Advanced Search

Home > Journals > European Journal of Physical and Rehabilitation Medicine > Past Issues > European Journal of Physical and Rehabilitation Medicine 2011 September;47(3) > European Journal of Physical and Rehabilitation Medicine 2011 September;47(3):441-6

ISSUES AND ARTICLES   MOST READ   eTOC

CURRENT ISSUEEUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE

A Journal on Physical Medicine and Rehabilitation after Pathological Events


Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,063

 

European Journal of Physical and Rehabilitation Medicine 2011 September;47(3):441-6

 ORIGINAL ARTICLES

Combined approach in bedside assessment of aspiration risk post stroke: PASS

Zhou Z. 1,2,3, Salle J.-Y. 1,2, Daviet J.-C. 1,2, Stuit A. 2, Nguyen C. L. 2

1 Institute of Neuroepidemiology and Tropical Neurology, Limoges, EA 3174, Faculty of Medicine, University of Limoges, Limoges, France
2 Department of Physical Medicine and Readapatation, University Hospital Center, Limoges, France
3 No. 2 Affiliated Hospital, Kunming Medical University, Kunming, China

BACKGROUND:Swallowing disorders are common and serious problems post stroke. Physical signs and ingestion test consist of main approaches of bedside screening of aspiration.
AIM: To assess the composability of these approaches.
DESIGN: A pilot study to develop a combined schema; secondly a validation study of this schema.
SETTING: Inpatient of Neurology Department and of Rehabilitation Department.
POPULATION: Forty-one patients post acute stroke included in the pilot study; 107 patients of subacute stroke for validation study.
METHODS: In pilot study, patients were assessed using Clinical Predicative Scale of Aspiration (CPSA) and 3-ounce Water swallow Test (3oz WT). Videofluoroscopic examination (VFSE) was performed as gold standard when the results of screening were discordant. In validation study, swallowing disorders were assessed systematically using CPSA, 3 oz WT and VFSE.
RESULTS:The combined screening schema, Practical Aspiration Screening Scheme (PASS), consisted of a 3oz WT to enhance results of the uncertain range of CPSA. Validation study showed that sensitivity and specificity of the 3oz WT were 87.3% and 42.3% respectively; those of CPSA were 50.1% and 50.0%, with a range of uncertainty in 42.6% of patients. The sensitivity of PASS was 89.1%, comparable to that of the 3oz WT, while the specificity of PASS was 80.8%, significantly higher than that of single tests. PASS also reduced systematic recourse to VFSE with a substantial agreement with it (kappa=0.7).
CONCLUSION:Physical signs and ingestion test are complementary in the screening of aspiration.
CLINICAL REHABILITATION IMPACT: Combined schema enhances the efficiency of bedside screening of aspiration.

language: English


FULL TEXT  REPRINTS

top of page