Bedside assessment of swallowing in stroke: water tests are not enough.

Abstract:

OBJECTIVE:The clinical functional evaluation is the usual method for dysphagia screening in patients with acute stroke. This study compared two methods of evaluation--with liquid and semisolid viscosities. METHOD:Twenty-six patients with stroke onset within 7 days--with a mean age of 63.5 +/- 12.4 years--were prospectively evaluated for deficit severity, swallowing mechanisms, chest X-ray studies, and late (30 days after discharge) assessment of disability with the modified Rankin Scale. RESULTS:Tests using water and pudding correlated poorly (p < .001). The water test exhibited higher sensitivity for detection of problems in laryngeal protection, and the test with pudding was more sensitive for the functional analysis of dysphagia itself. Abnormalities in the water test were associated with weak spontaneous cough, while a normal pudding test correlated well with oral feeding 30 days after hospital discharge. The initial neurological severity correlated with results from both tests. No patient had pulmonary infiltrates 72 hours after testing or pneumonia up to 30 days after hospital discharge. CONCLUSION:The two evaluation methods should be used to both decrease the risk of aspiration and increase the likelihood of a safe and early reintroduction of oral feeding.

journal_name

Top Stroke Rehabil

authors

Marques CH,de Rosso AL,André C

doi

10.1310/tsr1504-378

subject

Has Abstract

pub_date

2008-07-01 00:00:00

pages

378-83

issue

4

eissn

1074-9357

issn

1945-5119

pii

38G36511R0335412

journal_volume

15

pub_type

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