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Sudnawa KK, Li W, Calamia S, Kanner CH, Bain JM, Abdelhakim AH, Geltzeiler A, Mebane CM, Provenzano FA, Sands TT, Fee RJ, Montes J, Shen Y, Chung WK. Heterogeneity of comprehensive clinical phenotype and longitudinal adaptive function and correlation with computational predictions of severity of missense genotypes in KIF1A-associated neurological disorder. Genet Med 2024; 26:101169. [PMID: 38785164 PMCID: PMC11298291 DOI: 10.1016/j.gim.2024.101169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 05/15/2024] [Accepted: 05/15/2024] [Indexed: 05/25/2024] Open
Abstract
PURPOSE Pathogenic variants in kinesin family member 1A (KIF1A) are associated with KIF1A-associated neurological disorder. We report the clinical phenotypes and correlate genotypes of individuals with KIF1A-associated neurological disorder. METHODS Medical history and adaptive function were assessed longitudinally. In-person evaluations included neurological, motor, ophthalmologic, and cognitive assessments. RESULTS We collected online data on 177 individuals. Fifty-seven individuals were also assessed in-person. Most individuals had de novo heterozygous missense likely pathogenic/pathogenic KIF1A variants. The most common characteristics were hypotonia, spasticity, ataxia, seizures, optic nerve atrophy, cerebellar atrophy, and cognitive impairment. Mean Vineland adaptive behavior composite score (VABS-ABC) was low (M = 62.9, SD = 19.1). The mean change in VABS-ABC over time was -3.1 (SD = 7.3). The decline in VABS-ABC was associated with the age at first assessment and abnormal electroencephalogram/seizure. There was a positive correlation between evolutionary scale model (ESM) score for the variants and final VABS-ABC (P = .003). Abnormal electroencephalogram/seizure, neuroimaging result, and ESM explain 34% of the variance in final VABS-ABC (P < .001). CONCLUSION In-person assessment confirmed caregiver report and identified additional visual deficits. Adaptive function declined over time consistent with both the neurodevelopmental and neurodegenerative nature of the condition. Using ESM score assists in predicting phenotype across a wide range of unique variants.
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Affiliation(s)
- Khemika K Sudnawa
- Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA; Department of Pediatrics, Phramongkutklao Hospital and Phramongkutklao College of Medicine, Bangkok, Thailand
| | - Wenxing Li
- Department of Systems Biology, Columbia University Irving Medical Center, New York, NY
| | - Sean Calamia
- Department of Pediatrics, Columbia University, New York, NY
| | - Cara H Kanner
- Department of Rehabilitation and Regenerative Medicine, Columbia University Irving Medical Center, New York, NY
| | - Jennifer M Bain
- Departments of Neurology and Pediatrics, Columbia University Irving Medical Center, New York, NY
| | - Aliaa H Abdelhakim
- Harkness Eye Institute, Department of Ophthalmology, Columbia University Irving Medical Center, New York, NY
| | - Alexa Geltzeiler
- Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA
| | | | - Frank A Provenzano
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Department of Neurology, Columbia University Medical Center, New York, NY
| | - Tristan T Sands
- Departments of Neurology and Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY
| | - Robert J Fee
- Department of Neurology, Columbia University Vagelos College of Physicians and Surgeons and New York-Presbyterian Hospital, New York, NY
| | - Jacqueline Montes
- Department of Rehabilitation and Regenerative Medicine, Columbia University Irving Medical Center, New York, NY
| | - Yufeng Shen
- Department of Systems Biology, Columbia University Irving Medical Center, New York, NY; Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, NY
| | - Wendy K Chung
- Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA.
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Najeeb H, Augenstein KJ, Yee J, Broman AT, Rogus-Pulia N, Namasivayam-MacDonald A. Predictors of Swallowing-Related Quality of Life in United States Veterans with Dysphagia. Dysphagia 2024; 39:150-158. [PMID: 37410172 DOI: 10.1007/s00455-023-10602-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 06/27/2023] [Indexed: 07/07/2023]
Abstract
While both dysphagia and poor health-related quality of life frequently occur in United States (US) Veterans, swallowing-related quality of life in this population has not been systematically examined. This retrospective clinical observation study aimed to determine the independent predictors of swallowing-related quality of life for a sample of US Veterans. We examined the following variables in a multivariate analysis to determine the predictors of Swallowing Quality of Life Questionnaire scores: demographic information, Modified Barium Swallow Impairment Profile (MBSImP) scores, Penetration-Aspiration Scale scores, anterior lingual pressures, and Functional Oral Intake Scale scores. MBSImP oral phase score was the only variable that reached statistical significance (p ≤ 0.01), demonstrating that a more severe physiologic impairment in the oral phase of swallowing was independently predictive of worse swallowing-related quality of life. These findings highlight the need for clinicians to consider how impairments in swallowing physiology may impact the quality of life more broadly for patients with dysphagia.
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Affiliation(s)
- Hiba Najeeb
- St. Mary's Hospital, Kitchener, Canada
- School of Rehabilitation Science, McMaster University, 1280 Main Street West, IAHS 403, Hamilton, ON, L8S 4L8, Canada
| | | | - Joanne Yee
- William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
- University of Wisconsin-Madison, Madison, WI, USA
- Division of Geriatrics and Gerontology, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | | | - Nicole Rogus-Pulia
- University of Wisconsin-Madison, Madison, WI, USA
- Division of Geriatrics and Gerontology, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, USA
| | - Ashwini Namasivayam-MacDonald
- School of Rehabilitation Science, McMaster University, 1280 Main Street West, IAHS 403, Hamilton, ON, L8S 4L8, Canada.
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Lyster AE, Hansen SL, Andersen CT, Nielsen JB, Westerterp K, Wouters L, Kiens B, Ritterband-Rosenbaum A. Oral Motor Impairments Contribute to Weight Status of Adults with Severe Cerebral Palsy. Nutrients 2023; 15:5042. [PMID: 38140301 PMCID: PMC10745858 DOI: 10.3390/nu15245042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 11/29/2023] [Accepted: 12/02/2023] [Indexed: 12/24/2023] Open
Abstract
Adults with severe cerebral palsy (CP) are susceptible to malnutrition and metabolic disorders due to limited daily physical activity and challenges related to eating. We hypothesized that the condition of being underweight arises from inadequate energy intake due to difficulties in eating, rather than heightened total energy expenditure or an elevated resting metabolic rate. The present study encompassed 17 adults with severe CP (classified as GMFSC III-V). Energy intake, utilization, and expenditure were gauged via thorough dietary recordings and double-labeled water (DLW) analyses. Resting metabolic rates were assessed through indirect calorimetry, and metabolic health was investigated via blood samples. Oral motor function, eating assessment during meals, and weight fluctuations throughout the experimental period were also evaluated. We found significant correlations between weight, oral impairments (p < 0.01), and eating difficulties (p < 0.05). While total energy expenditure and daily consumption were similar between underweight (UW) and overweight (OW) individuals, significant variability in both expenditure and intake was evident within the UW group. Particularly, those with lower BMIs experienced heightened mealtime impairments and complications. Our present findings indicate that eating difficulties are the central concern for UW status in this population.
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Affiliation(s)
- Aslak Emil Lyster
- The August Krogh Section for Molecular Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Universitetsparken 13, 2100 Copenhagen, Denmark; (A.E.L.); (B.K.)
| | - Solvejg Lis Hansen
- Elsass Foundation, Holmegaardsvej 28, 2920 Charlottelund, Denmark; (S.L.H.); (C.T.A.); (J.B.N.)
| | | | - Jens Bo Nielsen
- Elsass Foundation, Holmegaardsvej 28, 2920 Charlottelund, Denmark; (S.L.H.); (C.T.A.); (J.B.N.)
- Department of Neuroscience, University of Copenhagen, Blegdamsvej 3, 2200 Copenhagen, Denmark
| | - Klaas Westerterp
- Department of Nutrition and Movement Sciences, The Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; (K.W.); (L.W.)
| | - Loek Wouters
- Department of Nutrition and Movement Sciences, The Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; (K.W.); (L.W.)
| | - Bente Kiens
- The August Krogh Section for Molecular Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Universitetsparken 13, 2100 Copenhagen, Denmark; (A.E.L.); (B.K.)
| | - Anina Ritterband-Rosenbaum
- Elsass Foundation, Holmegaardsvej 28, 2920 Charlottelund, Denmark; (S.L.H.); (C.T.A.); (J.B.N.)
- Department of Neuroscience, University of Copenhagen, Blegdamsvej 3, 2200 Copenhagen, Denmark
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Bell BG, Shah S, Coulson N, McLaughlin J, Logan P, Luke R, Avery AJ. The impact of ageing on adults with cerebral palsy: the results of a national online survey. BJGP Open 2023; 7:BJGPO.2023.0028. [PMID: 37591553 PMCID: PMC11176684 DOI: 10.3399/bjgpo.2023.0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/29/2023] [Accepted: 07/03/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND Cerebral palsy (CP) is one of the most common neurological disorders in children and results in lifelong physical impairments. Adults with CP have approximately the same life expectancy as their non-disabled peers, so helping them to stay healthy throughout the life course will have long-term cost benefits via reductions in hospital admissions, long-term care, and unemployment rates. AIM To explore how adults with CP experience ageing. DESIGN & SETTING National online survey given to adults with CP in the UK. METHOD The participants were adults with CP. Items for the online survey were taken from existing self-report measures, with additional items developed for the survey. Several domains of functioning were assessed including mobility, dexterity, fatigue, pain, speech, mental health, swallowing and health maintenance/self-care as well as healthcare usage. Data were analysed using χ2 to examine the relationships between the demographic variables and the survey responses. RESULTS The survey was completed by 395 participants, of whom 74.2% were female and approximately 59.3% aged <45 years. Responders reported having problems with mobility, pain, and fatigue with older participants reporting higher levels of pain and more mobility problems, although the correlations were fairly small. Healthcare usage was surprisingly low. CONCLUSION The study found that age was associated with a decline in mobility and a higher level of pain, although the relationships were weak. It is possible that the low healthcare usage among the responders is owing to services not being available to respond to their needs.
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Affiliation(s)
- Brian G Bell
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Sonali Shah
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Neil Coulson
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Janice McLaughlin
- School of Geography, Politics, and Sociology, Newcastle University, Newcastle upon Tyne, UK
| | - Pip Logan
- School of Medicine, University of Nottingham, Nottingham, UK
| | | | - Anthony J Avery
- School of Medicine, University of Nottingham, Nottingham, UK
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Constance D, Subbiah R, Sukumaran A, Madankumar PD. Barriers in maintaining oral health among the children with cerebral palsy - Parent/caregiver's perspective. J Indian Soc Pedod Prev Dent 2023; 41:234-238. [PMID: 37861638 DOI: 10.4103/jisppd.jisppd_360_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2023] Open
Abstract
Background Cerebral palsy (CP) is primarily a neuromotor disorder that affects the development of movement, muscle tone, and posture. Objective This qualitative study explores the underlying barriers in maintaining oral health from the perspective of the caregivers or parents. Materials and Methods Focus group discussion was conducted with the parents or caregivers in the National Institute for Empowerment of Persons with Multiple Disabilities (NIEPMD), Muttukadu, Chennai. Data were collected from seven participants. Thematic analysis identified key themes using NVivo software. Results The discussion on barriers to maintain oral health faced by parents of children with CP identified a collation of three key themes: behavioral challenges, inhibited social and communication skills, and parental dependence. Conclusion Oral health professionals should aim to raise awareness among health-care professionals to work toward reducing the barriers to oral health care that these populations currently experience.
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Affiliation(s)
- Diana Constance
- Department of Public Health Dentistry, Ragas Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Rohini Subbiah
- Department of Public Health Dentistry, Ragas Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Aparna Sukumaran
- Department of Public Health Dentistry, Ragas Dental College and Hospital, Chennai, Tamil Nadu, India
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Oliveira LD, Marquitti FD, Ramos SCH, Almeida EAD, Nascimento WV, Dantas RO. RELATIONSHIP BETWEEN NUTRITIONAL STATUS, DYSPHAGIA, AND FUNCTIONAL EATING LEVEL IN ADULT PATIENTS WITH CEREBRAL PALSY IN LONG INSTITUTIONAL STAYS. ARQUIVOS DE GASTROENTEROLOGIA 2023; 60:194-200. [PMID: 37556745 DOI: 10.1590/s0004-2803.20230222-149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 05/11/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND Diets with modified consistencies for patients with dysphagia in long term care health institutions may be associated with malnutrition. OBJECTIVE : To assess the nutritional status of adult patients with cerebral palsy and dysphagia hospitalized in a health institution for more than 10 years. METHODS : This prospective investigation was performed in 56 patients with cerebral palsy (ages 25 to 71 years, mean: 44±12 years) and no other neurological diagnosis in hospital stay for more than 10 years had their nutritional status, dysphagia, and food ingestion capacity assessed in two moments with a 12-month interval in between them, respectively using the body mass index, the dysphagia risk assessment protocol (PARD), and the functional oral ingestion scale (FOIS). RESULTS : There were no differences between December 2015 and December 2016 in the patients' weight, nutritional status, diet consistency classification, PARD, and FOIS. The limits of prescribed diet consistency (IDDSI-FDS) and the assessments of dysphagia and functional eating level influenced the nutritional status. More intense dysphagia and greater eating restrictions were associated with a worse nutritional status. CONCLUSION : The nutritional status of adult patients with cerebral palsy hospitalized in a health long term institution who had modified diets according to their swallowing and mastication capacity did not worsen between assessments with a 12-month interval in between them. The severity of dysphagia and diet restrictions interfere with the patients' nutritional status: dysphagia and more intense eating restrictions are associated with a worse nutritional status.
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Affiliation(s)
| | | | | | | | | | - Roberto Oliveira Dantas
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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O'Leary L, Maine A, Ring N, Reid J, Speirs L, Allan L, Truesdale M, Taggart L. A scoping review of the evidence for the use of screening tools in people with intellectual disabilities with dysphagia. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2023; 36:429-447. [PMID: 36797039 DOI: 10.1111/jar.13076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 12/11/2022] [Accepted: 01/03/2023] [Indexed: 02/18/2023]
Abstract
BACKGROUND Dysphagia can have serious health implications including choking and respiratory infection leading to poorer quality of life. People with intellectual disabilities are at higher risk of dysphagia related health complications and early death. Robust dysphagia screening tools are vital for this population. METHOD A scoping review and appraisal of the evidence for dysphagia and feeding screening tools for use with people with intellectual disabilities was undertaken. RESULTS Seven studies (using six screening tools) met the review inclusion criteria. Mostly studies were limited by no defined dysphagia criteria, no verification of tools with a gold reference standard (e.g., videofluoroscopic examination) and lack of participant diversity (small samples, narrow age range, severity of intellectual disability or limited settings). CONCLUSIONS There is urgent need for development and rigorous appraisal of existing dysphagia screening tools to meet the needs of a wider range of people with intellectual disabilities (particularly mild-to-moderate severity) and in wider settings.
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Affiliation(s)
- Lisa O'Leary
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
| | - Andrew Maine
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
| | - Nicola Ring
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
| | - James Reid
- NHS Forth Valley, Community Hospital, Stirling, UK
| | | | - Louise Allan
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
| | - Maria Truesdale
- Institute of Health and Well Being, University of Glasgow, Glasgow, UK
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Kamal S, Kamaralzaman S, Sharma S, Jaafar NH, Chern PM, Hassan NI, Toran H, Ismail NAS, Yusri G, Hamzaid NH. A Review of Food Texture Modification among Individuals with Cerebral Palsy: The Challenges among Cerebral Palsy Families. Nutrients 2022; 14:nu14245241. [PMID: 36558401 PMCID: PMC9782059 DOI: 10.3390/nu14245241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/03/2022] [Accepted: 12/04/2022] [Indexed: 12/13/2022] Open
Abstract
Individuals with cerebral palsy (CP) frequently present with multiple feeding problems, which may require food texture modification to ensure safe feeding. This review aims to explore the challenges individuals with CP and their caregiver's face and recommend modified food textures to ensure safety and improve the quality of life and nutritional status. A systematic search was carried out through four databases (i.e., EBSCO (Medline), PubMed, Science Direct, and Web of Science) between January 2011 and May 2022. Out of 86 articles retrieved, seven were selected based on keywords and seven other studies through manual search-five cross-sectional studies, two qualitative studies, one correlational study, one mixed method study, one case-control study, two sections of books, and two educational materials. The findings suggest that preparation and intake of food with modified texture play a necessary role in the safety of swallowing in addition to physical, social, and environmental aspects. Safety was found to be the crucial part of the food texture modification provision besides considering the stress of the caregivers and the nutritional status of individuals with CP. Currently, there are no standard guidelines available pertaining to food texture modification. This led to uncertainties in the dietary provision among caregivers, which may lead to undernourishment. Hence, standard guidelines relating to food texture modification that focuses on food preparation and menus with calorie and nutrient information are timely to be developed.
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Affiliation(s)
- Sakinah Kamal
- Center for Rehabilitation and Special Needs Studies (iCaRehab), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
- Dietetics Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
| | - Sazlina Kamaralzaman
- Center for Rehabilitation and Special Needs Studies (iCaRehab), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
| | - Shobha Sharma
- Center for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
| | - Nurul Hazirah Jaafar
- Department of Nutrition Sciences, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia (IIUM), Jalan Sultan Ahmad Shah, Bandar Indera Mahkota, Kuantan 25200, Malaysia
| | - Phei Ming Chern
- Department of Rehabilitation Medicine (Paediatric Rehabilitation), Hospital Rehabilitasi Cheras, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia
| | - Nurul Izzaty Hassan
- Department of Chemical Sciences, Faculty of Science & Technology, Universiti Kebangsaan Malaysia (UKM), Bandar Baru Bangi 43600, Malaysia
| | - Hasnah Toran
- Faculty of Education, Universiti Kebangsaan Malaysia (UKM), Bandar Baru Bangi 43600, Malaysia
| | - Noor Akmal Shareela Ismail
- Department of Biochemistry, Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM), Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia
| | - Ghazali Yusri
- Akademi Pengajian Bahasa, Universiti Teknologi Mara (UiTM), Shah Alam 40450, Malaysia
- Malaysian Advocates for Cerebral Palsy (MyCP), No 4., USJ3/4X, USJ3, Subang Jaya 47600, Malaysia
| | - Nur Hana Hamzaid
- Center for Rehabilitation and Special Needs Studies (iCaRehab), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
- Dietetics Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
- Correspondence:
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George RG, Jagtap M. Impact of Swallowing Impairment on Quality of Life of Individuals with Dysphagia. Indian J Otolaryngol Head Neck Surg 2022; 74:5473-5477. [PMID: 36742852 PMCID: PMC9895758 DOI: 10.1007/s12070-021-02798-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 08/01/2021] [Indexed: 02/07/2023] Open
Abstract
To explore oral intake and quality of life measures among individuals with dysphagia. This cross-sectional study with purposive sampling included 15 individuals with dysphagia. Functional oral intake scale (FOIS) and Dysphagia Quality of Life questionnaire in Marathi (DQOL-QM) were administered on individuals with dysphagia to evaluate oral intake levels and swallow related quality of life respectively. Data was collected using the interview method via tele-mode. Statistical analysis using Spearman's rank correlation revealed significant negative correlation (ρ = - 0.87) between oral intake and overall quality of life of the individuals with dysphagia. This negative impact was observed across all the domains of their quality of life. A considerable negative impact on quality of life was observed with declining oral intake of the individual with dysphagia. As oral intake plays an important role in the quality of life, decisions regarding the mode of feeding must be guided by the preferences of the individual and their family. strategies that enhance oral intake improves quality of life of dysphagic individual.
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Affiliation(s)
- Rebecca. Grace. George
- School of Audiology and Speech Language Pathology, Bharati Vidyapeeth (Deemed To Be University), Pune, Maharashtra India
| | - Mansi. Jagtap
- School of Audiology and Speech Language Pathology, Bharati Vidyapeeth (Deemed To Be University), Pune, Maharashtra India
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Relationship between daily swallowing frequency and pneumonia in patients with severe cerebral palsy. BMC Pediatr 2022; 22:485. [PMID: 35964106 PMCID: PMC9375420 DOI: 10.1186/s12887-022-03547-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 08/09/2022] [Indexed: 11/10/2022] Open
Abstract
Background Aspiration pneumonia is a major complication that occurs in patients with severe cerebral palsy and is associated with their survival prognosis, necessitating appropriate assessment and response. We focused on swallowing frequency as an index of daily swallowing function due to the difficulty in evaluating the risk of pneumonia. The swallowing motion protects the airway by safely directing the food, saliva, and secretions accumulated in the pharynx into the esophagus to prevent aspiration and entry into the trachea. Thus, swallowing frequency may be correlated with the incidence of pneumonia. In this study, we aimed to investigate the relationship between swallowing frequency and history of pneumonia in patients with severe cerebral palsy. Methods Fifty-seven patients with cerebral palsy were included in this study. Swallowing frequency was measured three times for each patient on separate days, and the reproducibility was examined by calculating the intraclass correlation coefficient. Further, the relationship between swallowing frequency and history of pneumonia was investigated using multivariate logistic regression analysis. Results While swallowing frequency differed between participants, it was constant within individuals (intraclass correlation coefficient: 0.941). Furthermore, the swallowing frequencies per hour were 12.2 ± 12.2 and 27.0 ± 20.4 in the patient groups with and without a history of pneumonia, respectively (P < 0.001). Swallowing frequency (odds ratio: 10.489, 95% confidence interval: 2.706–40.663, P = 0.001) was significantly associated with the incidence of pneumonia in the previous year. Conclusions Swallowing frequency could be used as an index for assessing the risk of dysphagia and pneumonia in patients with severe cerebral palsy.
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McAllister A, Sjöstrand E, Rodby‐Bousquet E. Eating and drinking ability and nutritional status in adults with cerebral palsy. Dev Med Child Neurol 2022; 64:1017-1024. [PMID: 35229295 PMCID: PMC9314006 DOI: 10.1111/dmcn.15196] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 01/09/2022] [Accepted: 02/10/2022] [Indexed: 12/31/2022]
Abstract
AIM To describe eating and drinking ability in adults with cerebral palsy (CP) relative to sex, age, subtype, and severity of gross motor and hand function and nutritional status. METHOD This was a cross-sectional study based on data of 2035 adults with CP, median age 26 years (range 18-78 years). The Eating and Drinking Ability Classification System (EDACS), Gross Motor Function Classification System (GMFCS), and Manual Ability Classification System (MACS) were used in addition to subtype, body weight, height, body mass index (BMI), skin fold thickness, and gastrostomy. Linear regression models were used to estimate associations between body weight and the other variables. RESULTS More than half of the adults (52.5%) eat and drink safely and 32.4% have dysphagia with limitations to eating and drinking safety. Weight, height, and BMI decreased with increasing EDACS levels. In EDACS level V, 86% had a gastrostomy, 23.4% in EDACS levels III to V were underweight, whereas 42.3% in EDACS levels I to II had a BMI over 25, indicating overweight or obesity. Increasing EDACS levels and need of support during meals were associated with lower body weight. INTERPRETATION Adults with CP should be routinely screened and treated for dysphagia to avoid nutritional complications. Being dependent on others during mealtimes is a risk factor for low body weight.
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Affiliation(s)
- Anita McAllister
- Division of Speech and Language PathologyDepartment of Clinical Science, Intervention and Technology—CLINTECKarolinska InstitutetStockholmSweden,Medical Unit Speech and Language PathologyWomen’s Health and Allied Health Professionals ThemeKarolinska University HospitalStockholmSweden
| | | | - Elisabet Rodby‐Bousquet
- Department of Clinical Sciences LundOrthopaedicsLund UniversityLundSweden,Centre for Clinical ResearchUppsala University—Region VästmanlandVästeråsSweden
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Clinicopathological characterization of children with dysphagia, family impact and health-related quality of life of their caregivers. An Pediatr (Barc) 2022; 96:431-440. [DOI: 10.1016/j.anpede.2022.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 06/14/2021] [Indexed: 11/20/2022] Open
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Ortiz Pérez P, Valero Arredondo I, Torcuato Rubio E, Rosa López A, García-Herrera Taillifer P, Navas-López VM. [Clinicopathological characterization of children with dysphagia, family impact and health-related quality of life of their caregivers]. An Pediatr (Barc) 2021; 96:S1695-4033(21)00219-8. [PMID: 34257061 DOI: 10.1016/j.anpedi.2021.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/04/2021] [Accepted: 06/14/2021] [Indexed: 10/20/2022] Open
Abstract
INTRODUCTION Oropharyngeal dysphagia (DOF) without proper evaluation can be underdiagnosed in certain groups of the pediatric population. Meeting the needs of these patients can lead to an overload of their caregivers. OBJECTIVES To describe the epidemiological and clinical characteristics of the patients evaluated after starting a monographic DOF clinic (C-DOF) and study whether there are changes at the nutritional level, as well as the burden and impact that caregivers find on quality of life related to health (HRQOL). MATERIAL AND METHODS Descriptive observational study of patients evaluated in a C-DOF from its start-up. To evaluate HRQOL, an ad hoc survey adapted from the Swallowing Quality of Life Questionnaire of the adult population was designed. RESULTS 103 patients were evaluated, 85.4% presenting some neurological disease. A videofluoroscopic study was performed in 51 patients (49.5%), reporting combined alterations in both the oral and pharyngeal phases in 64.7% of them. There was a directly proportional correlation between the severity of the DOF and the presence of aspirations, as well as with the patient's motor impairment. Regarding the anthropometric evaluation, there was a trend toward improvement in weight z-score (+0.14 SD), height (+0.17 SD) and BMI (+0.16 SD). Out of 46.2% of the caregivers reported that the DOF problem interfered negatively in the basic activities of daily life. The increase in HRQOL, after the evaluation in the monographic DOF clinic, was statistically significant overall. CONCLUSIONS The monographic DOF clinic provided specialized care, impacting positively at the nutritional status of patients, as well as perceived changes in HRQOL, with a probable impact on caregivers.
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Affiliation(s)
- Pilar Ortiz Pérez
- Sección de Gastroenterología y Nutrición Infantil, Hospital Regional Universitario de Málaga, Málaga, España.
| | - Inés Valero Arredondo
- Sección de Gastroenterología y Nutrición Infantil, Hospital Regional Universitario de Málaga, Málaga, España
| | - Encarnación Torcuato Rubio
- Sección de Gastroenterología y Nutrición Infantil, Hospital Regional Universitario de Málaga, Málaga, España
| | - Andrés Rosa López
- Sección de Radiología Pediátrica, Hospital Regional Universitario de Málaga, Málaga, España
| | | | - Víctor Manuel Navas-López
- Sección de Gastroenterología y Nutrición Infantil, Hospital Regional Universitario de Málaga, Málaga, España
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Acar G, Ejraei N, Turkdoğan D, Enver N, Öztürk G, Aktaş G. The Effects of Neurodevelopmental Therapy on Feeding and Swallowing Activities in Children with Cerebral Palsy. Dysphagia 2021; 37:800-811. [PMID: 34173063 DOI: 10.1007/s00455-021-10329-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 06/08/2021] [Indexed: 12/01/2022]
Abstract
This study investigated the effect of the structured Neurodevelopmental Therapy Method-Bobath (NDT-B) approach on the feeding and swallowing activity of patients with cerebral palsy (CP) and feeding difficulties. In addition to feeding and oral motor intervention strategies (OMIS), and nutrition-related caregiver training (NRCT), and the NDT-B, which was structured to increase trunk and postural control, was added to the therapy program. Forty patients with CP, with a mean age of 3.25 ± 0.927 years, were classified using the Gross Motor Function Classification System, Eating and Drinking Ability Classification System, and Mini-Manual Ability Classification System. The patients were randomly assigned into two groups as OMIS + NRCT (n = 20) and OMIS + NRCT + NDT-B (n = 20). The program was applied for 6 weeks, 2 days/week, for 45 min. The patients were evaluated using the Trunk Impairment Scale, Schedule for Oral Motor Assessment, and the Pediatric Quality of Life Inventory before and after 6 weeks. The trunk control of the OMIS + NRCT + NDT-B group was superior to the other group (P = 0.026). Although there was an improvement in the groups according to the subcategories of SOMA, the OMIS + NRCT + NDT-B group was superior in the trainer cup and puree subcategories of SOMA (P = 0.05). A significant correlation was observed between trunk control and oral motor functions in children with CP, and the eating function of children in the OMIS + NRCT + NDT-B group further improved. NDT-B-based neck and trunk stabilization exercises should be added to the treatment programs.Trial Registration NCT04403113.
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Affiliation(s)
- Gönül Acar
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Marmara University, Basibuyuk, Basibuyuk Cd. No:9, Maltepe, Istanbul, 34854, Turkey
| | - Nasim Ejraei
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Marmara University, Basibuyuk, Basibuyuk Cd. No:9, Maltepe, Istanbul, 34854, Turkey.
| | - Dilşad Turkdoğan
- Department of Child Health and Diseases, Department of Pediatric Neurology, Marmara University Istanbul Pendik Training and Research Hospital, Istanbul, Turkey
| | - Necati Enver
- Department of Otolaryngology, Pendik Training and Research Hospital, Marmara University, Istanbul, Turkey
| | - Gülten Öztürk
- Department of Child Health and Diseases, Department of Pediatric Neurology, Marmara University Istanbul Pendik Training and Research Hospital, Istanbul, Turkey
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15
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Bushuven S, Niebel I, Huber J, Diesener P. Emotional and Psychological Effects of Dysphagia: Validation of the Jugendwerk Dysphagia Emotion and Family Assessment (JDEFA). Dysphagia 2021; 37:375-391. [PMID: 33817751 PMCID: PMC8019588 DOI: 10.1007/s00455-021-10289-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 03/16/2021] [Indexed: 01/10/2023]
Abstract
Introduction Patients suffering from swallowing disorders are experiencing emotional effects like anger, anxiety, and sadness. This may be affecting patient–therapist relation and family functioning. To assess emotional reaction and their influence on family systems, we developed a 55-item questionnaire based on the Atlas of Emotion and the Calgary Family Intervention Model. Methods We recruited more than 160 participants to validate an online survey, namely the Jugendwerk Dysphagia Emotion and Family Assessment Score (JDEFA). Forty-Nine health care workers, patients, and family members completed the survey and provided additional comments regarding interactions of emotions and dysphagia. Analysis was accomplished by non-parametric tests and principal component analyses with Varimax rotation. Additionally, we accomplished a qualitative content analysis taking a phenomenological single-coder approach. Results Analysis revealed a Cronbach’s Alpha of 0.93. Using primary component analyses, justified by a Kaiser–Meyer–Olkin value of 0.81, we identified two main factors (emotion and family). Patients experienced sadness and anger more often than health care providers, whereas family members felt anxiety even more often. Our qualitative analysis revealed 20 themes (7 for anger, 2 enjoyment, 4 sadness, 3 anxiety, 2 disgust, 1 shame, and 1 punishment). Predominantly, the fear of choking was mentioned by patients, whereas professionals reported about the fear of making mistakes. Conclusion The JDEFA is a valid and reliable testing tool for the assessment of swallowing disorders concerning emotional aspects and family functioning. Both factors have a significant role in dysphagia and evaluations should go along with functional assessments and psychological scores for a holistic understanding of swallowing disorders.
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Affiliation(s)
- Stefan Bushuven
- Department of Neurorehabilitation, Hegau-Jugendwerk Gailingen, Healthcare Association Constance (GLKN), Gailingen, Germany. .,Institute for Infection Control and Infection Prevention, Healthcare Association Constance (GLKN), Hegau-Bodensee-Hospital, 78315, Radolfzell, Germany. .,Institute for Medical Education, University Hospital, LMU Munich, Munich, Germany.
| | - Isabell Niebel
- Department of Neurorehabilitation, Hegau-Jugendwerk Gailingen, Healthcare Association Constance (GLKN), Gailingen, Germany
| | - Johanna Huber
- Institute for Medical Education, University Hospital, LMU Munich, Munich, Germany
| | - Paul Diesener
- Department of Neurorehabilitation, Hegau-Jugendwerk Gailingen, Healthcare Association Constance (GLKN), Gailingen, Germany
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Shune SE, Resnick B, Zarit SH, Namasivayam-MacDonald AM. Creation and Initial Validation of the Caregiver Analysis of Reported Experiences with Swallowing Disorders (CARES) Screening Tool. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 29:2131-2144. [PMID: 33049154 DOI: 10.1044/2020_ajslp-20-00148] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose Dysphagia is a debilitating condition with widespread consequences. Previous research has revealed dysphagia to be an independent predictor of caregiver burden. However, there is currently no systematic method of screening for or identifying dysphagia-related caregiver burden. The aim of this study was to develop a set of questions for a dysphagia-related caregiver burden screening tool, the Caregiver Analysis of Reported Experiences with Swallowing Disorders (CARES), and pilot the tool to establish preliminary validity and reliability. Method The questionnaire was developed through an iterative process by a team of clinical researchers with expertise in dysphagia, dysphagia-related and general caregiver burden, and questionnaire design. A heterogenous group of 26 family caregivers of people with dysphagia completed the CARES, along with the Eating Assessment Tool (EAT-10), the International Dysphagia Diet Standardisation Initiative Functional Diet Scale (IDDSI-FDS), and the Zarit Burden Interview (ZBI). Information on construct validity, item fit, convergent validity, internal consistency, and reliability was determined via Rasch analysis model testing, Cronbach's alpha, and Spearman's rho calculations. Results The final CARES questionnaire contained 26 items divided across two subscales. The majority of the questionnaire items fit the model, there was evidence of internal consistency across both subscales, and there were significant relationships between dysphagia-specific burden (CARES) and perceived swallowing impairment (EAT-10), general caregiver burden (ZBI), and diet restrictiveness (IDDSI-FDS). Conclusions Results from the current study provide initial support for the validity and reliability of the CARES as a screening tool for dysphagia-related burden, particularly among caregivers of adults with swallowing difficulties. While continued testing is needed across larger groups of specific patient populations, it is clear that the CARES can initiate structured conversations about dysphagia-related caregiver burden by identifying potential sources of stress and/or contention. This will allow clinicians to then identify concrete methods of reducing burden and make appropriate referrals, ultimately improving patient care.
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Affiliation(s)
- Samantha E Shune
- Communication Disorders and Sciences Program, University of Oregon, Eugene
| | | | - Steven H Zarit
- Human Development and Family Studies, The Pennsylvania State University, University Park
| | - Ashwini M Namasivayam-MacDonald
- Department of Communication Sciences and Disorders, Adelphi University, Garden City, NY
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
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Merino G, Gómez I, Marín-Arroyo MR, Beriain MJ, Ibañez FC. Methodology for design of suitable dishes for dysphagic people. INNOV FOOD SCI EMERG 2020. [DOI: 10.1016/j.ifset.2020.102383] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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The relationship of serum 25-hydroxyvitamin D concentration with clinical variables in patients with oropharyngeal dysphagia. Clin Nutr ESPEN 2020; 38:229-235. [PMID: 32690163 DOI: 10.1016/j.clnesp.2020.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 03/06/2020] [Accepted: 04/09/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS The relationship between vitamin D and oropharyngeal dysphagia (OD) is still poorly understood. The aim of this study was to evaluate 25-hydroxyvitamin D [25(OH)D] concentration in patients with OD and to verify its association to nutritional status, functional independence measure (FIM), time of clinical signs (TCS) and OD severity. This is a cross-sectional study conducted with outpatients. Body mass index (BMI), FIM, TCS, causes of OD, comorbidities, penetration-aspiration scale (PAS) and severity scale were evaluated. METHODS A multiple linear regression and effect size were performed to evaluate the association between serum 25(OH)D concentration and independent variables. RESULTS Forty-eight participants were included, with a mean age of 60.1 ± 15.3 years. The mean of the 25(OH)D concentration was 26.10 ± 12.0 ng/mL. The prevalence of hypovitaminosis D (<30 ng/mL) was 73%. In the multiple linear regression analysis (adjusted for sex, age, BMI, dietary intake and solar radiation), 25(OH)D concentration was significantly related with the TCS (p = 0.01, f2 = 0.48). Patients with hypovitaminosis D had a moderate effect (p = 0.08, δ = 0.36) for a lower FIM score. CONCLUSIONS These findings indicate that serum 25(OH)D concentration may be related to the TCS and the functional capacity of patients with OD.
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Nakashima T, Suzuki H, Sugiura S, Beppu R, Ishida K. Gustatory function in persons with cerebral palsy. J Oral Rehabil 2020; 47:523-527. [PMID: 31925969 DOI: 10.1111/joor.12933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 12/23/2019] [Accepted: 01/05/2020] [Indexed: 12/31/2022]
Abstract
Gustatory function is closely related to chewing and swallowing; however, there are currently no reports regarding gustatory function in persons with cerebral palsy (CP). The aim of this study was to compare the gustatory function between persons with CP and healthy controls. We investigated sweet, salty, sour and bitter tastes using the whole-mouth method and measured the electrogustometric thresholds in the chorda tympani nerve area. Twelve participants with CP (6 women and 6 men) for whom gustatory testing was possible at our facilities, and 17 age-matched controls (9 women and 8 men) were included. The mean age ± standard deviation was 58.6 ± 8.1 years and 58.5 ± 8.7 years in subjects with CP and controls, respectively. Taste detection and identification were significantly worse in persons with CP compared with the controls. Taste identification was more impaired than taste detection. At the highest concentration, taste identification was impossible 11 times out of 48 (12 persons × 4 kinds of tastes) in persons with CP but such a deficit was not observed in 68 attempts (17 persons × 4 kinds of tastes) involving controls. The electrogustometric thresholds were not significantly different between the groups. Gustatory function associated with chewing and swallowing is worse in persons with CP compared to the controls.
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Affiliation(s)
- Tsutomu Nakashima
- Department of Rehabilitation, Ichinomiya Medical Treatment & Habilitation Center, Ichinomiya, Japan.,Department of Otorhinolaryngology, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Hirokazu Suzuki
- Department of Otorhinolaryngology, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Saiko Sugiura
- Department of Otorhinolaryngology, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Reiko Beppu
- Department of Otorhinolaryngology, Aichi Aoitori Medical Welfare Center, Nagoya, Japan
| | - Kazuo Ishida
- Kashinoki Welfare Association, Ichinomiya, Japan
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Sungsinchai S, Niamnuy C, Wattanapan P, Charoenchaitrakool M, Devahastin S. Texture Modification Technologies and Their Opportunities for the Production of Dysphagia Foods: A Review. Compr Rev Food Sci Food Saf 2019; 18:1898-1912. [PMID: 33336963 DOI: 10.1111/1541-4337.12495] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 07/16/2019] [Accepted: 07/28/2019] [Indexed: 12/27/2022]
Abstract
Dysphagia or swallowing difficulty is a common morbidity experienced by those who have suffered a stroke or those undergone such treatments as head and neck surgeries. Dysphagic patients require special foods that are easier to swallow. Various technologies, including high-pressure processing, high-hydrodynamic pressure processing, pulsed electric field treatment, plasma processing, ultrasound-assisted processing, and irradiation have been applied to modify food texture to make it more suitable for such patients. This review surveys the applications of these technologies for food texture modification of products made of meat, rice, starch, and carbohydrates, as well as fruits and vegetables. The review also attempts to categorize, via the use of such key characteristics as hardness and viscosity, texture-modified foods into various dysphagia diet levels. Current and future trends of dysphagia food production, including the use of three-dimensional food printing to reduce the design and fabrication time, to enhance the sensory characteristics, as well as to create visually attractive foods, are also mentioned.
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Affiliation(s)
- Sirada Sungsinchai
- Dept. of Chemical Engineering, Faculty of Engineering, Kasetsart Univ., Bangkok, 10900, Thailand
| | - Chalida Niamnuy
- Dept. of Chemical Engineering, Faculty of Engineering, Kasetsart Univ., Bangkok, 10900, Thailand.,Research Network of NANOTEC-KU on NanoCatalysts and NanoMaterials for Sustainable Energy and Environment, Kasetsart Univ., Bangkok, 10900, Thailand
| | - Pattra Wattanapan
- Dept. of Rehabilitation Medicine, Faculty of Medicine, and Dysphagia Research Group, Khon Kaen Univ., Khon Kaen, 40002, Thailand
| | - Manop Charoenchaitrakool
- Dept. of Chemical Engineering, Faculty of Engineering, Kasetsart Univ., Bangkok, 10900, Thailand
| | - Sakamon Devahastin
- Advanced Food Processing Research Laboratory, Dept. of Food Engineering, Faculty of Engineering, King Mongkut's Univ. of Technology Thonburi, Bangkok, 10140, Thailand.,The Academy of Science, The Royal Society of Thailand, Dusit, Bangkok, 10300, Thailand
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Yi YG, Shin HI. Psychometrics of the Functional Oral Intake Scale for Infants. Front Pediatr 2019; 7:156. [PMID: 31058124 PMCID: PMC6482161 DOI: 10.3389/fped.2019.00156] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Accepted: 04/02/2019] [Indexed: 01/04/2023] Open
Abstract
This study aimed to investigate the reliability and validity of the Functional Oral Intake Scale (FOIS) for infants. Infants (age, <1 year) who underwent a videofluoroscopic swallowing study (VFSS) were included in this retrospective study. Their nutrition records at the time of the VFSS were separately evaluated by two raters using the five-point FOIS for infants. Categorical swallowing and aspiration impairment scale data were also obtained from the VFSS. The inter-rater reliability of the FOIS for infants was high (95.5% absolute agreement) among the 201 evaluated infants, and this scale was significantly correlated with aspiration severity in the VFSS. We also investigated whether infants with partial oral feeding (POF) at the FOIS evaluation had achieved full oral feeding within 1 year of the evaluation and used this information to estimate whether the caloric contribution, as well as consistency of oral feeding, affected the feeding outcomes. This analysis included 33 infants who were receiving both oral and tube feeding (i.e., POF). Among them, 26 infants achieved full oral feeding (FOF) without tube feeding after 1 year. Their initial contribution from oral feeding was higher than that in infants who still maintained POF after 1 year (28.46 ± 22.79 vs. 6.00 ± 5.45%, p < 0.001). The five-point FOIS for infants, which reflected the expansion of their oral diet with growth, had adequate reliability and validity. The caloric contribution as well as consistency of oral feeding could be used to distinguish FOIS levels 2 and 3, which correspond to the POF status in infants.
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Affiliation(s)
- You Gyoung Yi
- Department of Rehabilitation Medicine, Veterans Medical Research Institute, Veterans Health Service Medical Center, Seoul, South Korea.,Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Hyung-Ik Shin
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
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