Objective
Dysphagia is a common clinical condition characterized by difficulty in swallowing. It is sub-classified into oropharyngeal dysphagia, which refers to problems in the mouth and pharynx, and esophageal dysphagia, which refers to problems in the esophageal body and esophagogastric junction. Dysphagia can have a significant negative impact one’s physical health and quality of life as its severity increases. Therefore, proper assessment and management of dysphagia are critical for improving swallowing function and preventing complications. Thus a guideline was developed to provide evidence-based recommendations for assessment and management in patients with dysphagia.
Methods
Nineteen key questions on dysphagia were developed. These questions dealt with various aspects of problems related to dysphagia, including assessment, management, and complications. A literature search for relevant articles was conducted using Pubmed, Embase, the Cochrane Library, and one domestic database of KoreaMed, until April 2021. The level of evidence and recommendation grade were established according to the Grading of Recommendation Assessment, Development and Evaluation methodology.
Results
Early screening and assessment of videofluoroscopic swallowing were recommended for assessing the presence of dysphagia. Therapeutic methods, such as tongue and pharyngeal muscle strengthening exercises and neuromuscular electrical stimulation with swallowing therapy, were effective in improving swallowing function and quality of life in patients with dysphagia. Nutritional intervention and an oral care program were also recommended.
Conclusion
This guideline presents recommendations for the assessment and management of patients with oropharyngeal dysphagia, including rehabilitative strategies.

Citations

• Using concept mapping to guide dysphagia service enhancements in Singapore: Recommendations from the speech-language pathology workforce
  Flora M.M Poon, Elizabeth C. Ward, Clare L. Burns
  International Journal of Speech-Language Pathology.2025; 27(1): 56.     CrossRef
• Cough Suppression Therapy in Patients With Chronic Refractory Cough and Oropharyngeal Dysphagia
  ShengYing A. Chen, Jessica F. Kim, Priya Krishna, Ethan Simmons, Brianna K. Crawley, Thomas Murry
  American Journal of Speech-Language Pathology.2025; 34(3): 1058.     CrossRef
• Characterization of Beverage Viscosity Based on the International Dysphagia Diet Standardisation Initiative and Its Correspondence to the Japanese Dysphagia Diet 2021
  Mari Nakao-Kato, Aya Takahashi, Jin Magara
  Nutrients.2025; 17(6): 1051.     CrossRef
• Factors influencing oropharyngeal dysphagia in individuals with chronic neurological disorders presenting to the outpatient swallowing disorder clinic
  Güleser Güney Yılmaz, Müberra Tanrıverdi, Remzi Doğan, Orhan Özturan
  Multiple Sclerosis and Related Disorders.2025; 97: 106387.     CrossRef
• The Efficacy of Outpatient Swallowing Therapy: A Retrospective Longitudinal Cohort Study
  Tyler W. Crosby, Sonja Molfenter, Matina Balou, Uche C. Ezeh, Milan R. Amin
  Dysphagia.2025;[Epub]     CrossRef
• The Role of Dysphagia on Head and Neck Cancer Patients’ Quality of Life, Functional Disabilities and Psychological Distress: Outcomes of Cancer Rehabilitation from an Observational Single-Center Study
  Špela Matko, Christina Knauseder, David Riedl, Vincent Grote, Michael J. Fischer, Samuel Moritz Vorbach, Karin Pfaller-Frank, Wilhelm Frank, Thomas Licht
  Current Oncology.2025; 32(4): 220.     CrossRef
• The impact of physical therapy on dysphagia in neurological diseases: a review
  Kun Li, Cuiyuan Fu, Zhen Xie, Jiajia Zhang, Chenchen Zhang, Rui Li, Caifeng Gao, Jiahui Wang, Chuang Xue, Yuebing Zhang, Wei Deng
  Frontiers in Human Neuroscience.2024;[Epub]     CrossRef
• Clinical Characteristics and Evaluation of Dysphagia in Patients with Parkinson’s Disease
  Seo Jung Yun, Han Gil Seo
  Journal of the Korean Dysphagia Society.2024; 14(1): 10.     CrossRef
• Updated Clinical Practice Guidelines for the Diagnosis and Management of Long COVID
  Jun-Won Seo, Seong Eun Kim, Yoonjung Kim, Eun Jung Kim, Tark Kim, Taehwa Kim, So Hee Lee, Eunjung Lee, Jacob Lee, Yu Bin Seo, Young-Hoon Jeong, Young Hee Jung, Yu Jung Choi, Joon Young Song
  Infection & Chemotherapy.2024; 56(1): 122.     CrossRef
• Association between the C-reactive protein/albumin ratio and mortality in older Japanese patients with dysphagia
  Chunhong Guo, Pingping Zheng, Shiyang Chen, Lin Wei, Xiuzhen Fu, Youyuan Fu, Tianhong Hu, Shaohua Chen
  Frontiers in Nutrition.2024;[Epub]     CrossRef
• Compensatory strategies of dysphagia after anterior cervical spinal surgery: A case report
  Sung Joon Chung, Jun Ho Lee, Yunsoo Soh
  Medicine.2024; 103(29): e39016.     CrossRef
• The Right ICD Code, Right Now: A Call to Action for Pragmatic Language Disorders After Right Hemisphere Stroke
  Jamila Minga, Shanika Phillips Fullwood, Deborah Rose, Danai Kasambira Fannin
  American Journal of Speech-Language Pathology.2024; 33(6): 3121.     CrossRef
• Dysphagia Screening in Residential Long-Term Care Settings in the Republic of Ireland: A Cross-Sectional Survey
  Constantino Estupiñán Artiles, Claire Donnellan, Julie Regan, Mary Mooney
  Dysphagia.2024;[Epub]     CrossRef
• Dysphagia and Dysphonia After Head and Neck Cancer
  Aaron Parsons, Karuna Dewan
  Oral Diseases.2024;[Epub]     CrossRef
• The pathophysiology of dysphagia post‐lung transplant: A systematic review
  Sana Smaoui, Elly Cummins, Maryah Mena, Summer Scott, Rodrigo Tobar‐Fredes
  Laryngoscope Investigative Otolaryngology.2024;[Epub]     CrossRef
• Effect of segmental tongue function training on tongue pressure attributes in individuals with dysphagia after receiving radiotherapy for nasopharyngeal carcinoma
  Fei Zhao, Chen Yang, Si-Ming Sun, Yao-Wen Zhang, Hong-Mei Wen, Zu-Lin Dou, Xiao-Mei Wei, Chun-Qing Xie
  BMC Oral Health.2024;[Epub]     CrossRef
• Diagnosis and treatment of dysphagia
  Kyoung Hyo Choi
  Journal of the Korean Medical Association.2023; 66(10): 604.     CrossRef

Objective
To utilize pulmonary function parameters as predictive factors for dysphagia in individuals with cervical spinal cord injuries (CSCIs).
Methods
Medical records of 78 individuals with CSCIs were retrospectively reviewed. The pulmonary function was evaluated using spirometry and peak flow meter, whereas the swallowing function was assessed using a videofluoroscopic swallowing study. Participants were divided into the non-penetration-aspiration group (score 1 on the Penetration-Aspiration Scale [PAS]) and penetration-aspiration group (scores 2–8 on the PAS). Individuals with pharyngeal residue grade scores >1 were included in the pharyngeal residue group.
Results
The mean age was significantly higher in the penetration-aspiration and pharyngeal residue groups. In this study, individuals with clinical features, such as advanced age, history of tracheostomy, anterior surgical approach, and higher neurological level of injury, had significantly more penetration-aspiration or pharyngeal residue. Individuals in the penetration-aspiration group had significantly lower peak cough flow (PCF) levels. Individuals in the pharyngeal residue group had a significantly lower forced expiratory volume in 1 second (FEV1). According to the receiver operating characteristic curve analysis of PCF and FEV1 on the PAS, the cutoff value was 140 L/min and 37.5% of the predicted value, respectively.
Conclusion
Low PCF and FEV1 values may predict the risk of dysphagia in individuals with CSCIs. In these individuals, active evaluation of swallowing is recommended to confirm dysphagia.

Citations

• Methods of diagnosis and rehabilitation of dysphagia in patients with spinal cord injury: a systematic review
  Roberta ZUPO, Beatrice POGGI, Nicole CAGGIANO, Giulio VARRONE, Fabio CASTELLANA, Silvia NATOLI, Rodolfo SARDONE, Antonio NARDONE, Chiara PAVESE
  European Journal of Physical and Rehabilitation Medicine.2025;[Epub]     CrossRef
• Pulmonary function and sarcopenia as predictors of dysphagia in cervical spinal cord injury
  Su Ji Lee, Ji Cheol Shin
  Spinal Cord.2024; 62(1): 42.     CrossRef
• Evaluation of clinical factors predicting dysphagia in patients with traumatic and non-traumatic cervical spinal cord injury: a retrospective study
  Jin-Woo Choi, Dae Yeong Kim, Sun Young Joo, Donghwi Park, Min Cheol Chang
  Frontiers in Neurology.2024;[Epub]     CrossRef
• Coordination Between Respiration and Swallowing in Patients With Dysphagia After Cervical Spinal Cord Injury: An Observational Case–Control Study
  Xuluan Xu, Qingsu Zhang, Yongqi Xie, Degang Yang, Feng Gao, Yongxue Yuan, Yu Zhang, Jianjun Li
  American Journal of Speech-Language Pathology.2024; 33(5): 2572.     CrossRef
• Flujo máximo de tos y evaluación de la deglución: Una revisión de literatura
  Amalia Nanjarí R , María del Carmen Campos
  Revista Científica Signos Fónicos.2024; 10(1): 7.     CrossRef
• Voluntary Cough Testing as a Clinical Indicator of Airway Protection in Cervical Spinal Cord Injury
  Laura Pitts, Valerie K. Hamilton, Erin A. Walaszek, Stephanie Watts, Leora R. Cherney
  The Laryngoscope.2023; 133(6): 1434.     CrossRef
• Association between Anterior Surgical Approach and Dysphagia Severity in Patients with Cervical Spinal Cord Injury
  Min Cheol Chang, Dae Yeong Kim, Jin-Woo Choi, Ho Yong Choi, Jin-Sung Park, Donghwi Park
  Journal of Clinical Medicine.2023; 12(9): 3227.     CrossRef
• Successful Continuation of Oral Intake in a Dysphagic and Tetraplegic Patient With Alternate Right and Left Complete Lateral Decubitus Positions in Rehabilitation
  Yoshinori Maki, Mayumi Takagawa, Akio Goda, Junichi Katsura, Ken Yanagibashi
  Cureus.2023;[Epub]     CrossRef
• Laryngeal and swallow dysregulation following acute cervical spinal cord injury
  Teresa Pitts, Kimberly E. Iceman, Alyssa Huff, M. Nicholas Musselwhite, Michael L. Frazure, Kellyanna C. Young, Clinton L. Greene, Dena R. Howland
  Journal of Neurophysiology.2022; 128(2): 405.     CrossRef