Jaw-opening force test to screen for Dysphagia: preliminary results.
OBJECTIVE
To assess the jaw-opening force test (JOFT) for dysphagia screening.


METHODS
Criterion standard.


METHODS
University dental hospital.


METHODS
Patients complaining of dysphagia (N=95) and with symptoms of dysphagia with chronic underlying causes (mean age ± SD, 79.3±9.61y; range, 50-94y; men: n=49; mean age ± SD, 77.03±9.81y; range, 50-94y; women: n=46; mean age ± SD, 75.42±9.73y; range, 51-93y) admitted for treatment between May 2011 and December 2012 were included.


METHODS
None.


METHODS
All patients were administered the JOFT and underwent fiberoptic endoscopic evaluation of swallowing (FEES). The mean jaw-opening strength was compared with aspiration (ASP) and pharyngeal residue observations of the FEES, which was used as the criterion standard.


RESULTS
A receiver operating characteristic (ROC) curve analysis was performed. Forces of ≤3.2kg for men and ≤4kg for women were appropriate cutoff values for predicting ASP with a sensitivity and specificity of .57 and .79 for men and .93 and .52 for women, respectively. Based on the ROC analyses for predicting pharyngeal residue, forces of ≤5.3kg in men and ≤3.9kg in women were appropriate cutoff values, with a sensitivity and specificity of .80 and .88 for men and .83 and .81 for women, respectively.


CONCLUSIONS
The JOFT could be a useful screening tool for predicting pharyngeal residue and could provide useful information to aid in the referral of patients for further diagnostic imaging testing. However, given its low sensitivity to ASP the JOFT should be paired with other screening tests that predict ASP.
Dysphagia Rehabilitation, Nihon University School of Dentistry, Tokyo, Japan; Division of Community Oral Health Science, Kyushu Dental College, Fukuoka, Japan.
Koji
K
Hara
Dysphagia Rehabilitation, Nihon University School of Dentistry, Tokyo, Japan. Electronic address: haruka-t@rd5.so-net.ne.jp.
Haruka
H
Tohara
Dysphagia Rehabilitation, Nihon University School of Dentistry, Tokyo, Japan.
Satoko
S
Wada
Dysphagia Rehabilitation, Nihon University School of Dentistry, Tokyo, Japan.
Takatoshi
T
Iida
Dysphagia Rehabilitation, Nihon University School of Dentistry, Tokyo, Japan.
Koichiro
K
Ueda
Division of Community Oral Health Science, Kyushu Dental College, Fukuoka, Japan.
Toshihiro
T
Ansai
D000368:Aged; D000369:Aged, 80 and over; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000503:physiopathology / Q000534:rehabilitation; D005080:Exercise Test / Q000379:methods*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007568:Jaw / Q000503:physiopathology*; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D011379:Prognosis; D012372:ROC Curve; D015203:Reproducibility of Results
Deglutition; Deglutition disorders; Jaw; Rehabilitation