Comparison of Sequential Swallowing in Patients With Acute Stroke and Healthy Adults
Presented in part to the American Speech-Language-Hearing Association, November 20, 2008, Chicago, IL, and the Dysphagia Research Society, March 5, 2009, New Orleans, LA.
Abstract
Murguia M, Corey DM, Daniels SK. Comparison of sequential swallowing in patients with acute stroke and healthy adults.
Objectives
To compare hyolaryngeal complex (HLC) movement and leading-edge-of-the-bolus location patterns of sequential swallowing in patients with stroke and healthy adults, and to determine whether these patterns affect swallowing safety.
Design
Between-groups comparison.
Setting
Veterans hospital.
Participants
Consecutively admitted patients with acute unilateral supratentorial stroke (right hemisphere damage, n=13; left hemisphere damage, n=16) and age-matched healthy participants (n=25).
Interventions
Not applicable.
Main Outcome Measures
HLC movement pattern, bolus location, Penetration-Aspiration (P-A) Scale score.
Results
No significant group differences were observed for HLC movement pattern, bolus location, and P-A Scale score. Specific HLC movement patterns and bolus location were not associated with a higher P-A Scale score. A significant correlation between HLC movement pattern and bolus location was observed. Bolus location was typically inferior to the valleculae between swallows when the HLC was partially elevated. Across all groups, P-A Scale scores were significantly higher during sequential swallowing than single swallows.
Conclusions
HLC movement pattern and bolus location do not appear related to airway invasion, at least in persons without significant dysphagia. Given higher P-A Scale scores during sequential swallowing as compared with single swallows, sequential swallowing should always be evaluated in all patients.
aDepartment of Communication Sciences and Disorders, University of Houston, Houston, TX
bDepartment of Physical Medicine and Rehabilitation, Baylor College of Medicine and Michael E. DeBakey VA Medical Center, Houston, TX
cDepartment of Psychology, Tulane University, New Orleans, LA
Reprint requests to Stephanie K. Daniels, PhD, Rehab Research (153), Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd, Houston, TX 77030
Supported by the Department of Veterans Affairs, Rehabilitation Research and Development through career development grants (grants nos. B3019V, B4262K).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
ABSTRACT