Daniels, S.K., McAdam, C.P., Brailey, K, & Foundas, A.L. (1997). Clinical assessment of swallowing and prediction of dysphagia severity. American Journal of Speech-Language Pathology, 6(4):17-24. Retrieved from http://ajslp.asha.org/cgi/reprint/6/4/17
Introduction: Daniels, McAdam, Brailey, and Foundas (1997) reviewed literature from Linden, Kuhlemeier, and Patterson (1993) and examined signs of aspiration, but specifically six risk factors, including dysphonia, dysarthria, abnormal gag reflex, abnormal volitional cough, voice change after swallow, and cough after swallow. They then designed their study in an attempt to link the six signs of aspiration to the diagnosis and severity of dysphagia. The purpose of the study was to determine whether the six risk factors approximated the VSS in identification of dysphagia severity (Daniels et al., 1997). It was hypothesized that the presence of any one factor could predict at least mild dysphagia or normal swallowing on a video fluoroscopic swallow study (VSS) and that two factors could predict moderate dysphagia. Methods (Procedures): Fifty-nine male veterans, ages 41-88, with recent neurological deficits were recruited for the study and had one of the following issues: unilateral left hemispheric damage (22 men), bilateral hemispheric damage (18 men), and bilateral hemispheric damage (13 men), or brainstem lesions (6 men). The men were assessed by a neurologist using CT or MRI scans upon admission to view and localize lesions. They were then rescanned 2 weeks later if the initial scans yielded negative results. Excluded from the study were agitated patients and patients with a history of disorders and diseases other than stroke that would cause dysphagia. Within 5 days of admission, the men were given an oropharyngeal exam of gag reflex, volitional cough, speech, and voice. A video fluoroscopic assessment was also given that consisted of 3,5,10, and 20 ml, and ½ tsp of barium paste along with half of a cookie...
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