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http://dx.doi.org/10.5762/KAIS.2019.20.7.36

Characteristics of the Oropharyngeal Swallowing Impairment in Stroke Patient using the Modified Barium Swallowing Impairment Profile  

Im, Ikjae (Graduate Program in Speech-Language Pathology, Yonsei University)
Publication Information
Journal of the Korea Academia-Industrial cooperation Society / v.20, no.7, 2019 , pp. 36-44 More about this Journal
Abstract
Swallowing impairment is a frequent complication following stroke. The characteristics of swallowing impairment with stork patient can facilitate identification of individuals at risk of dysphagia would be of great helpful. The present study examined oropharyngeal swallowing impairment with subacute stroke patients using the Modified Barium Swallowing Impairment Profile(MBSImP). The 49 consecutive patients with the supratentorial stroke met inclusion criteria for the present study. A retrospective review was performed of patients who underwent the videofluoroscopic swallowing study(VFSS). Of Stroke patients, 95.9% exhibited abnormal function of lip closure. 98% and 57.1 % shown abnormal tongue function and lingual motion, respectively. Oral residue was present in 51% and delayed pharyngeal response was present in 89.9%. In addition, abnormal laryngeal and hyoid excursion was seen in 42.9% and 87.8%, respectively. Abnormal function of soft palate elevation was present in 18.4% and abnormal epiglottic movement was seen in 4.1%. 30.6% of 30.6% of these patients exhibited abnormal laryngeal closure. All of the stroke patients(100%) in this study exhibited abnormal pharyngeal stripping wave and pharyngoesophageal segment opening. Abnormal tongue base retraction and oral reside were present 91.8%, respectively. The results suggest that stroke patient is more likely to exhibit reduced swallowing functions including lip closure, tongue control, initiation of pharyngeal swallow, anterior hyoid motion, tongue base retraction, pharyngeal residue and pharyngoesophageal contraction. Therefore, these data could provide valid and precise information regarding physiological evidence to delineate symptoms of dysphagia in this stroke cohort. Future studies should explore the bolus effect in the swallowing impairment.
Keywords
Stroke; Deglutition; Deglutition Disorders; Fluoroscopy; Modified Barium Swallow;
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1 P. J. Kahrilas, S. Lin, A. W. Rademaker, and J. A. Logemann, "Impaired deglutitive airway protection: a videofluoroscopic analysis of severity and mechanism," Gastroenterology, vol. 113, no. 5, pp. 1457-64, Nov, 1997. DOI: http://doi.org/10.1053/gast.1997.v113.pm9352847   DOI
2 A. L. Perlman, B. M. Booth, and J. P. Grayhack, "Videofluoroscopic predictors of aspiration in patients with oropharyngeal dysphagia," Dysphagia, vol. 9, no. 2, pp. 90-5, Spring, 1994. DOI: http://doi.org/10.1007/BF00714593   DOI
3 M. L. Power, S. Hamdy, S. Singh, P. J. Tyrrell, I. Turnbull, and D. G. Thompson, "Deglutitive laryngeal closure in stroke patients," J Neurol Neurosurg Psychiatry, vol. 78, no. 2, pp. 141-6, Feb, 2007. DOI: http://doi.org/10.1136/jnnp.2006.101857   DOI
4 B. Martin-Harris,, M. BBrodsky,., YMichel,., D. O.Castell,, M.Schleicher,, , J.Sandidge, & , J Blair. MBS measurement tool for swallow impairment-MBSImp: establishing a standard. Dysphagia, 23(4), 392-405. 2008. DOI: http://doi.org/10.1007/s00455-008-9185-9   DOI
5 I. Im, J. P. Jun, M. A. Crary, G. D. Carnaby, and K. H. Hong, "Longitudinal Kinematic Evaluation of Pharyngeal Swallowing Impairment in Thyroidectomy Patients," Dysphagia, vol. 34, no. 2, pp. 161-169, Apr, 2019. DOI: https://doi.org/10.1007/s00455-018-9949-9   DOI
6 I. Im,, & , M.-H.Ko. Dysphagia and Oral Function in Chronic Stoke Patient: 3 Months Follow up Study. Journal of Rehabilitation Research, 22(1), 141-156. 2018. DOI:http://doi.org/10.16884/jrr.2018.22.1.141   DOI
7 S. K. Daniels, , S.Pathak, , S. V.Mukhi, C. B.Stach,, R. O.Morgan,, & J. A. Anderson. The relationship between lesion localization and dysphagia in acute stroke. Dysphagia, 32(6), 777-784. 2017. DOI: http://doi.org/10.1007/s00455-017-9824-0   DOI
8 P. Clave, M. de Kraa, V. Arreola, M. Girvent, R. Farre, E. Palomera, and M. Serra-Prat, "The effect of bolus viscosity on swallowing function in neurogenic dysphagia," Aliment Pharmacol Ther, vol. 24, no. 9, pp. 1385-94, Nov 1, 2006. DOI: http://doi.org/10.1111/j.1365-2036.2006.03118.x   DOI
9 I. Im, Y. Kim, E. Oommen, H. Kim, and M. H. Ko, "The Effects of Bolus Consistency in Pharyngeal Transit Duration during Normal Swallowing," Ann Rehabil Med, vol. 36, no. 2, pp. 220-5, Apr, 2012. DOI: http://doi.org/10.5535/arm.2012.36.2.220   DOI
10 Y. Y. Jang, S. J. Lee, J. Y. Jeon, and S. J. Lee, "Analysis of video fluoroscopic swallowing study in patients with vocal cord paralysis," Dysphagia, vol. 27, no. 2, pp. 185-90, Jun, 2012. DOI: http://doi.org/10.1007/s00455-011-9351-3   DOI
11 J. Schmidt, M. Holas, K. Halvorson, and M. Reding, "Videofluoroscopic evidence of aspiration predicts pneumonia and death but not dehydration following stroke," Dysphagia, vol. 9, no. 1, pp. 7-11, Winter, 1994. DOI: http://doi.org/10.1007/BF00262752   DOI
12 K. A. Kendall, S. McKenzie, R. J. Leonard, M. I. Goncalves, and A. Walker, "Timing of events in normal swallowing: a videofluoroscopic study," Dysphagia, vol. 15, no. 2, pp. 74-83, Spring, 2000. DOI: http://doi.org/10.1007/s004550010004   DOI
13 H. Abe, and A. Tsubahara, "Observation of arytenoid movement during laryngeal elevation using videoendoscopic evaluation of swallowing," Dysphagia, vol. 26, no. 2, pp. 150-4, Jun, 2011. DOI: http://doi.org/10.1007/s00455-010-9285-1   DOI
14 J. C. Rosenbek, J. A. Robbins, E. B. Roecker, J. L. Coyle, and J. L. Wood, "A penetration-aspiration scale," Dysphagia, vol. 11, no. 2, pp. 93-8, Spring, 1996. DOI: http://doi.org/10.1007/BF00417897   DOI
15 T. R. Han, , N. J.Paik,, & , J. W. Park. The functional dysphagia scale using videofluoroscopic swallowing study in stroke patients. Journal of Korean Academy of Rehabilitation Medicine, 23(6), 1118-1126. 1999.
16 J. Kim,, B. M.Oh,, J. Y Kim,., G. J. Lee,, S. A.Lee,, & , T. R. Han. Validation of the videofluoroscopic dysphagia scale in various etiologies. Dysphagia, 29(4), 438-443. 2014. DOI: http://doi.org/10.1007/s00455-014-9524-y   DOI
17 R. Martino, N. Foley, S. Bhogal, N. Diamant, M. Speechley, and R. Teasell, "Dysphagia after stroke: incidence, diagnosis, and pulmonary complications," Stroke, vol. 36, no. 12, pp. 2756-63, Dec, 2005. DOI: http://doi.org/10.1161/01.STR.0000190056.76543.eb   DOI
18 G. Mann, G. J. Hankey, and D. Cameron, "Swallowing disorders following acute stroke: prevalence and diagnostic accuracy," Cerebrovasc Dis, vol. 10, no. 5, pp. 380-6, Sep-Oct, 2000. DOI: http://doi.org/10.1159/000016094   DOI
19 S. Kumar, M. H. Selim, and L. R. Caplan, "Medical complications after stroke," Lancet Neurol, vol. 9, no. 1, pp. 105-18, Jan, 2010. DOI: http://doi.org/10.1016/S1474-4422(09)70266-2   DOI
20 I. Im, H. Kim,H.-G Kim, ., & M.-H. Ko, Relationship between Temporal Measurements of Pharyngeal Swallowing and Penetration-Aspiration in Unilateral Stroke Patients. Communication Sciences & Disorders, 22(3), 570-577. 2017. DOI: http://doi.org/10.12963/csd.17410   DOI
21 K. Mosier, R. Patel, W. C. Liu, A. Kalnin, J. Maldjian, and S. Baredes, "Cortical representation of swallowing in normal adults: functional implications," Laryngoscope, vol. 109, no. 9, pp. 1417-23, Sep, 1999. DOI: http://doi.org/10.1097/00005537-199909000-00011   DOI
22 J. A. Logemann, B. R. Pauloski, A. W. Rademaker, L. A. Colangelo, P. J. Kahrilas, and C. H. Smith, "Temporal and biomechanical characteristics of oropharyngeal swallow in younger and older men," J Speech Lang Hear Res, vol. 43, no. 5, pp. 1264-74, Oct, 2000. DOI: http://doi.org/10.1044/jslhr.4305.1264   DOI
23 I. Im, J. P. Jun, S. Hwang, and M. H. Ko, "Swallowing outcomes in patients with subcortical stroke associated with lesions of the caudate nucleus and insula," J Int Med Res, vol. 46, no. 9, pp. 3552-3562, Sep, 2018. DOI: http://doi.org/10.1177/0300060518775290.   DOI
24 S. L. Hamlet, J. Muz, R. Patterson, and L. Jones, "Pharyngeal transit time: assessment with videofluoroscopic and scintigraphic techniques," Dysphagia, vol. 4, no. 1, pp. 4-7, 1989. DOI: http://doi.org/10.1007/BF02407396   DOI
25 S. Hamdy, D. J. Mikulis, A. Crawley, S. Xue, H. Lau, S. Henry, and N. E. Diamant, "Cortical activation during human volitional swallowing: an event-related fMRI study," Am J Physiol, vol. 277, no. 1 Pt 1, pp. G219-25, Jul, 1999. DOI: http://doi.org/10.1152/ajpgi.1999.277.1.G219   DOI
26 R. Shaker, W. J. Dodds, R. O. Dantas, W. J. Hogan, and R. C. Arndorfer, "Coordination of deglutitive glottic closure with oropharyngeal swallowing," Gastroenterology, vol. 98, no. 6, pp. 1478-84, Jun, 1990. DOI: http://doi.org/10.1016/0016-5085(90)91078-K   DOI
27 S. K. Daniels, K. Brailey, D. H. Priestly, L. R. Herrington, L. A. Weisberg, and A. L. Foundas, "Aspiration in patients with acute stroke," Arch Phys Med Rehabil, vol. 79, no. 1, pp. 14-9, Jan, 1998. DOI: http://doi.org/10.1016/S0003-9993(98)90200-3   DOI
28 R. O. Dantas, W. J. Dodds, B. T. Massey, and M. K. Kern, "The effect of high- vs low-density barium preparations on the quantitative features of swallowing," AJR Am J Roentgenol, vol. 153, no. 6, pp. 1191-5, Dec, 1989. DOI: http://doi.org/10.2214/ajr.153.6.1191   DOI
29 Y. Inamoto, E. Saitoh, S. Okada, H. Kagaya, S. Shibata, K. Ota, M. Baba, N. Fujii, K. Katada, P. Wattanapan, and J. B. Palmer, "The effect of bolus viscosity on laryngeal closure in swallowing: kinematic analysis using 320-row area detector CT," Dysphagia, vol. 28, no. 1, pp. 33-42, Mar, 2013. DOI: http://doi.org/10.1007/s00455-012-9410-4   DOI
30 K. V.Kuhlemeier,, , J. B.Palmer, & , D. Rosenberg. Effect of liquid bolus consistency and delivery method on aspiration and pharyngeal retention in dysphagia patients. Dysphagia, 16(2), 119-122. 2001. DOI: http://doi.org/10.1007/s004550011003   DOI
31 J. H., Martin, B. Diamond,, J. E.Aviv, , R. L.Sacco, , M. S. Keen,, & D. Z. A. Blitzer, Supraglottic and pharyngeal sensory abnormalities in stroke patients with dysphagia. Annals of Otology, Rhinology & Laryngology, 105(2), 92-97. 1996. DOI: http://doi.org/10.1177/000348949610500202   DOI
32 W. G. Pearson, Jr., S. E. Langmore, L. B. Yu, and A. C. Zumwalt, "Structural analysis of muscles elevating the hyolaryngeal complex," Dysphagia, vol. 27, no. 4, pp. 445-51, Dec, 2012. DOI: http://doi.org/10.1007/s00455-011-9392-7   DOI
33 P. Jacob, P. J.Kahrilas,, J. A. Logemann,, , V.Shah, & T.Ha, . Upper esophageal sphincter opening and modulation during swallowing. Gastroenterology, 97(6), 1469-1478. 1989. DOI: http://doi.org/10.1016/0016-5085(89)90391-0   DOI
34 J. G. Kennedy, 3rd, and R. D. Kent, "Physiological substrates of normal deglutition," Dysphagia, vol. 3, no. 1, pp. 24-37, 1988 DOI: http://doi.org/10.1007/BF02406277   DOI