Comparison of Sequential Swallowing in Patients With Acute Stroke and Healthy Adults

Murguia M, Corey DM, Daniels SK. Comparison of sequential swallowing in patients with acute stroke and healthy adults.ObjectivesTo compare hyolaryngeal complex (HLC) movement and leading-edge-of-the-bolus location patterns of sequential swallowing in patients with stroke and healthy adults, and to determine whether these patterns affect swallowing safety.DesignBetween-groups comparison.SettingVeterans hospital.ParticipantsConsecutively admitted patients with acute unilateral supratentorial stroke (right hemisphere damage, n=13; left hemisphere damage, n=16) and age-matched healthy participants (n=25).InterventionsNot applicable.Main Outcome MeasuresHLC movement pattern, bolus location, Penetration-Aspiration (P-A) Scale score.ResultsNo significant group differences were observed for HLC movement pattern, bolus location, and P-A Scale score. Specific HLC movement patterns and bolus location were not associated with a higher P-A Scale score. A significant correlation between HLC movement pattern and bolus location was observed. Bolus location was typically inferior to the valleculae between swallows when the HLC was partially elevated. Across all groups, P-A Scale scores were significantly higher during sequential swallowing than single swallows.ConclusionsHLC movement pattern and bolus location do not appear related to airway invasion, at least in persons without significant dysphagia. Given higher P-A Scale scores during sequential swallowing as compared with single swallows, sequential swallowing should always be evaluated in all patients.