagia was lowest using cursory screening techniques (37% to 45%), higher using clinical testing (51% to 55%), and highest using instrumental testing (64% to 78%). Dysphagia tends to be lower after hemispheric stroke and remains prominent in the rehabilitation brain stem stroke. There is increased risk for pneumonia in patients with dysphagia (RR, 3.17; 95% CI, 2.07, 4.87) and an even greater risk in patients with aspiration (RR, 11.56; 95% CI, 3.36, 39.77). Conclusions-The high incidence for dysphagia and pneumonia is a consistent finding with stroke patients. The pneumonia risk is greatest in stroke patients with aspiration. These findings will be valuable in the design of future dysphagia research.

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Section: Methodological Quality and Characteristics Of Included Studiesmentioning

confidence: 99%

“…Two studies 32,33 did not declare stroke type characteristics. Seventeen studies limited enrollment to only conscious patients, whereas 4 studies 4,30,42,48 included patients who were obtunded. Of these, 3 studies 30,42,48 provided the number of obtunded dysphagic patients.…”

Section: Methodological Quality and Characteristics Of Included Studiesmentioning

confidence: 99%

Dysphagia After Stroke

Martino

Foley²,

Bhogal³

et al. 2005

Stroke

1,574

592

View full text Add to dashboard Cite

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“…[1][2][3] Videofluoroscopic examination has been used as the gold standard for evaluating swallowing function but has limitations such as the inherent exposure to radiation, difficulty with performing the examination in disabled patients, and difficulties in quantitatively analyzing the biomechanics of swallowing-related organs.…”

mentioning

confidence: 99%

Reduced Tongue Pressure Against the Hard Palate on the Paralyzed Side During Swallowing Predicts Dysphagia in Patients With Acute Stroke

Hirota

Konaka

Ono

et al. 2010

Stroke

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Background and Purpose-Dysphagia is important for prognosis in patients with stroke because this condition can cause aspiration pneumonia or nutritional deficits. The present study investigated the relationship between tongue motor deficits and dysphagia in patients with acute stroke. Methods-Maximal tongue pressure on the hard palate when swallowing 5 mL of water was measured using a T-shaped sensor sheet with 5 measuring points in 33 dysphagic and 31 nondysphagic patients with acute stroke. Maximum tongue pressures at each measuring point were compared between dysphagic and nondysphagic groups and between paralyzed and nonparalyzed sides. Results-Tongue pressure at each measuring point was significantly smaller in dysphagic patients than in nondysphagic patients with the largest significant difference on the paralyzed side. The magnitude of tongue pressure to predict dysphagia was calculated as 4.6 kPa on the paralyzed side, offering 71.4% sensitivity and 72.3% specificity. Conclusions-Reduced tongue pressure on the paralyzed side may predict dysphagia in patients with acute stroke. (Stroke.

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“…Sixteen questionnaires were obtained using these keywords. The following inventories were excluded:  Toronto Bedside Swallowing Screening Test [12]  Burk dysphagia screening test [13]  DYMUS [14]  CMDQ [15]  MASA [16]  Dysphagia screening tool in acute stroke patients [17]  Assessment of swallowing and referral to speech and language in acute stroke [18] The following questionnaires were selected:  Clinical swallowing exam [7]  Clinical screening for dysphagia [4]  Italian reflux symptom index [10]  Self-report symptom inventory [8]  EAT-10 questionnaire [5]  SWAL-QOL questionnaire [6]  Anderson dysphagia inventory [9]  Functional oral intake scale [2] All items in these questionnaires were collected in one inventory and one item from among those measuring the same function was selected in the item reduction phase. This procedure decreased the number of items to 85.Two more items were added after clinical testing by a dysphagia expert.…”

Section: Item Generationmentioning

confidence: 99%

Development, Validity and Reliability of Dysphagia Assessment Test in Iranian Adults after Stroke

Dehaghani

Khosropoor

Yousefzadeh

et al. 2016

ijtmgh

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Introduction: Many patients who have had strokes suffer from dysphagia which can lead to aspiration pneumonia in 20% to 25% of cases. Early assessment of dysphagia has can reduce the risk of death and the cost of medical care. The present study developed a questionnaire to assess dysphagia in adult patients who have suffered strokes and determined the validity and reliability of the content. Methods: The phases of the study consisted of item generation, analysis of content validity and determination of reliability. To assess the content validity, the primary questionnaire was rated by five experts on swallowing disorders. Items with low scores were removed from the questionnaire. Next, 30 stroke patients were assessed using the final questionnaire and the reliability was assessed by Cronbach's alpha. Results:The average scores of the items ranged from 0.4 to 1. Only two items were omitted because of insufficient content validity. The Cronbach's alpha was 0.71 and the standard error of deviation was 4.96, signifying that the reliability was acceptable. Conclusion: This questionnaire has good content validity and reliability. Although it can be used for clinical assessment of stroke patients who suffer from dysphagia, the concurrent validity should be determined by comparison with to a gold standard such as videofluoroscopy.

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Assessment of swallowing and referral to speech and language therapists in acute stroke

Cited by 101 publications

References 2 publications

Dysphagia After Stroke

Dysphagia After Stroke

Reduced Tongue Pressure Against the Hard Palate on the Paralyzed Side During Swallowing Predicts Dysphagia in Patients With Acute Stroke

Development, Validity and Reliability of Dysphagia Assessment Test in Iranian Adults after Stroke

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