Comparison between bedside clinical assessments of swallowing and videofluoroscopy findings in acute stroke patients

Evidence and Recommendations for Acute Stroke Rehabilitation from the Japan Stroke Society: Abridged Secondary Publication of the Japanese-language Version

“… 62 ) A premise of many articles is that the combination of detailed examination by a SLHT and VF and VE by physicians is the standard evaluation for swallowing function. 65 , 66 , 67 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 ) Moreover, many articles mentioned the importance of early comprehensive screening of swallowing function by qualified and trained nurses. 59 , 67 ) The guidelines in the United States recommend that dysphagia screening be performed by SLHTs or other trained healthcare personnel.…”

“…Few study reports have mentioned the optimal timing of swallowing evaluations. Studies of swallowing evaluation methods in the acute phase have been varied and have included studies in which the recommended timing of the initial evaluation was immediately after admission, 25 , 26 , 82 , 83 ) within 24 h, 78 , 84 , 85 ) 48 h, 67 , 68 , 73 , 86 ) 72 h, 23 , 74 , 76 , 79 ) 4 days, 87 ) or 7 days 64 ) after admission. Although it is difficult to establish a uniform time at which the initial screening should be performed, it is important to at least establish a means of initial nutritional provision as early as possible.…”

“…In many studies, detailed examination by a physician or SLHT and VF/VE have been regarded as the gold standard for swallowing evaluation. 65 , 66 , 67 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 ) However, performing these examinations soon after admission is not possible for all patients, and bedside dysphagia screening is therefore recommended. An abundance of multicenter studies and meta-analyses have investigated the usefulness of bedside screening for dysphagia.…”

“… 62 , 65 , 66 , 70 , 71 , 72 , 74 , 75 , 86 , 88 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 ) The results of other studies in Japan have also indicated the usefulness of bedside screening for dysphagia, although they were single-center studies. 63 , 69 , 78 , 79 , 80 , 101 , 102 , 103 ) Many studies have found that dysphagia screening after admission is useful for predicting the medium-term and long-term risks of pneumonia and death, and that it may reduce the risk for them. 62 , 64 , 66 , 70 , 71 , 74 , 83 , 85 , 88 , 94 , 99 , 104 ) However, almost no studies have compared the usefulness of some methods of dysphagia screening.…”

“…In the literature from Japan, specialized methods, such as the 2-min spontaneous swallowing test, 63 ) tongue pressure assessment, 101 ) and use of an ultrasound device, 77 ) have been reported to be useful. Other general-purpose methods include the repetitive saliva swallowing test (RSST), 79 , 80 , 112 ) water drinking test, 78 , 79 , 80 , 102 , 103 ) and food test. 77 , 102 )…”