TY - GEN 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) T2 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe 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. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 854 KW - aspiration KW - dysphagia KW - FEES KW - Gugging Swallowing Screen KW - Parkinson' s disease Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-569625 SN - 1866-8364 IS - 5 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 - 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 - TY - JOUR A1 - Frank, Ulrike A1 - Frank, Katrin T1 - COVID-19 BT - neue Herausforderungen in der Dysphagie- und Atemtherapie BT - new challenges in dysphagia and respiratory therapy JF - Der Nervenarzt : Organ der Deutschen Gesellschaft für Psychiatrie, Psychotherapie und Nervenheilkunde ; Mitteilungsblatt der Deutschen Gesellschaft für Neurologie N2 - Eine COVID-19-Erkrankung kann zu schweren Krankheitsverläufen mit multiplen Organbeteiligungen und respiratorischen und neurologischen Funktionseinschränkungen führen. Schluckstörungen (Dysphagien) können in dieser Patientengruppe durch primäre Schädigungen des zentralen und peripheren neuronalen Netzwerkes der Schluckfunktion entstehen, aber auch bedingt durch die häufig längere intensivmedizinische Behandlung und Beatmung. Erste klinische Befunde zeigen persistierende Dysphagien im Rahmen des Post-COVID-Syndroms („Long-COVID“), sodass die Patienten auch längerfristige Maßnahmen zur Rehabilitation einer sicheren und suffizienten oralen Nahrungsaufnahme benötigen. Daher sollte in die Behandlung von COVID-19-Patienten ein strukturiertes erkrankungsspezifisches Monitoring in Bezug auf Dysphagiesymptome integriert werden, und atemtherapeutische Maßnahmen zur Regulation von Husteneffektivität und Atem-Schluck-Koordination sollten auch bei diesen Patienten essenzieller Bestandteil des Dysphagiemanagements sein. Herausforderungen ergeben sich dabei einerseits durch die erforderlichen Anpassungen etablierter Behandlungsstandards an den Infektionsschutz. Zudem müssen Auswahl und Durchführungsintensität therapeutischer Maßnahmen an die Kapazitäten und die spezifische Pathophysiologie der COVID-19- und Long-COVID-Patienten angepasst werden, um weitere funktionelle Verschlechterungen zu vermindern. N2 - Coronavirus disease 2019 (COVID-19) can lead to severe disease courses with multiple organ involvement, respiratory and neurological functional impairments. Swallowing disorders (dysphagia) in this patient group can result from primary damage to the central and peripheral neuronal swallowing network but also from the frequently prolonged intensive care treatment and mechanical ventilation. Clinical observations indicate persistence of dysphagia in post-acute COVID-19 syndrome (long COVID), so that these patients probably also need long-term interventions for rehabilitation of safe and sufficient oral feeding. Therefore, structured disease-specific monitoring of dysphagia symptoms should be integrated into the treatment of COVID-19 patients and respiratory therapy should be an essential part of dysphagia management to re-establish cough effectiveness and breathing-swallowing coordination. Challenges arise from necessary adjustments to established treatment standards to prevent infections. Furthermore, the selection and intensity of therapeutic measures have to be adapted to the capacities and the specific pathophysiology of COVID-19 and long COVID patients to prevent further functional deterioration. KW - Long COVID KW - Fatigue KW - Post intensive care syndrome (PICS) KW - Laryngeal functions KW - Laryngeale Funktionen KW - Hypoxemia KW - Hypoxämie KW - Long-COVID Y1 - 2021 U6 - https://doi.org/10.1007/s00115-021-01162-5 SN - 0028-2804 SN - 1433-0407 VL - 93 IS - 2 SP - 167 EP - 174 PB - Springer CY - New York ER - 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 - Frank, Ulrike A1 - Frank, Katrin T1 - Teamwork is it! BT - Intensivmedizin geht nicht allein JF - Spektrum Patholinguistik 15 Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-572134 SN - 978-3-86956-542-2 SN - 1866-9433 SN - 1866-9085 IS - 15 SP - 1 EP - 19 PB - Universitätsverlag Potsdam CY - Potsdam ER - TY - JOUR A1 - Frank, Ulrike A1 - Frank, Katrin A1 - Mohr, Bettina A1 - Kurtenbach, Stephanie A1 - Khader-Lindholz, Aischa A1 - Sallat, Stephan A1 - Wagner, Lilli A1 - Düring, Sarah A1 - Lubitz, Anika A1 - Schnelle, Kirsten A1 - Klitsch, Julia A1 - Netzebandt, Jonka A1 - Fritsche, Tom A1 - Uhlemann, Charlotte A1 - Wartenburger, Isabell A1 - Hilton, Matt A1 - Neitzel, Isabel A1 - Schmidt, Johanna A1 - Eikerling, Maren A1 - Cholin, Joana A1 - Menze, Clara A1 - Stadie, Nicole A1 - Schmitz-Antonischki, Dorit A1 - Heide, Judith A1 - Plath, Almut A1 - Corsten, Sabine A1 - Hoffmann, Marie A1 - Leinweber, Juliane A1 - Spelter, Bianca A1 - Karstens, Sven ED - Tan, Sarah ED - Düring, Sarah ED - Wilde, Alina ED - Wunderlich, Hanna ED - Fritzsche, Tom T1 - Spektrum Patholinguistik Band 15. Schwerpunktthema: Interdisziplinär behandeln – Multiprofessionelle Zusammenarbeit in der Sprachtherapie T2 - Spektrum Patholinguistik N2 - Das 15. Herbsttreffen Patholinguistik mit dem Schwerpunktthema »Interdisziplinär (be-)handeln – Multiprofessionelle Zusammenarbeit in der Sprachtherapie« fand am 20.11.2021 als Online-Veranstaltung statt. Das Herbsttreffen wird seit 2007 jährlich vom Verband für Patholinguistik e.V. (vpl), seit 2021 vom Deutschen Bundesverband für akademische Sprachtherapie und Logopädie (dbs) in Kooperation mit der Universität Potsdam durchgeführt. Der vorliegende Tagungsband beinhaltet die Vorträge zum Schwerpunktthema und Informationen aus der Podiumsdiskussion sowie die Posterpräsentationen zu weiteren Themen aus der sprachtherapeutischen Forschung und Praxis. N2 - The Fifteenth Autumn Meeting Patholinguistics with its main topic »Interdisciplinary treatment - multiprofessional cooperation in speech/language therapy« took place online on the 20th of November 2021. This annual meeting has been organised since 2007 by the Association for Patholinguistics (vpl), since 2021 by the German Federal Association for Academic Speech/Language Therapy and Logopaedics (dbs) in cooperation with the University of Potsdam. The present proceedings feature the keynote presentations on the main topic and information from the panel discussion as well as articles from the poster session covering a broad range of areas in research and practice of speech/language therapy. T3 - Spektrum Patholinguistik - 15 KW - Patholinguistik KW - Sprachtherapie KW - interdisziplinäre Behandlung KW - multiprofessionelle Zusammenarbeit KW - patholinguistics KW - speech/language therapy KW - interdisciplinary treatment KW - multiprofessional cooperation Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-558206 SN - 978-3-86956-542-2 SN - 1866-9433 SN - 1866-9085 IS - 15 PB - Universitätsverlag Potsdam CY - Potsdam ER - TY - JOUR A1 - Huckabee, Maggie-Lee A1 - McIntosh, Theresa A1 - Fuller, Laura A1 - Curry, Morgan A1 - Thomas, Paige A1 - Walshe, Margaret A1 - McCague, Ellen A1 - Battel, Irene A1 - Nogueira, Dalia A1 - Frank, Ulrike A1 - van den Engel-Hoek, Lenie A1 - Sella-Weiss, Oshrat T1 - The test of masticating and swallowing solids (TOMASS) BT - reliability, validity and international normative data JF - International Journal of language & communicaton disorders N2 - BackgroundClinical swallowing assessment is largely limited to qualitative assessment of behavioural observations. There are limited quantitative data that can be compared with a healthy population for identification of impairment. The Test of Masticating and Swallowing Solids (TOMASS) was developed as a quantitative assessment of solid bolus ingestion. AimsThis research programme investigated test development indices and established normative data for the TOMASS to support translation to clinical dysphagia assessment. Conclusions & ImplicationsThe TOMASS is presented as a valid, reliable and broadly normed clinical assessment of solid bolus ingestion. Clinical application may help identify dysphagic patients at bedside and provide a non-invasive, but sensitive, measure of functional change in swallowing. KW - deglutition KW - assessment KW - mastication KW - swallowing KW - timed KW - solid Y1 - 2018 U6 - https://doi.org/10.1111/1460-6984.12332 SN - 1368-2822 SN - 1460-6984 VL - 53 IS - 1 SP - 144 EP - 156 PB - Wiley CY - Hoboken ER - TY - JOUR A1 - Frank, Ulrike A1 - van den Engel-Hoek, Lenie A1 - Nogueira, Dalia A1 - Schindler, Antonio A1 - Adams, Sasha A1 - Curry, Morgan A1 - Huckabee, Maggie-Lee T1 - International standardisation of the test of masticating and swallowing solids in children JF - Journal of oral rehabilitation N2 - The Test of Masticating and Swallowing Solids (TOMASS) is a validated assessment tool measuring the efficiency of solid bolus intake by four quantitative parameters: discrete bites, masticatory cycles, swallows and time to ingest a single cracker. A normative database for adults (20-80+ years) has previously been established. The objective of this study was to investigate the applicability and reliability of the TOMASS in children and adolescents (TOMASS-C) and to establish the normative database for this younger population. We collected data from 638 participants (male: 311, female: 327) in five age groups (4-18 years) with five different but very similar test crackers in four countries. Significant effects of bolus type (cracker), age group and gender on the TOMASS parameters were identified, requiring stratification of the TOMASS-C database by these variables. Intra-rater reliability was excellent (ICC > 0.94) for all parameters; inter-rater reliability was moderate for "number of swallows" (ICC = 0.54), good for "bites" (ICC = 0.78) and "time" (ICC = 0.82), and excellent for "masticatory cycles" (ICC = 0.96). The "Test of Masticating and Swallowing Solids in Children (TOMASS-C)" was identified to be a reliable diagnostic tool for the comprehensive measurement of discrete oral stage components of solid bolus ingestion, standardised by a large normative database that covers age groups from preschoolers to young adults. While differences between gender groups were less pronounced than in the adult population, previous results relating to changes in masticatory and swallowing as a function of age are confirmed by our data. KW - mastication KW - normative data KW - reliability KW - solid bolus KW - swallowing Y1 - 2018 U6 - https://doi.org/10.1111/joor.12728 SN - 0305-182X SN - 1365-2842 VL - 46 IS - 2 SP - 161 EP - 169 PB - Wiley CY - Hoboken ER - TY - JOUR A1 - Gaeckle, Maren A1 - Domahs, Frank A1 - Kartmann, Angelika A1 - Tomandl, Bernd A1 - Frank, Ulrike T1 - Predictors of Penetration-Aspiration in Parkinson’s Disease Patients With Dysphagia BT - a retrospective analysis JF - Annals of Otology, Rhinology and Laryngology N2 - Methods: The data of 89 PD patients with dysphagia who underwent routinely conducted videofluoroscopic studies of swallowing (VFSS) were included in this retrospective study. The occurrence of penetration-aspiration was defined as scores >= 3 on the Penetration-Aspiration Scale (PAS). Four commonly reported signs of dysphagia in PD patients were evaluated as possible predictors. Furthermore, the relationships between the occurrence of penetration-aspiration and liquid bolus volume as well as clinical severity of PD (modified Hoehn and Yahr scale) were examined. Results: Logistic regression showed that a delayed initiation of the pharyngeal swallow (odds ratio [OR] = 7.47, P = .008) and a reduced hyolaryngeal excursion (OR = 5.13, P = .012) were predictors of penetration-aspiration. Moreover, there was a strong, positive correlation between increasing liquid bolus volume and penetration-aspiration (gamma = 0.71, P < .001). No correlation was found between severity of PD and penetration-aspiration (gamma = 0.077, P = .783). Conclusion: Results of the present study allow for a better understanding of penetration-aspiration risk in PD patients. They are useful for treatment planning in order to improve safe oral intake and adequate nutrition. KW - pneumonia KW - videofluoroscopy Y1 - 2019 U6 - https://doi.org/10.1177/0003489419841398 SN - 0003-4894 SN - 1943-572X VL - 128 IS - 8 SP - 728 EP - 735 PB - Sage Publ. CY - Thousand Oaks ER -