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Cutoff value of pharyngeal residue in prognosis prediction after neuromuscular electrical stimulation therapy for Dysphagia in subacute stroke patients.

Park JM, Yong SY, Kim JH, Jung HS, Chang SJ, Kim KY, Kim H - Ann Rehabil Med (2014)

Bottom Line: The results were analyzed for comparison of the pharyngeal residue in the improved group and the non-improved group.A total of 59 patients concluded the test, in which 42 patients improved well enough to change the dietary methods while 17 did not improve sufficiently.The R/T ratios of valleculae and pyriformis sinus were significantly lower in the improved group than the non-improved group in all food types before treatment.

View Article: PubMed Central - PubMed

Affiliation: Department of Rehabilitation Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.

ABSTRACT

Objective: To determine the cutoff value of the pharyngeal residue for predicting reduction of aspiration, by measuring the residue of valleculae and pyriformis sinuses through videofluoroscopic swallowing studies (VFSS) after treatment with neuromuscular electrical stimulator (VitalStim) in stroke patients with dysphagia.

Methods: VFSS was conducted on first-time stroke patients before and after the VitalStim therapy. The results were analyzed for comparison of the pharyngeal residue in the improved group and the non-improved group.

Results: A total of 59 patients concluded the test, in which 42 patients improved well enough to change the dietary methods while 17 did not improve sufficiently. Remnant area to total area (R/T) ratios of the valleculae before treatment in the improved group were 0.120, 0.177, and 0.101 for solid, soft, and liquid foods, respectively, whereas the ratios for the non-improved group were 0.365, 0.396, and 0.281, respectively. The ratios of the pyriformis sinuses were 0.126, 0.159, and 0.121 for the improved group and 0.315, 0.338, and 0.244 for the non-improved group. The R/T ratios of valleculae and pyriformis sinus were significantly lower in the improved group than the non-improved group in all food types before treatment. The R/T ratio cutoff values were 0.267, 0.250, and 0.185 at valleculae and 0.228, 0.218, and 0.185 at pyriformis sinuses.

Conclusion: In dysphagia after stroke, less pharyngeal residue before treatment serves as a factor for predicting greater improvement after VitalStim treatment.

No MeSH data available.


Related in: MedlinePlus

Pyriformis remnant area to total area ratio is defined as proportion of residue areas of pyriformis sinuses (A) to their total space (B) viewed on lateral image of videofluoroscopic swallowing study.
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Figure 3: Pyriformis remnant area to total area ratio is defined as proportion of residue areas of pyriformis sinuses (A) to their total space (B) viewed on lateral image of videofluoroscopic swallowing study.

Mentions: Lateral VFSS images of individuals classified into two groups were analyzed using an image analysis program (ImageJ, http://imagej.nih.gov/ij/). Residues of valleculae and pyriformis sinuses were analyzed using remnant area to total area (R/T) ratio which is the proportion of residues of valleculae and pyriformis sinuses to their total spaces in solid/soft/liquid foods (Figs. 2, 3). Linear spreading test was done to check viscosity of food. The average value of the test was taken after repeating 10 times on glass plate using pipe containing specimen of 5 mL. Results were acquired after one minute of tilting the pipe that is 2 cm in diameter and height [13]. Pudding was used as solid food which showed 0.48 cm on linear spreading test. Soft food (rice porridge) showed 1.83 cm on linear spreading test. Liquid food which was yogurt with ioversol (Optiray 320; Mallinckrodt Korea Inc., Seoul, Korea) showed 5.27 cm. Classification of groups and calculation of the R/T ratio were done by a different individual to satisfy requirements of the double blind test.


Cutoff value of pharyngeal residue in prognosis prediction after neuromuscular electrical stimulation therapy for Dysphagia in subacute stroke patients.

Park JM, Yong SY, Kim JH, Jung HS, Chang SJ, Kim KY, Kim H - Ann Rehabil Med (2014)

Pyriformis remnant area to total area ratio is defined as proportion of residue areas of pyriformis sinuses (A) to their total space (B) viewed on lateral image of videofluoroscopic swallowing study.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4221389&req=5

Figure 3: Pyriformis remnant area to total area ratio is defined as proportion of residue areas of pyriformis sinuses (A) to their total space (B) viewed on lateral image of videofluoroscopic swallowing study.
Mentions: Lateral VFSS images of individuals classified into two groups were analyzed using an image analysis program (ImageJ, http://imagej.nih.gov/ij/). Residues of valleculae and pyriformis sinuses were analyzed using remnant area to total area (R/T) ratio which is the proportion of residues of valleculae and pyriformis sinuses to their total spaces in solid/soft/liquid foods (Figs. 2, 3). Linear spreading test was done to check viscosity of food. The average value of the test was taken after repeating 10 times on glass plate using pipe containing specimen of 5 mL. Results were acquired after one minute of tilting the pipe that is 2 cm in diameter and height [13]. Pudding was used as solid food which showed 0.48 cm on linear spreading test. Soft food (rice porridge) showed 1.83 cm on linear spreading test. Liquid food which was yogurt with ioversol (Optiray 320; Mallinckrodt Korea Inc., Seoul, Korea) showed 5.27 cm. Classification of groups and calculation of the R/T ratio were done by a different individual to satisfy requirements of the double blind test.

Bottom Line: The results were analyzed for comparison of the pharyngeal residue in the improved group and the non-improved group.A total of 59 patients concluded the test, in which 42 patients improved well enough to change the dietary methods while 17 did not improve sufficiently.The R/T ratios of valleculae and pyriformis sinus were significantly lower in the improved group than the non-improved group in all food types before treatment.

View Article: PubMed Central - PubMed

Affiliation: Department of Rehabilitation Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.

ABSTRACT

Objective: To determine the cutoff value of the pharyngeal residue for predicting reduction of aspiration, by measuring the residue of valleculae and pyriformis sinuses through videofluoroscopic swallowing studies (VFSS) after treatment with neuromuscular electrical stimulator (VitalStim) in stroke patients with dysphagia.

Methods: VFSS was conducted on first-time stroke patients before and after the VitalStim therapy. The results were analyzed for comparison of the pharyngeal residue in the improved group and the non-improved group.

Results: A total of 59 patients concluded the test, in which 42 patients improved well enough to change the dietary methods while 17 did not improve sufficiently. Remnant area to total area (R/T) ratios of the valleculae before treatment in the improved group were 0.120, 0.177, and 0.101 for solid, soft, and liquid foods, respectively, whereas the ratios for the non-improved group were 0.365, 0.396, and 0.281, respectively. The ratios of the pyriformis sinuses were 0.126, 0.159, and 0.121 for the improved group and 0.315, 0.338, and 0.244 for the non-improved group. The R/T ratios of valleculae and pyriformis sinus were significantly lower in the improved group than the non-improved group in all food types before treatment. The R/T ratio cutoff values were 0.267, 0.250, and 0.185 at valleculae and 0.228, 0.218, and 0.185 at pyriformis sinuses.

Conclusion: In dysphagia after stroke, less pharyngeal residue before treatment serves as a factor for predicting greater improvement after VitalStim treatment.

No MeSH data available.


Related in: MedlinePlus