title: Longitudinal changes of the swallowing process in subacute stroke patients with aspiration.
abstract: The purpose of this study was to evaluate longitudinal changes of the swallowing process in stroke patients with aspiration using kinematic analysis. Twenty-eight subacute stroke patients with aspiration on fluid at initial videofluoroscopic swallowing studies (VFSS) were included. Follow-up VFSS was performed at 2-4 weeks after initial studies that were conducted at an average of 26 days after stroke. Temporal and spatial variables were calculated by two-dimensional motion analysis of hyoid bone and epiglottic movements. Swallowing process delays associated with hyoid bone and epiglottic movements were improved at follow-up studies, whereas spatial variables were not. Fourteen patients had recovered from aspiration at follow-up. Time to the start of the hyoid movement was longer in the nonrecovered patient group at initial studies (1.76 ± 1.07 s) than in the recovered group (0.90 ± 0.82 s, P=0.024). Although time-associated differences between the nonrecovered and recovered groups disappeared at follow-up studies, aspiration persisted in the nonrecovered group. This study shows that recovery from delays in the swallowing process is a conspicuous change during the subacute stage in stroke patients with aspiration. Our findings suggest that delayed swallowing triggering at initial VFSS is a useful predictor of poor recovery from aspiration in stroke patients.
authors.affiliation: Department of Rehabilitation Medicine, Seoul National University Hospital, 101, Daehang-ro, Jongno-gu, Seoul 110-744, Republic of Korea.
authors.forename: Han Gil
authors.initials: HG
authors.lastname: Seo
authors.forename: Byung-Mo
authors.initials: BM
authors.lastname: Oh
authors.forename: Tai Ryoon
authors.initials: TR
authors.lastname: Han
mesh_terms: D000208:Acute Disease; D000368:Aged; D001696:Biomechanical Phenomena; D003679:Deglutition; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000209:etiology / Q000534:rehabilitation; D005260:Female; D005471:Fluoroscopy / Q000295:instrumentation / Q000379:methods; D006305:Health Status Indicators; D006801:Humans; D006928:Hyoid Bone; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D053120:Respiratory Aspiration; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D020521:Stroke / Q000150:complications*; D013997:Time Factors; D016896:Treatment Outcome; D014741:Video Recording / Q000295:instrumentation / Q000379:methods