Ann Rehabil Med.  2014 Jun;38(3):304-309. 10.5535/arm.2014.38.3.304.

Effect of the Order of Test Diets on the Accuracy and Safety of Swallowing Studies

Affiliations
  • 1Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Boramae Medical Center, Seoul, Korea. shiuk.lee@gmail.com

Abstract


OBJECTIVE
To assess whether the order of test diets influences the results of swallowing studies with regard to their accuracy and safety.
METHODS
Subjects with suspected dysphagia underwent a videofluoroscopic swallowing study (VFSS) and/or a fiberoptic endoscopic evaluation of swallowing (FEES) and repeated the study on the same day or within a week. The order of test diets comprised of two different sets: trial 1 with the fluid first and trial 2 with the semi-solid food first. Main outcome measurements were the modified penetration-aspiration scale (mPAS) and the pharyngeal residue severity scale (PRSS) for the vallecula and the pyriform sinus.
RESULTS
Sixty-six patients (44 men and 22 women, aged 65.0+/-15.0 years) were enrolled in this study. Forty-three subjects were evaluated with VFSS only and 23 with both VFSS and FEES. As a result of the swallowing studies, there was no significant difference in each chosen diet sequence regarding mPAS and PRSS. Furthermore, there was no difference regarding the duration of studies, rate of premature study termination, rate of abnormal findings in post-study chest X-ray, and rate of fever or pneumonia post-study.
CONCLUSION
The accuracy and safety of the swallowing studies do not rely on the order of test diets.

Keyword

Deglutition disorders; Diet; Deglutition; Evaluation studies

MeSH Terms

Deglutition Disorders
Deglutition*
Diet*
Fees and Charges
Female
Fever
Humans
Male
Pneumonia
Pyriform Sinus
Thorax

Figure

  • Fig. 1 The patients were randomly allocated to two groups (A and B). Subjects underwent the swallowing studies and repeated the study on the same day or within a week. The order of test diets comprised of two different sets: trial 1 with the fluid first and trial 2 with the semi-solid food first. Patients in group A underwent trial 1 first and trial 2 later. Patients in group B underwent trial 2 first and trial 1 later. VFSS, videofluoroscopic swallowing study; FEES, fiberoptic endoscopic evaluation of swallowing.


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