Profiles of Swallowing Impairment in a Cohort of Patients With Reduced Tongue Strength Within 3 Months of Cerebral Ischemic Stroke.

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...

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Publicado en:Journal of Speech, Language & Hearing Research Vol. 65; no. 7; pp. 2399 - 2412
Autores principales: Smaoui, Sana, Peladeau-Pigeon, Melanie, Mancopes, Renata, Sutton, Danielle, Richardson, Denyse, Steelea, Catriona M.
Formato: Artículo
Publicado: American Speech-Language-Hearing Association Jul2022
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Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jul2022
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      pub: American Speech-Language-Hearing Association
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        10.1044/2022_JSLHR-21-00586
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        atl: Profiles of Swallowing Impairment in a Cohort of Patients With Reduced Tongue Strength Within 3 Months of Cerebral Ischemic Stroke.
      aug:
        au:
          Smaoui, Sana
          Peladeau-Pigeon, Melanie
          Mancopes, Renata
          Sutton, Danielle
          Richardson, Denyse
          Steelea, Catriona M.
        affil:
          Swallowing Rehabilitation Research Laboratory, KITE, Toronto Rehabilitation Institute, University Health Network, Ontario, Canada
          Interprofessional Practice Based Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Canada
          Department of Medicine, Division of Physiatry, Temerty Faculty of Medicine, University of Toronto, Ontario, Canada
          Department of Physical Medicine and Rehabilitation, Toronto Rehabilitation Institute, University Health Network, Ontario, Canada
          Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Ontario, Canada
      su:
        Stroke
        Human research subjects
        Informed consent (Medical law)
        Statistics
        Confidence intervals
        Time
        Tongue
        Deglutition disorders
        Acquisition of data
        Functional assessment
        Fluoroscopy
        Medical records
        Intraclass correlation
        Descriptive statistics
        Research funding
        Data analysis
        Cerebral ischemia
        Longitudinal method
        Disease complications
      sug:
        subj:
          Stroke
          Human research subjects
          Informed consent (Medical law)
          Statistics
          Confidence intervals
          Time
          Tongue
          Deglutition disorders
          Acquisition of data
          Functional assessment
          Fluoroscopy
          Medical records
          Intraclass correlation
          Descriptive statistics
          Research funding
          Data analysis
          Cerebral ischemia
          Longitudinal method
          Disease complications
      ab: 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 = 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.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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