swallowing; dysphagia; consciousness disorders; severe brain injury; assessment
Abstract :
[en] Background: After a severe brain injury and a coma, patients may develop disorders of consciousness (DoC), frequently accompanied by severe dysphagia. The evaluation and therapy of swallowing are therefore essential aspects of their management. Objectives: This study aims to evaluate the SWallowing Assessment in Disorders of Consciousness (SWADOC) tool in the assessment of swallowing in post-comatose patients. Here, we validate its quantitative items, describe preliminary results and identify limitations. Methods: Fourteen post-comatose patients were repeatedly evaluated with the Simplified Evaluation of CONsciousness Disorders (SECONDs) and with the SWADOC. Results: The internal consistency of the oral and pharyngeal subscales of the SWADOC was good. The test–retest reliability showed that all items, all subscores and the total score were stable except for two items (endo-buccal secretions and bronchial congestion). A comparison to the Facial Oral Tract Therapy Swallowing Assessment of Saliva (F.O.T.T-SAS) confirmed that scoring with the SWADOC offers a greater potential for quantitative observations in assessing swallowing abilities among patients with DoC. The SECONDs scores and SWADOC total scores showed a significant positive correlation (τ = 0.78, p < 0.001). Conclusions: This study provides preliminary but encouraging results on the psychometric properties of the SWADOC tool. It shows that this tool is relevant and feasible as a bedside assessment of dysphagia in patients with DoC.
Disciplines :
Neurology
Author, co-author :
Herr, Roxanne ✱; Neurology Department, Haguenau Hospital, 67500 Haguenau, France
Regnier, Amandine ✱; Université de Liège - ULiège > GIGA > GIGA Consciousness - Coma Science Group ; Centre Hospitalier Universitaire de Liège - CHU > > Service de médecine de l'appareil locomoteur
Belorgeot, Marion ✱; Physical Medecine and Rehabilitation Medicine Department, University Hospital of Nîmes, 30029 Nîmes, France
Mélotte, Evelyne ; Université de Liège - ULiège > Département de Logopédie > Logopédie des troubles de la voix
Simon, Jessica ; Université de Liège - ULiège > Département de Psychologie > Psychologie quantitative
Sanz, Leandro ; Université de Liège - ULiège > GIGA > GIGA Consciousness - Coma Science Group
Lejeune, Nicolas ; Université de Liège - ULiège > GIGA > GIGA Consciousness - Coma Science Group ; William Lennox Neurological Hospital Center, 1340 Ottignies-Louvain-la-Neuve, Belgium ; Institute of NeuroScience, Université Catholique de Louvain, 1200 Brussels, Belgium
Chavet, Valérie; Physical Medicine and Rehabilitation Medicine Department, Center for Traumatology and Rehabilitation Erasme, 1070 Brussels, Belgium
PALUSZKIEWICZ, Jenny ; Centre Hospitalier Universitaire de Liège - CHU > > Service de médecine de l'appareil locomoteur
Pellas, Frédéric; Physical Medecine and Rehabilitation Medicine Department, University Hospital of Nîmes, 30029 Nîmes, France
Chevallier, Jean-Baptiste; EVC-EPR Unit, Functional Rehabilitation Center of Fontfroide, 34070 Montpellier, France
Laureys, Steven ; Université de Liège - ULiège > Département des sciences cliniques ; Joint International Research Unit on Consciousness, CERVO Brain Research Centre, Laval University, Québec, QC G1J2G3, Canada
Kaux, Jean-François ; Université de Liège - ULiège > Département des Sciences de l'activité physique et de la réadaptation > Médecine physique, réadaptation et traumatologie du sport ; Université de Liège - ULiège > Evaluation-Revalidation (EVAREVA) ; Centre Hospitalier Universitaire de Liège - CHU > > Service de médecine de l'appareil locomoteur
Gosseries, Olivia ; Université de Liège - ULiège > GIGA > GIGA Consciousness - Coma Science Group
CHU Liège - Central University Hospital of Liege Leon Fredericq Foundation F.R.S.-FNRS - Fonds de la Recherche Scientifique FRB - King Baudouin Foundation ESA - European Space Agency UET - Université Européenne du Travail FERB - Fondazione Europea Ricerca Biomedica Bial Foundation MSF - Mind Science Foundation EC - European Commission Mind Care Foundation NSCF - National Natural Science Foundation of China ULiège - University of Liège
Funding text :
We would like to express our gratitude to all the patients who took part in the assessments and their families. We thank the health care teams of the post-coma units and rehabilitation services in the William Lennox Neurological Hospital in Ottignies-Louvain-La Neuve, the Center of Traumatology and Rehabilitation Erasme in Brussels, the Neurological and Functional Rehabilitation Centre of University Hospital of Liège in Fraiture-en-Condroz and the Functional Rehabilitation Clinic of Fontfroide in Montpellier. We also extend our thanks to Naji Alnagger for his
assistance with the English revision; Horizon 2020 MSCA—Research and Innovation Staff Exchange
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