Validation of the German Version of Functional Oral Intake Scale (FOIS-G) for Flexible Endoscopic Evaluation of Swallowing (FEES)

Validation of the Italian Version of the Functional Oral Intake Scale (FOIS-It) Against Fiberoptic Endoscopic Evaluation of Swallowing and Nutritional Status

Dysphagia ◽

10.1007/s00455-021-10257-9 ◽

2021 ◽

Author(s):

Aurora Ninfa ◽

Nicole Pizzorni ◽

Angelo Eplite ◽

Claudia Moltisanti ◽

Antonio Schindler

Keyword(s):

Nutritional Status ◽

Rating Scale ◽

Oropharyngeal Dysphagia ◽

Oral Intake ◽

Endoscopic Evaluation ◽

Severity Rating ◽

Group Validity ◽

Functional Oral Intake Scale ◽

Spearman’S Correlation ◽

Etiological Heterogeneity

AbstractThe Functional Oral Intake Scale (FOIS) is a reliable and valid tool to assess functional oral intake of food and liquids in patients with oropharyngeal dysphagia (OD). Its validity was established for stroke patients against Videofluoroscopic Swallowing Study in English and Chinese and against Fiberoptic Endoscopic Evaluation of Swallowing (FEES) in German. FOIS was cross-culturally validated into Italian (FOIS-It), but construct validity against instrumental assessment and nutritional status was not investigated. The study aims at contributing to the validation of the FOIS-It, by performing convergent and known-group validity against FEES and nutritional status in patients with OD of different etiologies. Overall, 220 adult patients with OD of etiological heterogeneity were recruited. FOIS-It score and Body Mass Index (BMI) were collected. FEES was performed to assess swallowing safety and efficiency based on the Penetration-Aspiration Scale (PAS) and the Yale Pharyngeal Residue Severity Rating Scale (YPRSRS). Moderate to weak associations with PAS (ρ = − .37, p < .01), YPRSRS in the pyriform sinuses (ρ = − .20, p < .01), and BMI (ρ = .24, p < .01) were detected with Spearman’s correlation. FOIS-It distribution was compared with the Mann–Whitney U and Kruskal–Wallis tests. Significantly lower FOIS-It scores were detected among patients with penetration/aspiration (PAS > 2) and penetration (PAS > 2 ≤ 5) for all consistencies (p < .01), aspiration (PAS > 5) of liquids and semisolids (p < .001), residue in the pyriform sinuses (YPRSRS > 3) with semisolids (p < .001) and solids (p = .02), and malnutrition (BMI ≤ 18.5; p = .019). FOIS-It appears as a valid tool to assess functional oral intake against FEES’ measures of swallowing safety and efficiency and nutritional status in patients with OD of etiological heterogeneity.

Download Full-text

Adaptation and Validation of the Dynamic Imaging Grade of Swallowing Toxicity for Flexible Endoscopic Evaluation of Swallowing: DIGEST-FEES

Journal of Speech Language and Hearing Research ◽

10.1044/2021_jslhr-21-00014 ◽

2021 ◽

pp. 1-9

Author(s):

Heather M. Starmer ◽

Loni Arrese ◽

Susan Langmore ◽

Yifei Ma ◽

Joseph Murray ◽

...

Keyword(s):

Interrater Reliability ◽

Rating Scale ◽

Oral Intake ◽

Weighted Kappa ◽

Dynamic Imaging ◽

Severity Scale ◽

Endoscopic Evaluation ◽

Md Anderson ◽

Functional Oral Intake Scale ◽

Anderson Dysphagia Inventory

Purpose While flexible endoscopic evaluation of swallowing (FEES) is a common clinical procedure used in the head and neck cancer (HNC) population, extant outcome measures for FEES such as bolus-level penetration–aspiration and residue scores are not well suited as global patient-level endpoint measures of dysphagia severity in cooperative group trials or clinical outcomes research. The Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) was initially developed and validated for use during videofluoroscopic evaluations as a way to grade safety, efficiency, and overall pharyngeal swallowing impairment. The purpose of this study was to adapt and validate DIGEST for use with FEES. Method A modified Delphi exercise was conducted for content validation, expert consensus, adaptation, and operationalization of DIGEST-FEES. Three blinded, expert raters then evaluated 100 de-identified post-HNC treatment FEES examinations. Intra- and interrater reliability were tested with quadratic weighted kappa. Criterion validity against the MD Anderson Dysphagia Inventory, Functional Oral Intake Scale, Secretion Severity Scale, and Yale Residue Rating Scale was assessed with Spearman correlation coefficients. Results Interrater reliability was almost perfect for overall DIGEST-FEES grade (κ w = 0.83) and safety grade (κ w = 0.86) and substantial for efficiency grade (κ w = 0.74). Intrarater reliability was excellent for all raters (0.9–0.91). Overall DIGEST-FEES grade correlated with MD Anderson Dysphagia Inventory ( r = −.43, p < .0001), Functional Oral Intake Scale ( r = −.43, p < .0001), Secretion Severity Scale ( r = .47, p < .0001), Yale Vallecular Residue ( r = .73, p < .0001), and Yale Pyriform Sinus Residue ( r = .65, p < .0001). Conclusion DIGEST-FEES is a valid and reliable scale to describe the severity of pharyngeal dysphagia in patients with HNC. Supplemental Material https://doi.org/10.23641/asha.14642787

Download Full-text

Change in Spontaneous Swallowing Frequency in HNC Patients Undergoing C/RT

Otolaryngology ◽

10.1177/01945998211020744 ◽

2021 ◽

pp. 019459982110207

Author(s):

Giselle D. Carnaby ◽

Aarthi Madhavan ◽

Ali Barikroo ◽

Michael Crary

Keyword(s):

Repeated Measures ◽

Prospective Cohort ◽

Area Under The Curve ◽

Objective Measure ◽

Oral Intake ◽

Comprehensive Cancer Center ◽

Cancer Center ◽

Swallowing Function ◽

Function Change ◽

Functional Oral Intake Scale

Objective This study sought to evaluate the role and trajectory of spontaneous swallowing frequency (SFA) in patients with head and neck cancer (HNC) undergoing chemoradiotherapy (C/RT). Study Design. Prospective cohort. Setting University comprehensive cancer center. Methods A prospective cohort of 80 patients with HNC was followed from baseline to 3 months post-C/RT. Subjects were evaluated for performance on swallowing function, functional diet consumed, weight, swallowing frequency rate, perceived xerostomia, perceived pain, and mucositis. Relationships were evaluated using univariate correlations, t tests, and repeated-measures analysis of variance. The diagnostic accuracy of SFA to express dysphagia was calculated by area under the curve (AUROC) and displayed using receiver operator characteristic curves. Results In general, patients with HNC demonstrated a parabolic decline in most measures over the C/RT trajectory. SFA and perceived xerostomia did not show improved recovery by 3 months. SFA was related to swallow function, xerostomia, and functional diet consumed posttreatment and pain at 3 months. The ability of SFA to correctly identify clinical dysphagia (Mann Assessment of Swallowing–Cancer version [MASA-C]) and reduced oral intake (Functional Oral Intake Scale [FOIS]) at posttreatment was strong (AUROC MASA-C: 0.824 [95% CI, 0.63-1.00], P < .0018; AUROC FOIS: 0.96 [95% CI, 0.87-0.96], P < .0001). Conclusion This exploratory study suggests SFA may provide a useful method to identify dysphagia after HNC treatment. Furthermore, SFA may offer a simple, objective measure of swallowing function change in HNC over the C/RT trajectory.

Download Full-text

Initial Psychometric Assessment of a Functional Oral Intake Scale for Dysphagia in Stroke Patients

Archives of Physical Medicine and Rehabilitation ◽

10.1016/j.apmr.2004.11.049 ◽

2005 ◽

Vol 86 (8) ◽

pp. 1516-1520 ◽

Cited By ~ 575

Author(s):

Michael A. Crary ◽

Giselle D. Carnaby Mann ◽

Michael E. Groher

Keyword(s):

Oral Intake ◽

Psychometric Assessment ◽

Stroke Patients ◽

Functional Oral Intake Scale

Download Full-text

Ingesta oral do paciente hospitalizado com disfagia orofaríngea neurogênica

Revista CEFAC ◽

10.1590/s1516-18462010005000090 ◽

2010 ◽

Vol 12 (6) ◽

pp. 964-970 ◽

Cited By ~ 7

Author(s):

Carolina Castelli Silvério ◽

Ana Maria Hernandez ◽

Maria Inês Rebelo Gonçalves

Keyword(s):

Oral Intake ◽

Functional Oral Intake Scale ◽

I 31

OBJETIVO: verificar a evolução na ingesta oral e a ocorrência de broncopneumonias (BCP) em pacientes hospitalizados com disfagia orofaríngea neurogênica, após atuação fonoaudiológica. MÉTODOS: 50 pacientes adultos, divididos em grupos: I: 31 pacientes pós-acidente vascular encefálico; II: sete pacientes pós-traumatismo crânio-encefálico; III: 12 pacientes com demência. Foram levantadas as informações antes e após a atuação fonoaudiológica: nível da Functional Oral Intake Scale (FOIS), ocorrência de BCP; número de atendimentos fonoaudiológicos e motivo de interrupção destes. RESULTADOS: houve aumento significativo dos níveis da escala FOIS e redução do percentual de ocorrência de BCP nos três grupos estudados. Nos grupos pós-AVE e demência a interrupção da fonoterapia ocorreu devido à alta hospitalar, enquanto que no grupo pós-TCE devido à alta fonoaudiológica. CONCLUSÃO: os pacientes deste estudo demonstraram avançar das consistências alimentares na ingesta oral, e redução da ocorrência de BCP, após a intervenção fonoaudiológica com relação à disfagia.

Download Full-text

Paciente com paralisa cerebral coreoatetoide: evolução clínica pós-intervenção

Revista CEFAC ◽

10.1590/s1516-18462010005000007 ◽

2010 ◽

Vol 12 (2) ◽

pp. 250-256

Author(s):

Carolina Castelli Silvério ◽

Cristiane Soares Henrique

Keyword(s):

Oral Intake ◽

Functional Oral Intake Scale

OBJETIVO: verificar a eficácia da intervenção terapêutica na função de deglutição e na estabilidade clínica de crianças portadoras de paralisia cerebral (PC) coreoatetoide com disfagia orofaríngea. MÉTODOS: 11 crianças portadoras de PC do tipo coreoatetoide, com média de idade de três anos e três meses, que frequentaram terapia fonoaudiológica. Foram levantados os seguintes dados: escala de avaliação funcional da alimentação (Functional Oral Intake Scale - FOIS); grau de severidade da disfagia; broncopneumonias (BCP), hipersecretividade pulmonar e peso; consistência alimentar; sinais de penetração e/ou aspiração laringotraqueal. Os dados foram levantados no relatório de avaliação antes da intervenção terapêutica e no relatório final de evolução, no momento da alta. RESULTADOS: com relação à aplicação da escala FOIS, obteve-se que, tanto antes, quanto após a intervenção, a maioria dos pacientes encontrou-se no nível V da escala, com diminuição no segundo momento. Aumento dos pacientes nos níveis III e IV. Após intervenção terapêutica, houve diminuição de pacientes que ingeriam líquidos, aumento do uso do líquido espesso e do pastoso homogêneo. Houve diminuição da severidade da disfagia, redução dos episódios de BCP e de hipersecretividade pulmonar, aumento de peso e redução dos sinais de penetração e/ou aspiração laringotraqueal. CONCLUSÃO: a intervenção fonoaudiológica, dentro de uma equipe multidisciplinar em disfagia, em crianças portadoras de PC coreoatetoide promove deglutição mais segura e eficaz, com redução dos sinais sugestivos de penetração e/ou aspiração laringotraqueal, dos episódios de BCP e de hipersecretividade pulmonar, e aumento do peso.

Download Full-text

Role of preoperative cervical alignment on postoperative dysphagia after occipitocervical fusion

Surgical Neurology International ◽

10.25259/sni_547_2021 ◽

2021 ◽

Vol 12 ◽

pp. 350

Author(s):

Midori Miyagi ◽

Hiroshi Takahashi ◽

Hideki Sekiya ◽

Satoru Ebihara

Keyword(s):

Rank Correlation ◽

Oral Intake ◽

Postoperative Dysphagia ◽

Occipitocervical Fusion ◽

Cervical Alignment ◽

Pharyngeal Airway ◽

Before And After ◽

Functional Oral Intake Scale ◽

Relationship Of

Background: Dysphagia is one of the most serious complications of occipitocervical fusion (OCF). The previous studies have shown that postoperative cervical alignment, documented with occipito (O)-C2 angles, C2-C6 angles, and pharyngeal inlet angles (PIA), impacted the incidence of postoperative dysphagia in patients undergoing OCF. Here, we investigated the relationship of preoperative versus postoperative cervical alignment on the incidence of postoperative dysphagia after OCF. Methods: We retrospectively reviewed the clinical data/medical charts for 22 patients following OCF (2006– 2019). The O-C2 angles, C2-C6 angles, PIA, and narrowest pharyngeal airway spaces (nPAS) were assessed using plain lateral radiographs of the cervical spine before and after the surgery. The severity of dysphagia was assessed with the functional oral intake scale (FOIS) levels as documented in medical charts; based on this, patients were classified into the nondysphagia (FOIS: 7) versus dysphagia (FOIS: 1–6) groups. Results: Seven patients (35%) experienced dysphagia after OCF surgery. Preoperative PIA and nPAS were smaller in the dysphagia group. Spearman rank correlation showed a positive correlation between preoperative PIA and FOIS and between preoperative nPAS and FOIS. Conclusion: This study suggests that preoperative cervical alignment may best predict the incidence of postoperative dysphagia after OCF.

Download Full-text

Relationship between the Functional Oral Intake Scale (FOIS) and the Self-Efficacy Scale among Cancer Patients: A Cross-Sectional Study

Healthcare ◽

10.3390/healthcare8030269 ◽

2020 ◽

Vol 8 (3) ◽

pp. 269

Author(s):

Yuhei Matsuda ◽

Masaaki Karino ◽

Takahiro Kanno

Keyword(s):

Oral Health ◽

Self Efficacy ◽

Odds Ratio ◽

Oral Intake ◽

Cross Sectional Study ◽

The Self ◽

Sectional Study ◽

Cross Sectional ◽

Health Related ◽

Functional Oral Intake Scale

A few studies have provided detailed reports suggesting that subjective swallowing disorders may be related to dysphagia. Therefore, we verified the relationship between oral health-related self-efficacy and dysphagia severity in cancer treatment using a cross-sectional study. Participants included patients undergoing treatment for cancer at Shimane University Hospital in Shimane, Japan, and those receiving outpatient treatment at the hospital’s Oral Care Center between August 2018 and April 2019. In all, 203 participants enrolled in the study and completed the Functional Oral Intake Scale (FOIS), the Self-efficacy Scale for Advanced Cancer (SEAC), and the Oral Health-related Self-Efficacy Scale for Patients with Cancer (OSEC). Multivariate analysis showed a statistically significant correlation between the low FOIS score and the SEAC subscales of Activities of Daily Living Self-efficacy (ADE) (odds ratio 1.04, 95% [CI] 1.00–1.07) and Symptom Coping Self-efficacy (SCE) (odds ratio 0.61, 95% [CI] 0.42–0.88). Based on the Jonckheere-Terpstra test, the SEAC and the OSEC tended to increase as the category of the FOIS progressed. To conclude, self-efficacy played an important role in dysphagia and may affect the severity of dysphagia in cancer patients.

Download Full-text

Construct and content validity of the Functional Oral Intake Scale; Analyses from a cohort of patients with acquired brain injury

Brain Injury ◽

10.1080/02699052.2020.1800094 ◽

2020 ◽

Vol 34 (9) ◽

pp. 1257-1263

Author(s):

Jesper Mortensen ◽

Asger Roer Pedersen ◽

Jørgen Feldbæk Nielsen ◽

Mohit Kothari

Keyword(s):

Brain Injury ◽

Content Validity ◽

Oral Intake ◽

Acquired Brain Injury ◽

Functional Oral Intake Scale

Download Full-text

Disfagia orofaríngea na Síndrome de Wallenberg - série de casos

Revista CEFAC ◽

10.1590/1982-0216201618314615 ◽

2016 ◽

Vol 18 (3) ◽

pp. 721-726

Author(s):

Diego Fernando Dorneles Bilheri ◽

Renata Mancopes ◽

Sheila Tamanini de Almeida

Keyword(s):

Oral Intake ◽

Functional Oral Intake Scale

RESUMO: Objetivo: caracterizar o quadro de comprometimento da função da deglutição em pacientes com Síndrome de Wallenberg. Métodos: série de casos de sete pacientes, com diagnóstico dessa síndrome, encaminhados para avaliação fonoaudiológica. Para avaliação do grau de disfagia utilizou-se a escala Gugging Swallowing Screen e para avaliar o nível de ingestão oral utilizou-se a Functional Oral Intake Scale. Resultados: a média de idade foi de 60,57 anos; todos os sujeitos apresentaram alteração na função da deglutição de grau grave (71,42%) a moderado (28,58%); 85,71% necessitaram de Via Alternativa de Alimentação, sendo que, 71,43% eram alimentados exclusivamente por sonda nasoentérica; todos necessitaram de acompanhamento fonoaudiológico. Conclusão: este estudo concluiu que a disfagia orofaríngea na Síndrome de Wallenberg apresenta-se como um distúrbio de grau grave a moderado, sendo necessária a utilização de Via Alternativa de Alimentação na maioria dos casos.

Download Full-text