Clinical Utility of Swallowing Provocation Test and Water Swallowing Test in Stroke Patients.

, Kim, Ji Hoon; , Cheon, Seung Wook; , Ju, Sung Ryeol; , Lee, So Young; , Choi, In Sung; , Kim, Jae Hyung; , Lee, Sam Gyu

Original Article

Journal of the Korean Academy of Rehabilitation Medicine 2006;30(2):116-121.

Kim, Ji Hoon , Cheon, Seung Wook , Ju, Sung Ryeol , Lee, So Young , Choi, In Sung , Kim, Jae Hyung , Lee, Sam Gyu

¹Department of Physical Medicine & Rehabilitation, Chonnam National University Medical School, Korea. sam91@chonnam.ac.kr
²Chonnam National University Hwasun Hospital, Korea.

뇌졸중 환자에서 연하 유발 검사와 물 연하 검사의 임상적 유용성

김지훈, 천승욱, 주성렬, 이소영¹, 최인성, 김재형¹, 이삼규

전남대학교 의과대학 재활의학교실, ¹화순전남대학교병원 재활의학과

Abstract

Objective
To assess the clinical utility of the swallowing provocation test (SPT) and water swallowing test (WST) as a predictive factor of supraglottic penetration (SP) and subglottic aspiration (SA) in stroke patient with dysphagia.
Method
Fourty-one patients suffered from ischemic stroke with dysphagia and 20 normal controls were recruited. We performed 2-step SPT (0.4 ml, 2.0 ml) via nasopharyngeal tube and 2-step WST (10 ml, 30 ml) per oral, combined with the videofluoroscopic swallowing study (VFSS) to determine the presence of SP and SA.
Results
The cutoff values of the swallowing provocation latency in SPT for the detection of SP and SA were 2.45 sec, 2.75 sec (first step) and 2.25 sec, 2.34 sec (second step). For SPT, the sensitivity and specificity were 78.8%, 64.3% (first step) and 71.4%, 77.8% (second step) for the SP, and 77.8%, 76.7% (first step) and 75.0%, 66.7% (second step) for the SA. For WST, the sensitivity and specificity were 66.7%, 90.9% (first step) and 70.0%, 90.9% (second step) for the SP, and 61.1%, 56.5% (first step) and 72.2%, 60.9% (second step) for the SA.
Conclusion
SPT was more useful for the detection of SA than WST in stroke patient with dysphagia. (J Korean Acad Rehab Med 2006; 30: 116-121)

Key Words: Swallowing provocation test, Supraglottic penetration, Subglottic aspiration, Videofluoroscopic swallowing study