Relationships between Temporal Measurements and Swallowing Impairment in Unilateral Stroke Patients

Objectives: The primary aim of the present study was to investigate the relationships between temporal measurements and swallowing impairment. The secondary aim was to identify potential relationships among age, lesion side, clinical swallowing outcomes, fifty-six consecutive unilateral patients (mean age = 64.73 years, SD = 13.45, left damage=28 patients, right damage = 28 patients) participated in this study. Methods: A videofluoro-scopic swallowing study (VFSS) was performed using a single bolus of 5 mL of thin liquid. All patients completed both a magnetic resonance imaging study and VFSS. VFSS images were evaluated using the Modified Barium Swallowing Impairment Profile (MBSImP). Kinematic aspects of swallowing were characterized according to oral transit duration, pharyngeal transit duration, laryngeal response duration (LRD), and laryngeal closure duration (LCD). Path analyses were utilized to explore the relationships between age, lesion side, temporal measurements, and MBSImP score. Results: The results indicated that advanced age was associated with increased oral swallowing impairment and longer laryngeal response in unilateral stroke patients (p < .01). In addition, longer LRD was significantly associated with increased oral swallowing impairment (p < .05). Longer LRD and shorter LCD were significantly associated with increased pharyngeal swallowing impairment (p < .01). Right hemisphere damage was significantly associated with increased pharyngeal impairment (p < .01). Conclusion: The present study was the first to investigate the relationships between temporal measurements and MBSImP score, and the findings confirmed that swallowing outcomes via VFSS can provide physiologic evidence related to swallowing impairment in unilateral stroke patients. We discuss clinical markers to predict the risk of progression to swallowing impairments that may be useful as targets to effectively manage stroke patients with swallowing impairment.