Clinicians' comparisons of instrumental measures in the assessment and treatment of dysphagia.

摘要

Guidelines for evaluation and treatment of dysphagia developed by the American Speech-Language Hearing Association (ASHA, 2000) state that instrumental assessment procedures should be used to identify abnormal or impaired swallow physiology for effective and efficient treatment planning. However, observation of impaired physiology is limited during fiberoptic endoscopic evaluation of swallowing (FEES) compared to videofluoroscopic evaluation of swallowing (VFSS) (ASHA, 2004a, 2004b). This study examined SLPs comparisons of VFSS and FEES for (1) identification of symptoms of dysphagia and abnormal physiologic swallowing events, and (2) determination of appropriate treatment strategies and maneuvers for patients with dysphagia. Results of an online survey found that clinicians rated VFSS more useful than FEES in identifying abnormal physiology of the patient's swallow, but rated both procedures useful in observing symptoms of dysphagia. Both procedures were rated useful in gathering information for treatment planning; however, VFSS was rated more useful than FEES in determining rehabilitative exercises.