Clinical measurement of swallowing in health and in neurogenic dysphagia

Abstract

We studied clinical features potentially related to dysphagia and three indices from a timed test of swallowing--average volume per swallow (ml), average time (s) per swallow and swallowing capacity (ml/s)--in 181 screened healthy adults and 30 patients with motor neurone disease (MND). In healthy adults, age, sex and height accounted for 44.3% and 55.6% of the variance of log average volume per swallow and log swallowing capacity, respectively. Symptoms and signs were more prevalent in the MND group and were associated with reduced swallowing capacity and reduced average volume per swallow; repeatability studies on these two indices in both groups showed that the median difference between the mean of two recordings on successive days and the mean of all recordings (6-15 over 3 days) was < 5% (maximum third quartile 12.8%, indices expressed as percent predicted according to age and sex). Using this simple bedside test, swallowing function can be quantified on a ratio scale and expressed as percent of that predicted by age and sex; such information may improve the predictive value of clinical assessment and provides a practical way of monitoring change in patients with dysphagia.

Efeito do gênero, da altura corporal e da etnia nas medidas antropométricas orofaciais

“…The observed differences can explain the behavior of men and women during deglutition (1,2,5) . Men swallow a greater volume of water in each deglutition, with larger flow, in relation to women (1,2) , and women have longer oral and pharyngeal transit in comparison to men (5) .…”

“…Many studies reveal anatomical and functional differences between men and women in relation to the mouth, pharynx, upper esophageal sphincter, esophagus and deglutition (1)(2)(3)(4)(5) .…”

Using spaced retrieval and Montessori‐based activities in improving eating ability for residents with dementia

“…The reason why self-eating time in the SR group and the Montessori group is significantly longer than in the control group may be because subjects in the SR group and Montessori group may have acquired a lasting positive affect toward eating and the mealtime environment, becoming more sociable or relaxed during mealtime. The mean self-eating time at posttest in the SR group and the Montessori group were 18 min and 22 min, respectively, and the literature reveals that older people tend to eat slower than young people (Hughes and Wiles, 1996). Also, 18-22 min for having a meal in an institutional setting is certainly a socially acceptable time for the activity.…”

A Descriptive Study of the Fluid Intake, Hydration, and Health Status of Rehabilitation Inpatients without Dysphagia Following Stroke

“…Clinical assessment of swallowing was conducted by the first author or by an experienced speech-language pathologist from the rehabilitation facility and included an oro-motor assessment, mealtime observation [17], a timed 150ml water test [18,19] and an oral health assessment [20]. To be classified as non-dysphagic and therefore eligible for inclusion, participants needed a 'no abnormality detected' rating on the oro-motor and mealtime assessment according to the AusTOMS criteria [17] for dysphagia and aspiration and pass the water test according to the norms for age and gender.…”