Abstract
This study used comparison with videofluoroscopic examination of swallowing (VFES) to examine the validity of a 100-ml water swallowing test (WST) in assessing swallowing dysfunction. Fifty-nine consecutive outpatients (15 females, 44 males) with clinically suspected dysphagia were enrolled in this study. Each subject underwent a 100-ml WST followed by VFES. Data was obtained on swallowing speed and signs of choking (coughing and a wet-hoarse voice). The analytical results revealed that 49 subjects had abnormal swallowing speeds (< 10 ml/s) in the 100-ml WST, and 47 of them were identified as having dysphagia by VFES. Among the ten participants with normal swallowing speed (> 10 ml/s), eight were diagnosed with dysphagia by VFES. Notably, 14 participants choked in the 100-ml WST, 11 of whom exhibited aspiration or penetration in VFES. Among the 45 participants without choking in WST, 12 displayed aspiration or penetration in VFES. The sensitivity of swallowing speed in detecting the swallowing dysfunction was 85.5%, and the specificity was 50%. Moreover, the sensitivity of using choking or wet-horse voice in the 100-ml WST as the sole factor for predicting the presence of aspiration was 47.8%, while the specificity was 91.7%. Therefore, this study concluded that swallowing speed is a sensitive indicator for identifying patients at risk for swallowing dysfunction. Moreover, choking in the 100-ml WST may be a potential specific indicator for followup aspiration.
Similar content being viewed by others
References
SF Noll CE Bender MC Nelson (1996) Rehabilitation of patients with swallowing disorders. RL Braddom (Eds) Physical Medicine and Rehabilitation 1st ed. W.B. Saunders Philadelphia 533–554
K DePippo M Holas M Reding (1992) ArticleTitleValidation of the 3-Oz WST for aspiration following stroke. Arch Neurol 49 1259–1611 Occurrence Handle1:STN:280:ByyD1c%2Fkslc%3D Occurrence Handle1449405
J Horner EW Massey (1998) ArticleTitleSilent aspiration following stroke. Neurology 38 317–319
P Linden A Siebens (1983) ArticleTitleDysphagia: predicting laryngeal penetration. Arch Phys Med Rehabil 64 281–283 Occurrence Handle1:STN:280:BiyB3s%2FhslY%3D Occurrence Handle6860100
Scales K, Patterson C, Linden P: Correlation between clinical and motion fluoroscopy observation of swallowing. American Speech-Language-Hearing Association Annual Meeting. Boston, November 21, 1998
KM Nathadwarawala A McGroary CM Wiles (1994) ArticleTitleSwallowing in neurological outpatients: use of a timed test. Dysphagia 9 120–129 Occurrence Handle1:STN:280:ByuB2szlsFQ%3D Occurrence Handle8005007
KM Nathadwarawala J Nicklin CM Wiles (1992) ArticleTitleA timed test of swallowing capacity for neurological patients. J Neurol Neurosurg Psychiatry 55 822–825 Occurrence Handle1:STN:280:ByyD3MbjtlQ%3D Occurrence Handle1402974
JA Logemann (1986) ArticleTitleTreatment for aspiration related to dysphagia: an overview. Dysphagia 1 34–38
JB Palmer KV Kuhlemeier DC Tippett (1993) ArticleTitleA protocol for the videofluorographic swallowing study. Dysphagia 8 209 Occurrence Handle1:STN:280:ByyA28rjtVc%3D Occurrence Handle8359040
J Horner EW Massey JE Riski DL Lathrop KNL Chase (1998) ArticleTitleAspiration following stroke: clinical correlates and outcome. Neurology 38 1359–1362
YN Lin TG Wang YC Chang FM Hsieh IN Lien (1998) ArticleTitleValidation of clinical swallowing evaluation in stroke patients. J Rehab Med Assoc ROC 26 175–180
BR Garon M Engle C Ormiston (1995) ArticleTitleReliability of the 3-Oz WST utilizing cough reflex as sole indicator of aspiration. J Neurol Rehabil 9 139–143
S Teramoto Y Fukuchi (2000) ArticleTitleDetection of aspiration and swallowing disorder in older stroke patients: simple swallowing provocation test versus WST. Arch Phys Med Rehabil 81 1517–1519 Occurrence Handle10.1053/apmr.2000.9171 Occurrence Handle1:STN:280:DC%2BD3M%2FkvVansA%3D%3D Occurrence Handle11083358
WR Addington RE Stephens K Gilliland M Rodriguez (1999) ArticleTitleAssessing the laryngeal cough reflex and the risk of developing pneumonia after stroke. Arch Phys Med Rehabil 80 150–154 Occurrence Handle1:STN:280:DyaK1M7kvVemtw%3D%3D Occurrence Handle10025488
DW Buchholz JF Bosma MW Donner (1985) ArticleTitleAdaptation, compensation, and decompensation of the pharyngeal swallow. Gastrointest Radiol 10 235–239 Occurrence Handle1:STN:280:BiqB1cnht1I%3D Occurrence Handle4029539
TAT Hughes CM Wiles (1996) ArticleTitleClinical measurement of swallowing in health and in neurogenic dysphagia. Q J Med 89 109–116 Occurrence Handle1:STN:280:BymA3cnls10%3D
P Linden KV Kuhlemeier C Patterson (1993) ArticleTitleThe probability of correctly predicting subglottic penetration from clinical observation. Dysphagia 8 170–179 Occurrence Handle1:STN:280:ByyA28rivFw%3D Occurrence Handle8359036
JA Logemann (1983) Evaluation and treatment of swallowing disorders. College Hill Press San Diego, CA
ML Splaingard B Hutchins L Sultan G Chanudhuri (1988) ArticleTitleAspiration in rehabilitation patients: videofluoroscopy vs. bedside clinical assessment. Arch Phys Med Rehabil 69 637–640 Occurrence Handle1:STN:280:BieA3cfmvFQ%3D Occurrence Handle3408337
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Wu, MC., Chang, YC., Wang, TG. et al. Evaluating Swallowing Dysfunction Using a 100-ml Water Swallowing Test . Dysphagia 19, 43–47 (2004). https://doi.org/10.1007/s00455-003-0030-x
Issue Date:
DOI: https://doi.org/10.1007/s00455-003-0030-x