Profiles of Swallowing Impairment in a Cohort of Patients with Reduced Tongue Strength within 3 Months of Cerebral Ischemic Stroke
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| Title: | Profiles of Swallowing Impairment in a Cohort of Patients with Reduced Tongue Strength within 3 Months of Cerebral Ischemic Stroke |
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| Language: | English |
| Authors: | Smaoui, Sana (ORCID |
| Source: | Journal of Speech, Language, and Hearing Research. Jul 2022 65(7):2399-2411. |
| Availability: | American Speech-Language-Hearing Association. 2200 Research Blvd #250, Rockville, MD 20850. Tel: 301-296-5700; Fax: 301-296-8580; e-mail: slhr@asha.org; Web site: http://jslhr.pubs.asha.org |
| Peer Reviewed: | Y |
| Page Count: | 13 |
| Publication Date: | 2022 |
| Sponsoring Agency: | National Institute on Deafness and Other Communication Disorders (NIDCD) (DHHS/NIH) |
| Contract Number: | R01DC011020 |
| Document Type: | Journal Articles Reports - Research |
| Descriptors: | Physical Disabilities, Speech Language Pathology, Patients, Human Body, Neurological Impairments, Brain, Motor Reactions, Older Adults, Physiology |
| DOI: | 10.1044/2022_JSLHR-21-00586 |
| ISSN: | 1092-4388 1558-9102 |
| Abstract: | Purpose: Patients with poststroke dysphagia may experience inefficient bolus clearance or inadequate airway protection. Following a stroke, impairments in lingual pressure generation capacity are thought to contribute to oropharyngeal dysphagia. The goal of our study was to determine whether similar profiles of swallowing impairment would be seen across a cohort of patients with reduced tongue strength within 3 months after cerebral ischemic stroke. Method: The sample comprised six adults with reduced tongue strength (i.e., maximum anterior isometric pressure < 40 kPa). Participants underwent a videofluoroscopy according to a standard protocol. Post hoc blinded ratings were completed using the Analysis of Swallowing Physiology: Events, Kinematics and Timing Method and coded as "typical" versus "atypical" (i.e., within vs. outside the healthy interquartile range) in comparison to published reference values. Results: The videofluoroscopies suggested that having reduced tongue strength did not translate into a common profile. Of the six participants, two showed Penetration-Aspiration Scale (PAS) scores of [greater than or equal to] 3 on thin liquids, associated with incomplete laryngeal vestibule closure (LVC). Another two participants displayed PAS scores of 2 (transient penetration), but these were not associated with incomplete LVC. Pharyngeal residue, above the healthy 75th percentile, was seen for three participants. Five participants presented with atypical reductions in hyoid XY peak position. Conclusions: In this cohort of adults within 3 months of cerebral ischemic stroke, reductions in tongue strength presented alongside a variety of changes in swallowing physiology. There was no straightforward relationship linking reduced tongue strength to particular patterns of impairment on videofluoroscopy. |
| Abstractor: | As Provided |
| Entry Date: | 2022 |
| Accession Number: | EJ1355733 |
| Database: | ERIC |
| Abstract: | Purpose: Patients with poststroke dysphagia may experience inefficient bolus clearance or inadequate airway protection. Following a stroke, impairments in lingual pressure generation capacity are thought to contribute to oropharyngeal dysphagia. The goal of our study was to determine whether similar profiles of swallowing impairment would be seen across a cohort of patients with reduced tongue strength within 3 months after cerebral ischemic stroke. Method: The sample comprised six adults with reduced tongue strength (i.e., maximum anterior isometric pressure < 40 kPa). Participants underwent a videofluoroscopy according to a standard protocol. Post hoc blinded ratings were completed using the Analysis of Swallowing Physiology: Events, Kinematics and Timing Method and coded as "typical" versus "atypical" (i.e., within vs. outside the healthy interquartile range) in comparison to published reference values. Results: The videofluoroscopies suggested that having reduced tongue strength did not translate into a common profile. Of the six participants, two showed Penetration-Aspiration Scale (PAS) scores of [greater than or equal to] 3 on thin liquids, associated with incomplete laryngeal vestibule closure (LVC). Another two participants displayed PAS scores of 2 (transient penetration), but these were not associated with incomplete LVC. Pharyngeal residue, above the healthy 75th percentile, was seen for three participants. Five participants presented with atypical reductions in hyoid XY peak position. Conclusions: In this cohort of adults within 3 months of cerebral ischemic stroke, reductions in tongue strength presented alongside a variety of changes in swallowing physiology. There was no straightforward relationship linking reduced tongue strength to particular patterns of impairment on videofluoroscopy. |
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| ISSN: | 1092-4388 1558-9102 |
| DOI: | 10.1044/2022_JSLHR-21-00586 |
