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Inhalt: 1. Einleitung 2. Fragestellungen 3. Methoden 3.1 Methodisches Vorgehen: Interdisziplinäre Trachealkanülenentwöhnung und Dekanülierungsentscheidung im Basler Ansatz 3.2 Methodisches Vorgehen: Probanden und Messverfahren 4. Ergebnisse 4.1 Effektivität und Effizienz des multidisziplinären Ansatzes: Dekanülierungs- und Komplikationsraten und Therapiedauer bis zur Dekanülierung 4.2 Einfluss der Dekanülierung auf den Rehabilitationsverlauf funktioneller Fähigkeiten: Vergleich der funktionellen Selbständigkeit vor vs. nach der Dekanülierung 4.3 Entwicklung der Schluckfunktion und oralen Nahrungsaufnahme nach der Dekanülierung 5. Diskussion 6. Fazit 7. Literatur 8. Danksagung
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.
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.