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Journal of the Korean Academy of Rehabilitation Medicine 1999;23(6):1118-1126.
The Functional Dysphagia Scale Using Videofluoroscopic Swallowing Study in Stroke Patients.
Han, Tai Ryoon , Paik, Nam Jong , Park, Jin Woo
Department of Rehabilitation Medicine, Seoul National University College of Medicine.
비디오투시검사를 이용한 뇌졸중 환자의 기능적 연하곤란척도
한태륜, 백남종, 박진우
서울대학교 의과대학 재활의학교실
Abstract

Objective
Early detection and identification of the aspiration in stroke patients are essential for the prevention of respiratory complications. The purpose of this study is to develop a simple, easy-to-use, quantifiable functional dysphagia scale for stroke patients using videofluoroscopic swallowing study findings.


Method
Oral and pharyngeal videofluoroscopic swallowing study findings of a consecutive series of 103 stroke patients were analysed. Items of the functional dysphagia scale were determined by the polychotomous linear logistic regression analysis between videofluoroscopic findings and aspiration. The sensitivity and specificity of the scale, and correlation between the total score of the scale and aspiration grade were measured.


Results
The final scale included the following eleven items; The score of lip closure, bolus formation, residue in oral cavity, oral transit time, triggering of pharyngeal swallow, laryngeal elevation and epiglottic closure, nasal penetration, residue in valleculae, coating of pharyngeal wall after swallow, pharyngeal transit time. The sensitivity and specificity of the scale for detecting supraglottic penetration and subglottic aspiration were 81.0%, 70.7% and 78.1%, 77.9% respectively. The total score of the scale was significantly correlated with the severity of aspiration. (Spermann correlation coefficient r=0.58943, p=0.00001).


Conclusion
We developed functional dysphagia scale using videofluoroscopic swallowing study in stroke patients, which could be used as a simple, easy-to-use, quantifiable method to evaluate the severity of the dysphagia.

Key Words: Dysphagia, Evaluation, Videofluoroscopic study, Modified barium swallow study, Swallowing


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