Feasibility of instrumental swallowing assessments in patients with prolonged disordered consciousness while undergoing inpatient rehabilitation.
OBJECTIVE
To evaluate the feasibility, safety, and potential benefit of instrumental swallowing assessments for patients with prolonged disordered consciousness participating in rehabilitation.


METHODS
Case-control, retrospective.


METHODS
Thirty-five participants divided into 2 cohorts according to cognitive level at the time of baseline instrumental swallowing assessment. Group 1 (n = 17) participants were at Rancho Los Amigo (RLA) level II/III or RLA level III, while Group 2 (n = 18) participants were rated better than RLA level III.


RESULTS
Aspiration and laryngeal penetration rates for both groups were similar (aspiration rate Group 1 = 41%, Group 2 = 39%; laryngeal penetration rate Group 1 = 59%, Group 2 = 61%). Overall, 76% (13/17) of Group 1 and 72% (13/18) of Group 2 were able to receive some type of oral feedings following baseline video fluoroscopic swallow study (VFSS) or endoscopic exam of the swallow (FEES).


CONCLUSIONS
The majority of participants who underwent an instrumental swallowing examination while still functioning at RLA level II/III or RLA level III were able to return to some form of oral feedings immediately following their baseline examination. Swallowing as a treatment modality can be considered a part of the overall plan to facilitate neurobehavioral recovery for patients with prolonged disordered consciousness participating in rehabilitation.
Voice & Swallowing Center, Department of Speech-Language Pathology, Marianjoy Rehabilitation Hospital, 26 W. 171 Roosevelt Road, Wheaton, IL 60187, USA. sbrady@marianjoy.org
Susan L
SL
Brady
Theresa L-B
TL
Pape
Meghan
M
Darragh
Nelson G
NG
Escobar
Noel
N
Rao
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D015331:Cohort Studies; D020207:Coma, Post-Head Injury / Q000175:diagnosis* / Q000503:physiopathology / Q000534:rehabilitation*; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000503:physiopathology / Q000534:rehabilitation*; D004185:Disability Evaluation; D004750:Enteral Nutrition; D005240:Feasibility Studies; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007828:Laryngoscopy; D007830:Larynx / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D011015:Pneumonia, Aspiration / Q000175:diagnosis / Q000209:etiology; D012047:Rehabilitation Centers; D053120:Respiratory Aspiration / Q000175:diagnosis* / Q000503:physiopathology / Q000534:rehabilitation*; D012189:Retrospective Studies; D014741:Video Recording; D055815:Young Adult