TY - JOUR A1 - Frank, Ulrike A1 - Radtke, Julia A1 - Nienstedt, Julie Cläre A1 - Pötter-Nerger, Monika A1 - Schönwald, Beate A1 - Buhmann, Carsten A1 - Gerloff, Christian A1 - Niessen, Almut A1 - Flügel, Till A1 - Koseki, Jana-Christiane A1 - Pflug, Christina T1 - Dysphagia screening in Parkinson's Disease BT - a diagnostic accuracy cross-sectional study investigating the applicability of the Gugging Swallowing Screen (GUSS) JF - Neurogastroenterology and motility N2 - Background Simple water-swallowing screening tools are not predictive of aspiration and dysphagia in patients with Parkinson's Disease (PD). We investigated the diagnostic accuracy of a multi-texture screening tool, the Gugging Swallowing Screen (GUSS) to identify aspiration and dysphagia/penetration in PD patients compared to flexible endoscopic evaluation of swallowing (FEES). Methods Swallowing function was evaluated in 51 PD participants in clinical 'on-medication' state with the GUSS and a FEES examination according to standardized protocols. Inter-rater reliability and convergent validity were determined and GUSS- and FEES-based diet recommendations were compared. Key Results Inter-rater reliability of GUSS ratings was high (r(s) = 0.8; p < 0.001). Aspiration was identified by the GUSS with a sensitivity of 50%, and specificity of 51.35% (PPV 28%, NPV 73%, LR+ 1.03, LR- 0.97), dysphagia/penetration was identified with 72.97% sensitivity and 35.71% specificity (PPV 75%, NPV 33.33%, LR+ 1.14, LR- 0.76). Agreement between GUSS- and FEES-based diet recommendations was low (r(s) = 0.12, p = 0.42) with consistent NPO (Nil per Os) allocation by GUSS and FEES in only one participant. Conclusions and Inferences The multi-texture screening tool GUSS in its current form, although applicable with good inter-rater reliability, does not detect aspiration in PD patients with acceptable accuracy. Modifications of the GUSS parameters "coughing," "voice change" and "delayed swallowing" might enhance validity. The GUSS' diet recommendations overestimate the need for oral intake restriction in PD patients and should be verified by instrumental swallowing examination. KW - aspiration KW - dysphagia KW - FEES KW - Gugging Swallowing Screen KW - Parkinson' s disease Y1 - 2021 U6 - https://doi.org/10.1111/nmo.14034 SN - 1350-1925 SN - 1365-2982 VL - 33 IS - 5 PB - Wiley CY - Hoboken ER - TY - JOUR A1 - Müller, Nina A1 - Beer, Carola de A1 - Frank, Ulrike T1 - Ist die therapeutische Mundpflege bei Dysphagiepatient*innen verschwendete Zeit? BT - ein narrativer Review zu Effekten der Mundpflege auf die Pneumoniehäufigkeit und Ableitung einer Handlungsempfehlung BT - a narrative review on the effects of oral care on pneumonia risk and guidelines for an effective and structured approach JF - Sprache, Stimme, Gehör : Zeitschrift für Kommunikationsstörungen N2 - Aspirationspneumonien sind eine häufige Todesursache bei Dysphagiepatient*innen. In diesem Beitrag wird durch die Evaluation relevanter Studien die Frage untersucht, ob die therapeutische Mundpflege bei Dysphagiepatient*innen zur Verringerung des Pneumonierisikos beitragen kann. Zudem wird auf dieser Grundlage eine Handlungsempfehlung für die Umsetzung der Mundpflege entwickelt. Die ausgewählten Studien zeigen, dass die Mundpflege einen positiven Effekt auf das Pneumonie-Risiko von Dysphagiepatient*innen hat. Sie sollte auf den Grundsätzen Einfachheit, Sicherheit, Arbeitskräfteentlastung, Wirksamkeit, Universalität, Wirtschaftlichkeit und vollständige Mundpflege aller Teile der Mundhöhle beruhen und nimmt weniger als fünf Minuten täglich ein. Sie bereitet durch die taktile Stimulation auf die anschließende Dysphagie-Therapie vor und ist somit sinnvoll investierte Therapiezeit. N2 - Aspiration pneumonia is a common cause of death in dysphagia patients. In this review, we investigate whether a structured oral care approach can help to reduce pneumonia risk in dysphagic patients. In addition, guidelines for the implementation of oral care on the basis of the analyzed studies are presented. Oral care has positive effects on the risk of pneumonia in dysphagia patients. Oral care should be based on the principles of simplicity, safety, efficiency and effectiveness, universality and economy and it should include all parts of the oral cavity. Effective oral care takes less than five minutes a day. The tactile stimulation prepares the patient for dysphagia therapy and can be considered wisely-invested time. T2 - Is oral care for dysphagic patients wasted time? KW - oral care KW - dysphagia KW - pneumonia KW - Therapeutische Mundpflege KW - Dysphagie KW - Pneumonie Y1 - 2022 U6 - https://doi.org/10.1055/a-1714-1587 SN - 0342-0477 SN - 1439-1260 VL - 46 IS - 03 SP - 150 EP - 155 PB - Thieme CY - Stuttgart ER - TY - JOUR A1 - Frank, Ulrike A1 - Czepluch, C. A1 - Sticher, H. A1 - Maetzener, F. A1 - Schlaegel, W. A1 - Mäder, M. T1 - Modifiziertes Trachealkanülenmanagement - Platzhaltereinsatz als Option bei erschwerten Dekanülierungen (Pilotprojekt REHAB Basel) JF - Die Rehabilitation : Zeitschrift für Praxis und Forschung in der Rehabilitation N2 - Tracheotomierte Patienten, die sowohl eine Dysphagie als auch respiratorische Defizite aufweisen, haben nach der Dekanülierung häufig Probleme, sich an die translaryngeale Atmung anzupassen. Wir entwickelten ein Dekanülierungsprotokoll für diese Patientengruppe, das optional in unser bestehendes Trachealkanülenmanagement integriert werden kann. Erfüllt ein Patient die hierfür definierten Kriterien, so erfolgt unter laryngoskopischer Kontrolle die Einlage eines Platzhalters, der bis zu 3 Tage in situ verbleibt. Während dieser Probedekanülierungsphase werden die respiratorischen Funktionen und das Speichelmanagement engmaschig überwacht. Auf der Grundlage dieser Evaluation wird dann die Entscheidung für oder gegen eine endgültige Dekanülierung getroffen. Wir stellen den Ablauf, die Kriterienkataloge und die Evaluationsparameter für diese Probedekanülierungsphase vor und illustrieren den Ablauf anhand von 2 Fallbeispielen. KW - decannulation protocol KW - dilatational tracheostomy KW - stoma button KW - respiration KW - dysphagia Y1 - 2013 U6 - https://doi.org/10.1055/s-0032-1306290 SN - 0034-3536 VL - 52 IS - 1 SP - 20 EP - 26 PB - Thieme CY - Stuttgart ER - TY - JOUR A1 - Schlickewei, Ole A1 - Nienstedt, Julie Cläre A1 - Frank, Ulrike A1 - Fründt, Odette A1 - Pötter-Nerger, Monika A1 - Gerloff, Christian A1 - Buhmann, Carsten A1 - Müller, Frank A1 - Lezius, Susanne A1 - Koseki, Jana-Christiane A1 - Pflug, Christina T1 - The ability of the eating assessment tool‑10 to detect penetration and aspiration in Parkinson’s disease JF - European archives of oto-rhino-laryngology and head & neck N2 - Purpose: Dysphagia is common in patients with Parkinson's disease (PD) and often leads to pneumonia, malnutrition, and reduced quality of life. This study investigates the ability of the Eating Assessment Tool-10 (EAT-10), an established, easy self-administered screening tool, to detect aspiration in PD patients. This study aims to validate the ability of the EAT-10 to detect FEES-proven aspiration in patients with PD. Methods: In a controlled prospective cross-sectional study, a total of 50 PD patients completed the EAT-10 and, subsequently, were examined by Flexible Endoscopic Evaluation of Swallowing (FEES) to determine the swallowing status. The results were rated through the Penetration-Aspiration Scale (PAS) and data were analyzed retrospectively. Results: PAS and EAT-10 did not correlate significantly. Selected items of the EAT-10 could not predict aspiration or residues. 19 (38%) out of 50 patients with either penetration or aspiration were not detected by the EAT-10. The diagnostic accuracy was established at only a sufficient level (AUC 0.65). An optimal cut-off value of >= 6 presented a sensitivity of 58% and specificity of 82%. Conclusions: The EAT-10 is not suited for the detection of penetration and aspiration in PD patients. Therefore, it cannot be used as a screening method in this patient population. There is still a need for a valid, simple, and efficient screening tool to assist physicians in their daily diagnostics and to avoid clinical complications. KW - Parkinson's disease KW - dysphagia KW - questionnaire KW - screening Y1 - 2020 U6 - https://doi.org/10.1007/s00405-020-06377-x SN - 0937-4477 SN - 1434-4726 VL - 278 IS - 5 SP - 1661 EP - 1668 PB - Springer CY - Berlin ER -