Oropharyngeal Transition of the Bolus in Post-Stroke Patients

Park T, Kim Y, McCullough G: Oropharyngeal transition of the bolus in post-stroke patients. Am J Phys Med Rehabil 2013;92:320-326. Objective: The purposes of this study were to determine whether two bolus transition durations (oral transit time and pharyngeal transit time) were different during oropharyngeal swallowing in post-stroke patients who aspirated and who did not aspirate and to examine those differences across varying bolus viscosities. Design: Means and standard deviations of oral transit time and pharyngeal transit time were analyzed on 5 ml of thin and nectar thick liquids and puree swallows from videofluoroscopic swallowing examinations of 30 post-stroke patients. Statistical comparisons were made by repeated measures analysis of variance, with the within-subject variable being the three consistencies and the between-subject variable being the two groups. Significance level was set at P < 0.025. Results: Oral transition of the bolus did not differ between the two patient groups. Pharyngeal transition of the bolus differentiated the patients who aspirated from the patients who did not aspirate. Both the oral and pharyngeal transitions differed significantly for the puree compared with the thin and nectar thick liquids. Conclusions: Patients who demonstrate prolonged pharyngeal transit times may be at risk for aspiration.