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KMID : 0603920140220030025
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Journal of Korean Academy of Occupational Therapy
2014 Volume.22 No. 3 p.25 ~ p.36
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Predictive Validity of Aspiration Based on a Swallowing Function Test in Stroke Patients With Dysphagia
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Hong Deok-Gi
Lee Jae-Shin
Yoo Doo-Han
Choi Seong-Youl
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Abstract
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Objective : The purpose of this study was to verify the predictive validity of the aspiration capability in strokepatients with dysphagia based on a Swallowing Function Test (SFT).
Methods : The subjects of this study included 90 stroke patients with problems of dysphagia. The data collectedusing Videofluoroscopy Swallowing Studies (VFSS), Swallowing Function Test (SFT), Penetration -AspirationScale (PAS), and American Speech-Language-Hearing Association National Outcome Measurement System(ASHA NOMS) for the 90 stroke patients were analyzed based on a Receiver Operating Characteristic curve (ROCcurve) to determine the cutoff score of the aspiration Area Under the Curve (AUC), and the sensitivity andspecificity of the SFT. In addition, the data were analysed based on the positive and negative predictive values fora prediction of the aspiration capability. The items used for the validity of the SFT were analyzed based on theAUC value. In addition, The SFT was analyzed using a Pearson’s correlation analysis with ASHA NOMS andPAS.
Results : The cutoff score of the SFT was 36 points, and that of the AUC was .94. In addition, the sensitivity andspecificity of the SFT were 94.3% and 90.9%, respectively. The five best items of the SFT for predicting theaspiration capability were ‘voluntary cough,’ ‘laryngeal elevation,’ ‘swallowing before/during/after coughing,’ ‘voicechanges,’ and ‘the appearance of throat clearing.’ In addition, ASHA NOMS and PAS were significantly correlatedusing the SFT.
Conclusion : The SFT for stroke patients with dysphagia has been proven to be a useful test. It is expected thatthe SFT will be used as a predictive tool of aspiration capability and will offer intervention guidelines fordysphagia rehabilitation.
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KEYWORD
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Dysphagia, Predictive validity, Stroke, Swallowing Function Test
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