Turkish Journal of Physical Medicine and Rehabilitation 2004 , Vol 50 , Num 5

Hemiplejik Hastalarda Disfajinin Klinik Risk Belirteçleri ile Değerlendirilmesi

Barın Selçuk 1 ,Levent Ekici 1 ,Aydan Kurtaran 2 ,Afşin Ali 3
1 Ankara Fizik Tedavi ve Rehabilitasyon Eğitim ve Araştırma Hastanesi, 1. Fizik Tedavi ve Rehabilitasyon Kliniği, Ankara
2 Ankara Fizik Tedavi ve Rehabilitasyon Eğitim ve Araştırma Hastanesi, Ankara, Türkiye
3 Ankara Numune Eğitim ve Araştırma Hastanesi 1. Radyoloji Kliniği, Ankara

Dysphagia is an important variable related to increased morbidity, mortality and cost of care for stroke patients. This study assesses a clinical swallowing examination consisting of six clinical predictors of aspiration risk, i.e., dysphonia, dysarthria, abnormal gag reflex, abnormal volitional cough, cough after swallow, voice change after swallow. Of the total stroke patients, 70 of 150 (%47) patients presented with no clinical predictor and 46 of 150 (%30) patients presented with one clinical predictor. Thirty-four patients (%23) presented with two or more clinical predictors of moderate to severe dysphagia and further evaluated with fluoroscopy and modified barium swallow study. Based on the results of fluoroscopic examination; 19 of 21 (%90.5) patients were dysphagic and 2 of 21 (%9.5) patients were normal. The most common clinical predictor was dysphonia (%95). Cough after swallow was seen in 17 patients (%89). Dysphonia and cough after swallow were the most common double combined clinical predictors and seen in 16 (%84) patients. Dysphonia, cough after swallow and abnormal gag reflex were the most common triple combined clinical predictor and seen in 4 (%21) patients. As a result, clinical use of this screening system can objectively and safely determine which patients need further deglutitive evaluation

Keywords : Dysphagia, hemiplegia, stroke, clinical predictor, rehabilitatio