Abstract
Study design
Prospective cohort study.
Objectives
This prospective cohort study aims to evaluate the recovery of penetration/aspiration and functional feeding outcome in patients with acute TCSCI.
Setting
Tampere University Hospital, Tampere, Finland
Methods
Forty-six patients with TCSCI were enrolled. All the patients received speech therapeutic interventions based on their clinical needs and were examined with a videofluoroscopic swallowing study (VFSS) at enrollment. The incidence of VFSS-verified laryngeal penetration/aspiration according to Rosenbek’s Penetration-Aspiration Scale (PAS) served as the primary outcome. The secondary outcome was the level of functional oral intake (as per the Functional Oral Intake Scale; FOIS). Based on the PAS results, the patients were divided into two groups: (i) penetrator/aspirators (PAS score ≥3) and (ii) non-penetrator/aspirators (PAS score ≤2). Follow-up VFS studies were primarily conducted on the patients with penetration/aspiration in prior VFS studies. The follow-up VFS studies were scheduled on the basis of clinical demand.
Results
Of the 46 patients, 48% had penetration/aspiration in the first VFSS. The second VFSS was conducted on 20 patients, of whom 6 patients (30%) had penetration/aspiration. The third VFSS was conducted on 9 patients. Of these, only two (22%) patients were still penetrator/aspirators. The majority (n = 37, 88%) of the patients presented a total oral intake without restrictions at the time of the final follow-up. Only one patient (2%) was still tube-dependent with consistent oral intake.
Conclusion
Swallowing physiology in patients with TCSCI improved during the first months after injury, and the number of penetrator/aspirators decreased progressively.
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Acknowledgements
The authors thank the patients, biostatistician Mika Helminen, and research assistant Anne Simi for their assistance.
Funding
This study was funded by Maire Taponen säätiö, The Finnish Dysphagia Rehabilitation Association, and Finnish Association of Speech Therapists.
Author contributions
TI contributed to the study design, data collection, data analysis, data interpretation, and article preparation. TML contributed to the data interpretation and article preparation. IR-K contributed to the data collection and article preparation. A-MK-H contributed to the article preparation. AR contributed to the study design and article preparation.
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TI has received research grants from Maire Taponen säätiö, The Finnish Dysphagia Rehabilitation Association, and Finnish Association of Speech Therapists. TML declares that he has no conflict of interest. IR-K declares that she has no conflict of interest. AR declares that he has no conflict of interest. A-MK-H declares that she has no conflict of interest.
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Ihalainen, T., Luoto, T.M., Rinta-Kiikka, I. et al. Traumatic cervical spinal cord injury: recovery of penetration/aspiration and functional feeding outcome. Spinal Cord 56, 1000–1007 (2018). https://doi.org/10.1038/s41393-018-0091-1
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DOI: https://doi.org/10.1038/s41393-018-0091-1
