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Logo for the Journal of Rehab R&D
Volume 43 Number 3, May/June 2006
Pages 347 — 356


Abstract - Dysphagia in stroke: Development of a standard method to examine swallowing recovery

Stephanie K. Daniels, PhD;1-2* Mae Fern Schroeder, BA;1 Maryellen McClain, PhD;2 David M. Corey, PhD;2-3 John C. Rosenbek, PhD;4-5 Anne L. Foundas, MD2,6

1Research Service, New Orleans Department of Veterans Affairs (VA) Medical Center (VAMC), New Orleans, LA; 2Department of Psychiatry and Neurology, Tulane University Health Sciences Center, New Orleans, LA; 3Department of Psychology, Tulane University, New Orleans, LA; 4Department of Communicative Disorders, University of Florida, Gainesville, FL; 5VA Rehabilitation Research and Development Brain Rehabilitation Research Center, Malcom Randall VAMC, Gainesville, FL; 6Neurology Service, New Orleans VAMC, New Orleans, LA
Abstract — This study began development of a standard method that uses the videofluoroscopic swallow study for evaluation of swallowing recovery after stroke based on a definition of dysphagia derived from three domains: bolus timing, bolus direction, and bolus clearance. Two experiments were conducted: one that defined normal versus disordered swallowing based on the range of scores in a sample of healthy adults (n = 13), and one that applied these thresholds to nine stroke patients to identify the presence of dysphagia. Results indicate that acute and protracted dysphagia may be more accurately detected by identifying abnormalities on multiple objective measures of swallowing rather than on laryngeal penetration or aspiration alone. Results indicate that our selected measures and use of healthy control subjects to establish normal thresholds may eventually contribute to the definition and differentiation of dysphagic and nondysphagic patients. Further research with a broader sample of healthy controls and stroke patients is mandatory.
Key words: aspiration, bolus clearance, bolus timing, deglutition, deglutition disorder, dysphagia, normal swallowing, Penetration-Aspiration Scale, rehabilitation, stroke, videofluoroscopic swallow study.

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