Abstract：
OBJECTIVE: Swallowing disorders are highly interrelated with increased morbidity and mortality rates; therefore, early detection is crucial. Most screening tools rely on subjective observation, thus making objective assessment tools more vital. Timed Water Swallowing Test (TWST) is a screening tool used in the field providing quantitative data. This study aimed to investigate the swallowing parameters in a wide age range by using TWST and to expand the already existing normative data pool accordingly. It is also aimed to examine the reliability of the TWST and assess its validity in stroke survivors.
METHODS: This study had a cross-sectional design. TWST carried out simultaneously along with surface EMG and laryngeal sensor on 196 healthy subjects aged 10 to 80 for normative data. Also, TWST carried out 30 patients having a history of recent stroke. Test-retest and inter-rater scoring analysis were used for reliability purposes, while Gugging Swallowing Screen (GUSS) test was used for validity purposes. Additionally, the correlations between the participants\' TWST scores and GUSS scores were examined using the Spearman correlation coefficient.
RESULTS: The normative TWST data of healthy participants are tabulated and presented and their average swallowing capacity was found 13.73 ml/s. Furthermore, the mean swallowing capacity of stroke survivors was found 4.61 ml/s. As a result of validity analyses, a statistically strong and significant relationship was found between GUSS and TWST parameters (r = 0.775, p < 0.001). Intraclass correlation coefficient (ICC) and correlation values were found between moderate to good agreement between test-retest measurement (ICC = 0.563 to 0.891, p < 0.05). Also, the agreement between the raters was found to be significant (ICC = 0.949 to 0.995, p < 0.05).
CONCLUSIONS: TWST is a valid and reliable screening tool to evaluate dysphagia on given population. Although the test\'s performance on healthy individuals is adequate, more research is still needed to confirm that it can be used as a screening tool for stroke.
METHODS: This study had a cross-sectional design. TWST carried out simultaneously along with surface EMG and laryngeal sensor on 196 healthy subjects aged 10 to 80 for normative data. Also, TWST carried out 30 patients having a history of recent stroke. Test-retest and inter-rater scoring analysis were used for reliability purposes, while Gugging Swallowing Screen (GUSS) test was used for validity purposes. Additionally, the correlations between the participants\' TWST scores and GUSS scores were examined using the Spearman correlation coefficient.
RESULTS: The normative TWST data of healthy participants are tabulated and presented and their average swallowing capacity was found 13.73 ml/s. Furthermore, the mean swallowing capacity of stroke survivors was found 4.61 ml/s. As a result of validity analyses, a statistically strong and significant relationship was found between GUSS and TWST parameters (r = 0.775, p < 0.001). Intraclass correlation coefficient (ICC) and correlation values were found between moderate to good agreement between test-retest measurement (ICC = 0.563 to 0.891, p < 0.05). Also, the agreement between the raters was found to be significant (ICC = 0.949 to 0.995, p < 0.05).
CONCLUSIONS: TWST is a valid and reliable screening tool to evaluate dysphagia on given population. Although the test\'s performance on healthy individuals is adequate, more research is still needed to confirm that it can be used as a screening tool for stroke.
摘要：
目的：吞咽障碍与发病率和死亡率的增加高度相关；因此，早期发现至关重要。大多数筛查工具依赖于主观观察，从而使客观评估工具更加重要。定时水吞咽测试(TWST)是在提供定量数据的领域中使用的筛选工具。本研究旨在通过使用TWST来调查大年龄范围内的吞咽参数，并相应地扩展现有的规范数据池。它还旨在检查TWST的可靠性并评估其在中风幸存者中的有效性。
方法：本研究采用横断面设计。TWST与表面肌电图和喉部传感器同时对196名10至80岁的健康受试者进行了规范数据。此外，TWST对30例有近期中风史的患者进行了研究。出于可靠性目的，使用了重测和评分者之间的评分分析，而GUSS测试用于有效性目的。此外,使用Spearman相关系数检验参与者的TWST评分和GUSS评分之间的相关性.
结果：列出健康参与者的标准TWST数据，发现他们的平均吞咽能力为13.73ml/s。此外，卒中幸存者的平均吞咽能力为4.61ml/s.作为有效性分析的结果，在GUSS和TWST参数之间发现了统计学上强烈且显著的关系(r=0.775,p<0.001).在重测测量之间发现了中等到良好的相关性之间的组内相关系数（ICC）和相关值（ICC=0.563至0.891，p<0.05）。此外，发现评估者之间的一致性是显著的(ICC=0.949至0.995，p<0.05)。
结论：TWST是评估特定人群吞咽困难的有效和可靠的筛查工具。虽然测试对健康个体的表现是足够的，仍需要更多的研究来确认它可以用作中风的筛查工具.
方法：本研究采用横断面设计。TWST与表面肌电图和喉部传感器同时对196名10至80岁的健康受试者进行了规范数据。此外，TWST对30例有近期中风史的患者进行了研究。出于可靠性目的，使用了重测和评分者之间的评分分析，而GUSS测试用于有效性目的。此外,使用Spearman相关系数检验参与者的TWST评分和GUSS评分之间的相关性.
结果：列出健康参与者的标准TWST数据，发现他们的平均吞咽能力为13.73ml/s。此外，卒中幸存者的平均吞咽能力为4.61ml/s.作为有效性分析的结果，在GUSS和TWST参数之间发现了统计学上强烈且显著的关系(r=0.775,p<0.001).在重测测量之间发现了中等到良好的相关性之间的组内相关系数（ICC）和相关值（ICC=0.563至0.891，p<0.05）。此外，发现评估者之间的一致性是显著的(ICC=0.949至0.995，p<0.05)。
结论：TWST是评估特定人群吞咽困难的有效和可靠的筛查工具。虽然测试对健康个体的表现是足够的，仍需要更多的研究来确认它可以用作中风的筛查工具.
