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Dysphagia

, Volume 31, Issue 2, pp 160–168 | Cite as

Swallowing Kinematics and Factors Associated with Laryngeal Penetration and Aspiration in Stroke Survivors with Dysphagia

  • Han Gil Seo
  • Byung-Mo Oh
  • Tai Ryoon Han
Original Article

Abstract

The purpose of this study was to investigate swallowing kinematics and explore kinematic factors related with penetration-aspiration in patients with post-stroke dysphagia. Videofluoroscopic images of 68 patients with post-stroke dysphagia and 34 sex- and age-matched healthy controls swallowing a thin liquid were quantitatively analyzed using two-dimensional motion digitization. The measurements included the movement distances and velocities of the hyoid and larynx, and the maximal tilt angles and angular velocities of the epiglottis. All velocity variables were significantly decreased in the stroke patients compared to the controls. There was a significant difference in the maximal horizontal displacement of the larynx, but there were no significant differences in other displacements of the larynx, the maximal displacements of the hyoid bone, and the maximum tilt angle of the epiglottis between the two groups. The maximal tilt angle of the epiglottis was lower in the aspiration subgroup than in the no penetration/aspiration and penetration subgroups as well as the controls. The maximal tilt angle from the y axis showed a dichotomous pattern at 90° of the angle, and all 11 patients with an angle <90° showed either penetration or aspiration. In the ROC curve of the angle for prediction of aspiration, the area under the curve was 0.725 (95 % CI 0.557–0.892, P = 0.008). This study suggested that sluggish rather than decreased hyolaryngeal movements during swallowing are a remarkable feature of post-stroke dysphagia. The association of reduced epiglottic movement with the risk of aspiration in patients with post-stroke dysphagia was supported by the quantitative analysis.

Keywords

Dysphagia Deglutition Stroke Aspiration Kinematics 

Notes

Compliance with Ethical Standards

Conflict of interest

The authors have no conflicts of interest to declare.

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Department of Rehabilitation Medicine, Seoul National University College of MedicineSeoul National University Hospital, SeoulSeoulRepublic of Korea
  2. 2.Department of Rehabilitation MedicineGangwon Do Rehabilitation HospitalChuncheon-siRepublic of Korea

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