Quantifying swallowing function after stroke: A functional dysphagia scale based on videofluoroscopic studies.
OBJECTIVE
To develop a sensitive, specific scale for quantifying functional dysphagia in stroke patients, using results obtained from videofluoroscopic swallowing studies.


METHODS
Data collected from a serial oral and pharyngeal videofluoroscopic swallowing study.


METHODS
A dysphagia clinic in a department of rehabilitation medicine at a tertiary care university hospital.


METHODS
One hundred three consecutively admitted stroke patients.


METHODS
Videoflurorscopy to measure a scale of 11 variables: lip closure score, bolus formation, residue in oral cavity, oral transit time, triggering of pharyngeal swallow, laryngeal elevation and epiglottic closure, nasal penetration, residue in valleculae, coating of pharyngeal wall after swallow, and pharyngeal transit time.


METHODS
Polychotomous linear logistic regression analysis of videofluoroscopic and aspiration results. Scale sensitivity and specificity, and the correlation between the total score of the scale and aspiration grade were analyzed.


RESULTS
The scale's sensitivity and specificity for detecting supraglottic penetration and subglottic aspiration were 81%, 70.7%, and 78.1%, 77.9%, respectively. A significant positive correlation was found between the scale's total score and the severity of aspiration (Spearman's r =.58943, p =.00001).


CONCLUSIONS
This functional dysphagia scale, which was based on a videofluoroscopic swallowing study in stroke patients, is a sensitive and specific method for quantifying the severity of dysphagia.
Han
T R
TR
Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Korea.
Paik
N J
NJ
Park
J W
JW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003679:Deglutition / Q000502:physiology; D003680:Deglutition Disorders / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation; D004185:Disability Evaluation; D005260:Female; D005471:Fluoroscopy / Q000379:methods*; D006801:Humans; D007830:Larynx / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010614:Pharynx / Q000000981:diagnostic imaging / Q000503:physiopathology; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications* / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D014741:Video Recording