Cutoff Value of Pharyngeal Residue in Prognosis Prediction After Neuromuscular Electrical Stimulation Therapy for Dysphagia in Subacute Stroke Patients

Overview

Journal Ann Rehabil Med

Specialty Rehabilitation Medicine

Date 2014 Nov 8

PMID 25379490

Citations 6

Authors

Jeong Mee Park

Sang Yeol Yong

Ji Hyun Kim

Hong Sun Jung

Sei Jin Chang

Ki Young Kim

Hee Kim

Affiliations

Soon will be listed here.

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.

Citing Articles

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Transcutaneous Electrical Neuromuscular Stimulation (TENS) Along with Traditional Dysphagia Therapy in Patients with Posterior Stroke: A Case Study.

Banik A, Hattiangadi G Indian J Otolaryngol Head Neck Surg. 2020; 72(3):279-283.

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Measuring Vallecular Volume on Flexible Endoscopic Evaluation of Swallowing: A Proof of Concept Study.

Kim K, Pisegna J, Kennedy S, Langmore S Dysphagia. 2020; 36(1):96-107.

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Reliability of Untrained and Experienced Raters on FEES: Rating Overall Residue is a Simple Task.

Pisegna J, Borders J, Kaneoka A, Coster W, Leonard R, Langmore S Dysphagia. 2018; 33(5):645-654.

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Change in Excitability of Cortical Projection After Modified Catheter Balloon Dilatation Therapy in Brainstem Stroke Patients with Dysphagia: A Prospective Controlled Study.

Wei X, Yu F, Dai M, Xie C, Wan G, Wang Y Dysphagia. 2017; 32(5):645-656.

PMID: 28550485 PMC: 5608794. DOI: 10.1007/s00455-017-9810-6.

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