TOWARD CLASSIFICATION OF DYSPHAGIC PATIENTS USING BIOMECHANICAL MEASUREMENTS

Identification of a patient at risk of aspiration is a major problem i n the rehabilitation of the dysphagic patient. The present methods of diagnosis are based on clinical evaluation or videofluorography or fib eroptic endoscopic examination of swallowing (FEES). Recently, we deve loped biomechanical techniques for noninvasive quantitative assessment of the dysphagic patient. The purpose of the present investigation wa s to assess the clinical validity of the technique. In a double-blind study, both biomechanical test results and videofluorography (includin g bedside evaluation) results were used to independently classify the patients into four categories of risk for aspiration. Of the 36 patien ts studied, there was complete agreement between the biomechanical and clinical classifications in 21 patients. In 11 patients, the biomecha nical technique overestimated the risk by one category, and underestim ated the risk by one category in four patients. The biomechanical tech nique presents a useful tool for continued patient assessment; however , further studies are needed.