Relationships between Temporal Measurements and Swallowing Impairment in Unilateral Stroke Patients

Im, Ikjae; Ko, Myoung-Hwan; Im, Ikjae; Ko, Myoung-Hwan

doi:2020.25.4.966

ORIGINAL ARTICLE

Commun Sci Disord. 2020;25(4): 966-975.
Published online December 31, 2020.
doi: https://doi.org/10.12963/csd.20778

Relationships between Temporal Measurements and Swallowing Impairment in Unilateral Stroke Patients

Ikjae Im^a

, and Myoung-Hwan Ko^b

^aDepartment of Language and Rehabilitation Counseling, Catholic Kwandong University Gangneung, Korea
^bDepartment of Physical Medicine and Rehabilitation, Jeonbuk National University Medical School, Jeonju, Korea

Corresponding Author: Myoung-Hwan Ko ,Tel: +82-63-250-1795, Fax: +82-63-254-4145, Email: mhko@jbnu.ac.kr

Received October 20, 2020 Revised: November 18, 2020 Accepted November 18, 2020

ABSTRACT

Objectives
The primary aim of the present study was to investigate the relationships between temporal measurements and swallowing impairment. The secondary aim was to identify potential relationships among age, lesion side, clinical swallowing outcomes, fifty-six consecutive unilateral patients (mean age=64.73 years, SD=13.45, left damage=28 patients, right damage=28 patients) participated in this study.
Methods
A videofluoroscopic swallowing study (VFSS) was performed using a single bolus of 5 mL of thin liquid. All patients completed both a magnetic resonance imaging study and VFSS. VFSS images were evaluated using the Modified Barium Swallowing Impairment Profile (MBSImP). Kinematic aspects of swallowing were characterized according to oral transit duration, pharyngeal transit duration, laryngeal response duration (LRD), and laryngeal closure duration (LCD). Path analyses were utilized to explore the relationships between age, lesion side, temporal measurements, and MBSImP score.
Results
The results indicated that advanced age was associated with increased oral swallowing impairment and longer laryngeal response in unilateral stroke patients (p<.01). In addition, longer LRD was significantly associated with increased oral swallowing impairment (p<.05). Longer LRD and shorter LCD were significantly associated with increased pharyngeal swallowing impairment (p<.01). Right hemisphere damage was significantly associated with increased pharyngeal impairment (p<.01).
Conclusion
The present study was the first to investigate the relationships between temporal measurements and MBSImP score, and the findings confirmed that swallowing outcomes via VFSS can provide physiologic evidence related to swallowing impairment in unilateral stroke patients. We discuss clinical markers to predict the risk of progression to swallowing impairments that may be useful as targets to effectively manage stroke patients with swallowing impairment.

Keywords: Unilateral | Stroke | Swallowing impairment | Modified Barium Swallowing Impairment Profile (MBSImP)