The discriminant ability of the Eating Assessment tool-10 to detect swallowing efficiency in neurogenic dysphagia.

PURPOSE: Neurogenic dysphagia causes complications such as malnutrition, dehydration, and aspiration pneumonia. Therefore, early detection with clinically valid tools is essential. This study aimed to investigate the Eating Assessment Tool-10 (EAT-10) ability to detect swallowing efficiency at three different consistencies in neurogenic dysphagia. METHODS: One hundred twelve patients with neurogenic dysphagia (74 males and 38 females, mean ± SD age 61.83 ± 9.72 years) were included in the study. A Fiberoptic Endoscopic Evaluation of Swallowing (FEES) was performed in the clinic following EAT-10 to assess swallowing efficacy at International Dysphagia Diet Standardization Initiative (IDDSI) consistencies of 0, 3, and 7. The swallowing efficiency of the patients was assessed using the Yale Pharyngeal Residue Severity Rating Scale (YPRSRS). Area under the curve, sensitivity, and specificity values were calculated to evaluate the ability of EAT-10 to discriminate between participants with and without residue and between participants with and without moderate-to-severe residue. RESULTS: The EAT-10 significantly detected participants with and without residues for three IDDSI consistent: for IDDSI 0 residue in the vallecula and pyriform sinus (cutoff score ≥ 14, p < 0.001), for IDDSI 3 residue in the vallecula and pyriform sinus (cutoff score ≥ 13, p < 0.001), for IDDSI 7 residue in the vallecula and pyriform sinus (respectively, cutoff score ≥ 13, cutoff score ≥ 14, p < 0.001). Additionally, the EAT-10 significantly detected those with and without moderate-to-severe residue. CONCLUSIONS: The EAT-10, frequently used in swallowing clinics, can determine swallowing efficiency in individuals with neurogenic dysphagia. Additionally, it has the power to detect moderate-to-severe pharyngeal residue.

Effectiveness of a Voice Training Program for Religious Officials in Turkey.

This study examines the effectiveness of a voice training program designed for Islamic religious officials, who are occupational voice users with a significant vocal load. The participants included 34 healthy religious officials whose acoustic measures were within normal voice ranges for healthy adults (jitter < 1%; shimmer < 3%) and reported no voice complaints. Participants were randomly divided into two groups (experimental, n = 17; control, n = 17). The two-stage voice training program consisted of 32 sessions over 8 weeks with informative and voice exercise stages. Objective and subjective voice measurements were performed at the beginning and end of the research. Objective measurements included fundamental frequency, percentage of vocal pitch perturbation (jitter), percentage of vocal intensity perturbation (shimmer), and harmonics-to-noise ratio. Subjective voice measurements included the Singing Voice Handicap Index, Vocal Fatigue Index (VFI), and Voice-Related Quality of Life (V-RQoL) scores. All initial measurements other than VFI scores were within acceptable limits for both groups. There were no significant differences between the groups initially (p > 0.05) and no significant changes in the control group in the second evaluation (p > 0.05). However, there was significant improvement in the experimental group after the training program in all measures, including VFI scores (p < 0.05). This study shows the positive results of a voice training program. Voice training should be integrated into the formal education of occupational voice users or in-service training programs of relevant institutions.

Comparing dysphonia severity index, objective, subjective, and perceptual analysis of voice in patients with multiple sclerosis and healthy controls.

BACKGROUND: Impairments in voice quality in Multiple Sclerosis (MS) have recently been investigated and different results were found. A voice-centered multidimensional assessment protocol with patient-reported outcome measures was conducted to evaluate all the aspects of the voice changes. OBJECTIVES: The study aimed to compare the objective, subjective, and perceptual measures of voice between the people with MS and the healthy control group. METHODS: A total of 128 participants, including 64 people with MS age, and gender-matched healthy controls were enrolled in the study. Subjective, objective, and auditory-perceptual voice assessments of the participants were performed. The auditory-perceptual evaluation was performed with GRBAS. The Dysphonia Severity index was computed for both groups. All the participants completed the Turkish version of The Voice Handicap Index-10 (VHI-10) and the Voice-Related Quality of Life (VRQoL). RESULTS: Acoustic and aerodynamic parameters of voice were found significantly different for both males and females between the MS and control group. DSI was found significantly different for both males and females in the MS group compared to the control group (p<0.05). All components of the GRBAS scale were significantly higher in the MS group (p<0.001). Using a multivariate regression model, it was determined that age, gender, EDSS score, number of MS attacks, and disease duration did not affect the DSI. The overall VHI-10 score was higher in the MS group (median=1.0 range= 0-28) and lower in the control group (median=0 range= 0-4). The mean VRQoL was lower in the MS group (median=95 range= 62.5-100) than in controls (median=100 range= 85-100) (p<0.001). CONCLUSION: Our results indicated that people with MS have significant differences in acoustic and aerodynamic parameters of voice compared to healthy individuals. A significant number of persons with MS are aware that their voice problem affects their quality of life. People with MS must be monitored for voice changes and a multidimensional voice assessment protocol should be implemented.

Reliability and validity of the Turkish version of speech pathology-specific questionnaire for persons with multiple sclerosis (SMS-TR).

PURPOSE: The aim of this study is to validate the speech pathology-specific questionnaire for persons with Multiple Sclerosis (SMS) in Turkish. METHOD: A total of 218 participants were included in the study. The study group was composed of 104 persons diagnosed with MS, and the control group was 114 healthy participants without any neurological deficits. The translated version of the SMS was administered to all participants. Test-retest reliability, internal consistency, construct validity, floor and ceiling effects were investigated. Dysphagia in multiple sclerosis questionnaire (DYMUS) was used for criterion validity. Finally, sensitivity and specificity of the SMS-TR was calculated using a ROC curve analysis. RESULT: SMS-TR has an excellent internal consistency (Cronbach's alpha = 0.92). Item-total correlations range between 0.45 and 0.78. The intraclass correlation coefficient (ICC) obtained for the test-retest indicates a good level of reproducibility (ICC = 0.86). According to confirmatory factor analysis, the fit measures of the scale were found to be acceptable. A significant difference was found between the total SMS scores of the study group and the control group (20.6 ± 10.4 and 1.9 ± 2.8, P < 0.001, respectively). A statistically significant correlation was observed between SMS and DYMUS (r = 0.833, P < 0.001). There were no floor and ceiling effects found in the study group. According to the ROC curve analysis, the area under the curve of SMS-TR was 0.98. The optimal cut-off value was 8, with a sensitivity of 91.3% and a specificity of 95.6%. CONCLUSION: SMS-TR is a valid and reliable patient-reported outcome measure suitable for the assessment of language, speech, and swallowing disorders in persons with MS. A score >8 is an indicator of language, speech, and swallowing pathology for persons.