Swallowing efficiency

  • 文章类型: Journal Article
    在口咽吞咽困难(OD)患者的日常护理中,广泛使用质地改良食物(TMF)。然而,TMF已被证明对患者的生活质量有负面影响。遵守率很低,在已经脆弱的患者人群中增加营养不良和误入歧途的风险。这项探索性研究的目的是深入了解在果泥食物中添加颗粒对舌头强度的可行性,OD患者的吞咽安全性和有效性。十名患有OD的成年参与者吞下了三种不同的推注。Bolus1由无粒子组成(IDDSI级别4),在推注2和3中添加较小和较大的颗粒。使用Iowa口腔性能仪器(IOPI)测量吞咽期间的舌强度(Pswal)。在通过PAS量表和Pooling评分进行吞咽的光纤内窥镜评估过程中,对吞咽安全性(渗透和抽吸)和吞咽效率(残留)进行了量化。进行RMAnova和Friedman试验以分析推注对结果参数的影响。测量到推注类型对Pswal没有显着影响。三种不同丸剂之间的PAS和Pooling评分都没有显着差异。在吞咽任何带有颗粒的推注期间从未观察到抽吸。这项初步研究表明,在泥状食品中添加颗粒对Pswal没有影响,OD患者的吞咽效率或安全性。该创新项目是探索TMF超越丸量的特征的研究的第一步,粘度和温度。
    The use of texture modified food (TMF) is widely spread in the daily care of patients with oropharyngeal dysphagia (OD). However, TMF have been shown to have a negative impact on the patients\' quality of life. Adherence rates are low, increasing the risk of malnutrition and aspiration in an already vulnerable patient population. The aim of this exploratory study was to gain insight in the feasibility of adding particles to pureed food on tongue strength, swallowing safety and efficiency in patients with OD. Ten adult participants with OD swallowed three different boluses. Bolus 1 consisted of no particles (IDDSI level 4), small and bigger particles were added in bolus 2 and 3. Tongue strength during swallowing (Pswal) was measured using the Iowa Oral Performance Instrument (IOPI). Swallow safety (penetration and aspiration) and swallow efficiency (residu) were quantified during fiberoptic endoscopic evaluation of swallowing by means of the PAS scale and Pooling score. RM Anova and Friedman tests were performed for analyzing the impact of bolus on the outcome parameters. No significant effect of bolus type on Pswal was measured. Neither the PAS nor the Pooling score differed significantly between the three different boluses. Aspiration was never observed during swallowing any bolus with particles. This preliminary study shows that the addition of particles to pureed food had no impact on Pswal, swallowing efficiency or safety in patients with OD. This innovative project is the first step in research to explore the characteristics of TMF beyond bolus volume, viscosity and temperature.
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  • 文章类型: Journal Article
    神经源性吞咽困难会导致营养不良等并发症,脱水,和吸入性肺炎。因此,早期检测与临床有效的工具是至关重要的。这项研究旨在研究进食评估工具-10(EAT-10)在神经性吞咽困难的三种不同一致性下检测吞咽效率的能力。
    112例神经性吞咽困难患者(男74例,女38例,平均±SD年龄61.83±9.72岁)纳入研究。在EAT-10之后,在诊所进行了纤维内窥镜吞咽评估(FEES),以评估国际吞咽困难饮食标准化计划(IDDSI)0、3和7的吞咽功效。使用耶鲁咽部残留严重程度评定量表(YPRSRS)评估患者的吞咽效率。曲线下面积,灵敏度,计算特异性值,以评估EAT-10区分有残留和无残留参与者以及有中重度残留和无残留参与者的能力.
    EAT-10显着检测到有和没有三个IDDSI残留的参与者一致:对于IDDSI0残留在谷类和梨状窦(截止分数≥14,p<0.001),对于谷型和梨状窦中的IDDSI3残基(截止分数≥13,p<0.001),对于谷型和梨状窦中的IDDSI7残基(分别,截止分数≥13,截止分数≥14,p<0.001)。此外,EAT-10显着检测到有和没有中度至重度残留物的人。
    经常用于吞咽诊所的EAT-10,可以确定患有神经性吞咽困难的个体的吞咽效率。此外,它有能力检测中度至重度咽部残留物。
    UNASSIGNED: Neurogenic dysphagia causes complications such as malnutrition, dehydration, and aspiration pneumonia. Therefore, early detection with clinically valid tools is essential. This study aimed to investigate the Eating Assessment Tool-10 (EAT-10) ability to detect swallowing efficiency at three different consistencies in neurogenic dysphagia.
    UNASSIGNED: One hundred twelve patients with neurogenic dysphagia (74 males and 38 females, mean ± SD age 61.83 ± 9.72 years) were included in the study. A Fiberoptic Endoscopic Evaluation of Swallowing (FEES) was performed in the clinic following EAT-10 to assess swallowing efficacy at International Dysphagia Diet Standardization Initiative (IDDSI) consistencies of 0, 3, and 7. The swallowing efficiency of the patients was assessed using the Yale Pharyngeal Residue Severity Rating Scale (YPRSRS). Area under the curve, sensitivity, and specificity values were calculated to evaluate the ability of EAT-10 to discriminate between participants with and without residue and between participants with and without moderate-to-severe residue.
    UNASSIGNED: The EAT-10 significantly detected participants with and without residues for three IDDSI consistent: for IDDSI 0 residue in the vallecula and pyriform sinus (cutoff score ≥ 14, p < 0.001), for IDDSI 3 residue in the vallecula and pyriform sinus (cutoff score ≥ 13, p < 0.001), for IDDSI 7 residue in the vallecula and pyriform sinus (respectively, cutoff score ≥ 13, cutoff score ≥ 14, p < 0.001). Additionally, the EAT-10 significantly detected those with and without moderate-to-severe residue.
    UNASSIGNED: The EAT-10, frequently used in swallowing clinics, can determine swallowing efficiency in individuals with neurogenic dysphagia. Additionally, it has the power to detect moderate-to-severe pharyngeal residue.
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  • 文章类型: Journal Article
    目的:研究进食评估工具-10(EAT-10)在不同稠度下检测吞咽后残留和误吸的判别能力。
    方法:连续72例吞咽困难的混合病因患者(男42例,女30例,平均±sd年龄为60.42±15.82)。完成EAT-10后,进行了纤维内窥镜吞咽评估(FEES),以评估吞咽的效率和安全性,以满足以下稠度:稀薄液体,浓浓的花蜜,酸奶,和固体。虽然使用耶鲁咽部残留严重程度评定量表(YPRSRS)评估吞咽效率,采用渗透抽吸量表(PAS)评估吞咽安全性.
    结果:EAT-10问卷在以下一致性和解剖位置上显著识别了有残留物的患者和无残留物的患者:梨状窦中的稀薄液体残留物(截止分数≥10,p=0.009),谷粒中的花蜜浓稠残留物(截止分数≥15,p=0.001),谷中的酸奶残留物(截止分数≥15,p=0.009),梨状窦中的酸奶残留物(截止分数≥9,p=0.015),和谷中的固体残留物(截止分数≥13,p=0.016)。然而,没有发现EAT-10在检测任何一致性的误吸方面具有相同的判别能力.
    结论:EAT-10问卷可作为判断混合病因吞咽困难患者吞咽效率的评估工具,但吞咽安全的情况并不明显。
    OBJECTIVE: To investigate the discriminant ability of the eating assessment tool-10 (EAT-10) to detect postswallow residue and aspiration for different consistencies.
    METHODS: Seventy-two consecutive patients with mixed etiology of dysphagia (42 males and 30 females, mean ± sd age of 60.42 ± 15.82) were included. After completing the EAT-10, Fiberoptic Endoscopic Evaluation of Swallowing (FEES) was performed to assess the efficiency and safety of swallowing for the following consistencies: thin liquid, nectar thick, yogurt, and solid. While swallowing efficiency was evaluated using the Yale Pharyngeal Residue Severity Rating Scale (YPRSRS), the Penetration-Aspiration Scale (PAS) was used to evaluate swallowing safety.
    RESULTS: The EAT-10 questionnaire significantly identified the patients with residue from those without residue for the following consistencies and anatomic locations: thin liquid residue in the pyriform sinus (cutoff score ≥ 10, p = 0.009), nectar thick residue in the vallecula (cutoff score ≥ 15, p = 0.001), yogurt residue in the vallecula (cutoff score ≥ 15, p = 0.009), yogurt residue in the pyriform sinus (cutoff score ≥ 9, p = 0.015), and solid residue in the vallecula (cutoff score ≥ 13, p = 0.016). However, the same discriminant ability of EAT-10 was not found for detecting aspiration in any consistency.
    CONCLUSIONS: The EAT-10 questionnaire can be used as an assessment tool to judge swallowing efficiency in patients with mixed etiology of dysphagia, but the same is not evident for swallowing safety.
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  • 文章类型: Journal Article
    100ml水吞咽测试(WST)是用于头颈部癌(HNC)的经验证的吞咽评估。我们旨在确定与标准面对面评估(FTF)相比,通过临床医生分级视频测试或患者自检完成100mlWST时的一致性水平。
    来自四个英国中心的便利采样。
    患有HNC的患者在接受治疗之前采用任何方式,或治疗5年内。招募参与者通过视频测试或自测完成100mlWST,并与FTF进行比较。
    招募了63名患者;1名无法执行任务;30名视频测试;32名自我测试。视频测试或自测吞咽能力(p=0.777)和体积(p=0.445)的吞咽能力(p=0.424)和体积(p=0.363)没有差异。
    这项研究表明,视频测试和自我测试是完成HNC患者样本100mlWST的可靠方法。
    The 100 ml water swallow test (WST) is a validated swallow assessment used in head and neck cancer (HNC). We aimed to determine the level of agreement when completing the 100 ml WST via clinician-graded video-testing or patient self-testing compared to standard face-to-face assessment (FTF).
    Convenience sampling from four UK centers.
    patients with HNC treated with any modality prior to, or within 5 years of treatment. Participants were recruited to complete the 100 ml WST by video-testing or self-testing and compared with FTF.
    Sixty-three patients were recruited; 1 was unable to perform the task; 30 in video-testing; and 32 in self-testing. There was no difference in swallow capacity (p = 0.424) and volume (p = 0.363) for the video-testing or the self-testing swallow capacity (p = 0.777) and volume (p = 0.445).
    This study demonstrates that video-testing and self-testing are reliable methods of completing the 100 ml WST for this sample of patients with HNC.
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