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BMC Research Notes Dec 2023Swallowing dysfunction (dysphagia) significantly impacts patient and medical outcomes. In Sweden, there is no comprehensive outcome measure for dysphagia that...
BACKGROUND
Swallowing dysfunction (dysphagia) significantly impacts patient and medical outcomes. In Sweden, there is no comprehensive outcome measure for dysphagia that incorporates holistic assessment and dysphagia impact on a person's impairment, function and participation. The Dysphagia Outcome and Severity Scale (DOSS) was developed and validated (in English) and incorporates the World Health Organisation's (WHO) aforementioned, International Classification of Functioning (ICF) aspects. This study translated then evaluated the validity and reliability of the Swedish version, DOSS-S.
METHOD
Translation occurred based on WHO recommendations. The Content Validity Index (CVI) of the translated version (DOSS-S) was assessed twice by 11 (multi-professional) dysphagia experts. Criterion validity and rater reliability was calculated using 18 Speech Pathologists assessing patient cases from International Dysphagia Diet Standardization Initiative-Functional Diet Scale (IDDS-FDS) research.
RESULTS
Very high CVI values (0.96-0.99) for the linguistic correlation, and high CVI values (0.84-0.94) for applicability correlation were achieved. High criterion validity of DOSS-S with IDDSI-FDS was demonstrated (r = 0.89, p < 0.01), with very high inter and intra rater reliabilities (ICC > 0.90).
CONCLUSION
The DOSS-S demonstrated very high validity values, and very high inter and intra rater reliability. This research contributes to improved dysphagia management by providing interprofessional dysphagia clinicians with a validated scale to identify patient progression, communicate dysphagia status between regions and countries, and document patient outcomes using an ICF framework.
Topics: Humans; Deglutition Disorders; Sweden; Reproducibility of Results; Deglutition; Language
PubMed: 38098056
DOI: 10.1186/s13104-023-06637-z -
American Journal of Physiology.... Apr 2022In Parkinson's disease (PD), oropharyngeal dysphagia is common and clinically relevant. The neurophysiology of dysphagia in PD is complex and incompletely understood....
In Parkinson's disease (PD), oropharyngeal dysphagia is common and clinically relevant. The neurophysiology of dysphagia in PD is complex and incompletely understood. The aim of the study was to determine the changes in oropharyngeal deglutitive pressure dynamics in PD and to correlate these with clinical characteristics including dysphagia and PD severity. In prospective consecutive series of 64 patients with PD [mean age: 66.9 ± 8.3 (SD)], we evaluated dysphagia severity clinically as well as with Sydney Swallow Questionnaire (SSQ) and Swallow Quality-of-Life Questionnaire (SWAL-QOL). PD severity was assessed with Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS). We used high-resolution pharyngeal impedance manometry (HRPIM) to objectively evaluate swallow function and compared data from 23 age-matched healthy controls [mean age 62.3 ± 9.1 (SD)]. Metrics assessed were upper esophageal sphincter (UES), integrated relaxation pressure (IRP), relaxation time (RT), maximum opening (MaxAdm), and pharyngeal intrabolus pressure (IBP) and pharyngeal contractility (PhCI). Mean MDS-UPDRS score was positively associated with dysphagia severity on SSQ and SWAL-QOL. HRPIM in PD compared with controls showed impaired UES relaxation parameters, with shorter RT, and elevated IRP and IBP. MaxAdm was not affected. The overall pharyngeal contractility was significantly higher in PD. Only the IBP and IRP were associated with PD severity and only IBP was significantly associated with dysphagia severity. UES dysfunction leading to increased flow resistance is common in patients with PD and correlates with dysphagia severity. Increased flow resistance may suggest impaired UES relaxation and/or impaired neuromodulation to bolus volume. In Parkinson's disease, objective assessment of swallow function with high-resolution impedance manometry identifies upper esophageal sphincter dysfunction leading to increased flow resistance.
Topics: Aged; Deglutition; Deglutition Disorders; Esophageal Sphincter, Upper; Humans; Manometry; Middle Aged; Parkinson Disease; Pressure; Prospective Studies; Quality of Life
PubMed: 35138164
DOI: 10.1152/ajpgi.00314.2021 -
Dysphagia Oct 2016Dysphagia is reported to be a common secondary complication for individuals with traumatic spinal injuries. Different etiologies of traumatic spinal injuries may lead to... (Review)
Review
Dysphagia is reported to be a common secondary complication for individuals with traumatic spinal injuries. Different etiologies of traumatic spinal injuries may lead to different profiles of swallowing impairment. We conducted a systematic review to determine the characteristics of dysphagia after traumatic spinal injury and to describe interventions currently used to improve swallowing function in this population. A comprehensive multiengine literature search identified 137 articles of which five were judged to be relevant. These underwent review for study quality, rating for level of evidence, and data extraction. The literature describing dysphagia after traumatic spinal injury was comprised predominantly of low-level evidence and single case reports. Aspiration, pharyngeal residue, and decreased/absent hyolaryngeal elevation were found to be common characteristics of dysphagia in this population. The most commonly used swallowing interventions included tube feeding, compensatory swallowing strategies, and steroids/antibiotics. Improvement in swallowing function following swallowing intervention was reported in all studies; however, there was no control for spontaneous recovery. The results demonstrate a need for high-quality research to profile the pathophysiology of dysphagia after traumatic spinal injury and controlled studies to demonstrate the efficacy of swallowing interventions in this population.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Deglutition; Deglutition Disorders; Enteral Nutrition; Female; Humans; Male; Middle Aged; Physical Therapy Modalities; Spinal Injuries; Steroids; Young Adult
PubMed: 27412004
DOI: 10.1007/s00455-016-9728-4 -
International Journal of Environmental... Aug 2022Tongue pressure (TP) is used to assess tongue muscle strength and is related to function and frailty. While performing TP, it is necessary to elevate the tongue and oral...
Tongue pressure (TP) is used to assess tongue muscle strength and is related to function and frailty. While performing TP, it is necessary to elevate the tongue and oral floor by contracting the suprahyoid muscles. However, the association between TP and suprahyoid muscle strength remains unclear. Accordingly, this study investigated the relationship between TP and jaw-opening force (JOF), an indicator of suprahyoid muscle strength. This cross-sectional study included 88 independent community-dwelling participants aged ≥65 years. Age, sex, and the number of remaining teeth were recorded. Ultrasonography was used to evaluate the cross-sectional area of the tongue and geniohyoid muscle, as representatives of the suprahyoid muscles. Sarcopenia was diagnosed based on appendicular skeletal muscle mass index, handgrip strength, and gait speed. Multiple regression analysis was performed with TP as the dependent variable. TP was significantly associated with JOF (β = 0.371, = 0.003). This study revealed that decreased TP was associated with a decline in JOF and suprahyoid muscle mass in older adults. Thus, low TP may be associated with decreased JOF. Prevention of the weakness of the suprahyoid muscles and maintaining TP may also contribute to the prevention of frailty associated with TP.
Topics: Aged; Cross-Sectional Studies; Deglutition; Frailty; Hand Strength; Humans; Muscle Strength; Pressure; Tongue
PubMed: 36011461
DOI: 10.3390/ijerph19169825 -
Arquivos de Neuro-psiquiatria Dec 2019
Topics: Deglutition; Deglutition Disorders; Humans; Mutation; Prevalence; Spastic Paraplegia, Hereditary
PubMed: 31939579
DOI: 10.1590/0004-282X20190153 -
Respiratory Care Aug 2020
Topics: Amyotrophic Lateral Sclerosis; Deglutition; Deglutition Disorders; Humans; Respiration; Saliva
PubMed: 32712585
DOI: 10.4187/respcare.08298 -
Dysphagia Aug 2022In order to ensure appropriateness and feasibility of examination items for remote evaluation for deglutition disorders, a questionnaire based on the Delphi method was...
In order to ensure appropriateness and feasibility of examination items for remote evaluation for deglutition disorders, a questionnaire based on the Delphi method was administered to 122 speech-language-hearing therapists (STs), and a set of examination items was selected. The participants were instructed to view a video recording of a remote assessment situation and answer a 30-item questionnaire. Of 19 items ensuring the appropriateness for deglutition disorders detection, 13 items ultimately met the consensus criteria for remote feasibility. Factor analysis extracted three factors: 'oral observation,' 'overall evaluation,' and 'perceptual voice judgment.' In free-text responses, "quality and stability of the voice that may be heard through the device" were the most common concerns, followed by "the need to correct of the camera angle, magnification, and targets that should be projected," "concerns about the technical aspects of the assistants and their role in relation with the examiner/ST," and "the need for palpation as well as visual confirmation." The proposed 13-item examination is considered to capture the characteristics of deglutition disorders, while items that appeared difficult to implement remotely were excluded. The fact that some items could be influenced by the video calling experience when judging the feasibility of remote implementation, the acceptability of such items, is likely to increase in the future.
Topics: Consensus; Deglutition; Deglutition Disorders; Humans; Surveys and Questionnaires; Video Recording
PubMed: 34435239
DOI: 10.1007/s00455-021-10357-6 -
European Annals of Otorhinolaryngology,... Feb 2015Adjuvant radiotherapy after surgery or exclusive radiotherapy, with or without concurrent chemotherapy is a valuable treatment option in the great majority of patients... (Review)
Review
Adjuvant radiotherapy after surgery or exclusive radiotherapy, with or without concurrent chemotherapy is a valuable treatment option in the great majority of patients with head and neck cancer. Recent technical progress in radiotherapy has resulted in a decreased incidence of xerostomia. Another common toxicity of radiotherapy is dysphagia, which alters the nutritional status and quality of life of patients in remission. The objective of this review is to describe the physiology of swallowing function, the pathophysiology of radiation-induced dysphagia and the various strategies currently available to prevent this complication.
Topics: Deglutition; Deglutition Disorders; Head and Neck Neoplasms; Humans; Radiotherapy
PubMed: 24924114
DOI: 10.1016/j.anorl.2013.09.006 -
European Archives of... Mar 2023Voice training has been proposed as an intervention to improve swallowing function in patients with dysphagia. However, little is known about the effects of voice... (Review)
Review
BACKGROUND
Voice training has been proposed as an intervention to improve swallowing function in patients with dysphagia. However, little is known about the effects of voice training on swallowing physiology.
OBJECTIVES
This systematic review investigates the effect of voice training on the swallowing function of patients with oropharyngeal dysphagia and provides the theoretical basis for improving the swallowing function and life quality of patients with oropharyngeal dysphagia.
DATA SOURCES
A systematic review using a narrative synthesis approach of all published studies was sought with no date restrictions. Five electronic databases (EMBASE, PubMed, CINAHL, Web of Science, and The Cochrane Library) were searched from inception to April 2022.
STUDY SELECTION
Eight studies were included. Two researchers screened the literature according to inclusion and exclusion criteria, extracted data, and carried out quality control according to the Cochrane handbook5.1.0. Data were analyzed narratively and descriptively.
CONCLUSIONS
In general, statistically significant positive therapy effects were found. Voice training improves the oral and pharyngeal stages of swallowing in patients with neurological causes of dysphagia, such as stroke, and in patients with non-neurological causes of dysphagia, such as head and neck cancer. However, the current literature is limited and further primary research is required to provide more evidence to support voice training intervention in dysphagia. Future studies could further refine the content of voice training interventions, increase the number of patients enrolled, assess the long-term effects of voice training interventions and add associated assessments of the quality of life after treatment.
Topics: Humans; Deglutition Disorders; Quality of Life; Voice Training; Deglutition; Head and Neck Neoplasms
PubMed: 36342516
DOI: 10.1007/s00405-022-07719-7 -
Brazilian Journal of Otorhinolaryngology 2023
Topics: Humans; Deglutition; Deglutition Disorders; Endoscopy
PubMed: 37348438
DOI: 10.1016/j.bjorl.2023.101280