Katıları Çiğneme ve Yutma Testi’nin Türkiye normatif verileri

Year 2021, Volume: 46 Issue: 3, 920 - 926, 30.09.2021

Mariam Kavakcı Melike Tanriverdi Elife Barmak Nazife Kapan

https://doi.org/10.17826/cumj.840796

Cited By: 1

Abstract

Amaç: Yutma, birçok kas ve sinirin bütünlüğünü gerektiren karmaşık bir nöromüsküler süreçtir. Doğal yaşlanma süreci, yutma yapılarının bozulmasına ve sağlıklı yaşlı yetişkinlerde fonksiyonel değişikliklere neden olabilir. Katıları Çiğneme ve Yutma Testi, katı gıda yenmesinde kantitatif ölçümler sağlayan tek enstrümental olmayan testtir. Bu çalışma, sağlıklı Türk yetişkinlerinde potansiyel olarak klinik disfaji değerlendirmesinde standart görevi görebilecek olan Katıları Çiğneme ve Yutma Testi için normatif verileri oluşturmayı amaçlamaktadır.
Gereç ve Yöntem: Çalışmaya yaş ve cinsiyete göre gruplandırılmış 144 sağlıklı Türk yetişkini (20-80 yaş arası) katılmıştır. Test, katılımcıların bölgesel bir kraker yemesini gerektirdi. Protokole göre çiğneme döngüsü sayısı, yutma sayısı, ısırık sayısı ve krakeri yutmak için toplam süre kaydedildi.
Bulgular: Katıları Çiğneme ve Yutma Testi için normatif veriler, bölgesel bir kraker için yaş ve cinsiyete göre gruplandırılmış 144 sağlıklı kontrolden elde edildi. Daha genç katılımcılar, yaşlı katılımcılara göre daha az ısırık (2,65'e karşı 2,00), daha az çiğnediler (51,02'ye karşı 34,50), daha az yuttular (2,06'ya karşı 3,39) ve daha hızlı yuttular (49,20'ye karşı 30,14). Cinsiyet açısından, erkekler kadınlara göre daha az ısırık (1.94'e karşı 2.59), daha az çiğneme (40.98'e karşı 45.83) ve daha hızlı yuttular (36.72'ye karşı 41.23).
Sonuç: Katıları Çiğneme ve Yutma Testi, yatak başında yutma güçlüğü çeken hastaları belirlemek ve yutmanın oral fazının etkinliğini değerlendirmek için yararlı olabilecek katı bolus yutmanın hızlı, hassas ve objektif bir ölçüsüdür.

Keywords

değerlendirme, çiğneme, yutma, normatif

Turkish normative data for the Test of Masticating and Swallowing Solids (TOMASS)

Abstract

Purpose: Swallowing is a complex neuromuscular process requiring the integrity of many muscles and nerves. The natural aging process can result in deterioration of the swallowing structures and result in functional changes in healthy older adults. The Test of Masticating and Swallowing Solids is the only non-instrumental test that provides quantitative measures for solid food ingestion. This study aimed to establish normative data for the Test of Masticating and Swallowing Solids in healthy Turkish adults to potentially serve as a standard in dysphagia evaluation.
Materials and Methods: A total of 144 healthy Turkish adults (ages 20-80+ years) grouped by age and gender participated in this study. The test required participants to eat a regional cracker. Per the protocol, the number of masticatory cycles, number of swallows, number of bites, and total duration to eat the cracker were recorded.
Results: Normative data were obtained for the Test of Masticating and Swallowing Solids from 144 healthy adults, stratified by age and gender. Younger participants took fewer bites (2.00 versus 2.65), chewed less (34.50 versus 51.02), swallowed less (2.06 versus 3.39), and swallowed quicker (30.14 versus 49.20) than older participants. In terms of gender, males took fewer bites (1.94 versus 2.59), chewed less (40.98 versus 45.83), and swallowed quicker (36.72 versus 41.23) than females.
Conclusion: The Test of Masticating and Swallowing Solids is a quick, sensitive, and objective measure of solid bolus ingestion that may be useful for identifying dysphagic patients at bedside and for tracking the efficiency of the oral phase of swallowing.

Keywords

assessment, mastication, deglutition, normative

References

• [1] Logemann J. Evaluation and Treatment of Swallowing Disorders, 2nd Ed. Austin, Pro-Ed, 1998.
• [2] Kennedy J, & Kent RD. Anatomy and physiology of deglutition and related functions. In: Logemann, J. (Ed.) Seminars in Speech and Language: The Relationship Between Speech and Swallowing (1–12). New York, Thieme-Stratton, 1985.
• [3] Robbins J. Normal swallowing and aging. Semin Neurol. 1996;16(4):309-317.
• [4] Fei T, Polacco RC, Hori SE, et al. Age-related differences in tongue-palate pressures for strength and swallowing tasks. Dysphagia. 2013;28(4):575-581.
• [5] Robbins J. Old Swallowing and Dysphagia: Thoughts on Intervention and Prevention. Nutrition in Clinical Practice. 1999; 14: S21-S26.
• [6] Robbins J, Gangnon RE, Theis SM, Kays SA, Hewitt AL, Hind JA. The effects of lingual exercise on swallowing in older adults. J Am Geriatr Soc. 2005;53(9):1483-1489.
• [7] Robbins J, Levine R, Wood J, Roecker EB, Luschei E. Age effects on lingual pressure generation as a risk factor for dysphagia. J Gerontol A Biol Sci Med Sci. 1995;50(5):M257-M262.
• [8] Tracy JF, Logemann JA, Kahrilas PJ, Jacob P, Kobara M, Krugler C. Preliminary observations on the effects of age on oropharyngeal deglutition. Dysphagia. 1989;4(2):90-94.
• [9] Carlsson GE. Masticatory efficiency: the effect of age, the loss of teeth and prosthetic rehabilitation. Int Dent J. 1984;34(2):93-97.
• [10] Ship JA, Duffy V, Jones JA, Langmore S. Geriatric oral health and its impact on eating. J Am Geriatr Soc. 1996;44(4):456-464.
• [11] Abdulmassih EM da S, Teive HAG, & Santos, RS. The evaluation of swallowing in patients with spinocerebellar ataxia and oropharyngeal dysphagia: A comparison study of videofluoroscopic and sonar doppler. International Archives of Otorhinolaryngology. 2013;17(1):66–73.
• [12] Ciucci MR, Grant LM, Rajamanickam ES, et al. Early identification and treatment of communication and swallowing deficits in Parkinson disease. Semin Speech Lang. 2013;34(3):185-202.
• [13] Gilheaney Ó, Zgaga L, Harpur I, et al. The Prevalence of Oropharyngeal Dysphagia in Adults Presenting with Temporomandibular Disorders Associated with Rheumatoid Arthritis: A Systematic Review and Meta-analysis. Dysphagia. 2017;32(5):587-600.
• [14] Robbins J, Hamilton JW, Lof GL, Kempster GB. Oropharyngeal swallowing in normal adults of different ages. Gastroenterology. 1992;103(3):823-829.
• [15] Perlman AL, Schultz JG, VanDaele DJ. Effects of age, gender, bolus volume, and bolus viscosity on oropharyngeal pressure during swallowing. J Appl Physiol (1985). 1993;75(1):33-37.
• [16] Athukorala RP, Jones RD, Sella O, Huckabee ML. Skill training for swallowing rehabilitation in patients with Parkinson's disease. Arch Phys Med Rehabil. 2014;95(7):1374-1382.
• [17] Huckabee ML, McIntosh T, Fuller L, et al. The Test of Masticating and Swallowing Solids (TOMASS): reliability, validity and international normative data. Int J Lang Commun Disord. 2018;53(1):144-156.
• [18] Nakayama, M. (1991). [Histological study on aging changes in the human tongue].Nihon Jibiinkoka Gakkai Kaiho, 94(4), 541–555.
• [19] Yamaguchi A, Nasu M, Esaki Y, Shimada H, Yoshiki S. Amyloid deposits in the aged tongue: a postmortem study of 107 individuals over 60 years of age. J Oral Pathol. 1982;11(3):237-244.
• [20] Balice-Gordon RJ. Age-related changes in neuromuscular innervation. Muscle Nerve Suppl. 1997;5:S83-S87.
• [21] Light KE, & Spirduso WW. Effects of adult aging on the movement complexity factor of response programming. Journal of Gerontology. 1990;45(3):107–109.
• [22] Kays SA, Hind JA, Gangnon RE, Robbins J. Effects of dining on tongue endurance and swallowing-related outcomes. J Speech Lang Hear Res. 2010;53(4):898-907.
• [23] Schiffman SS. Perception of taste and smell in elderly persons. Crit Rev Food Sci Nutr. 1993;33(1):17-26.
• [24] Weiffenbach JM, & Bartoshuk LM. Taste and smell. Clinics in Geriatric Medicine. 1992;8(3):543–555.
• [25] Smith CH, Logemann JA, Burghardt WR, Zecker SG, Rademaker AW. Oral and oropharyngeal perceptions of fluid viscosity across the age span. Dysphagia. 2006;21(4):209-217.
• [26] Calhoun KH, Gibson B, Hartley L, Minton J, & Hokanson JA. Age-related changes in oral sensation. The Laryngoscope. 1992;102(2):109–116.
• [27] Lee JH, Kim HS, Yun DH, et al. The Relationship Between Tongue Pressure and Oral Dysphagia in Stroke Patients. Ann Rehabil Med. 2016;40(4):620-628.
• [28] Theurer JA, Johnston JL, Taves DH, Bach D, Hachinski V, & Martin RE. Swallowing after right hemisphere stroke: oral versus pharyngeal deficits. Canadian Journal of Speech-Language Pathology & Audiology. 2008;32(3): 114–122
• [29] Colton-Hudson A, Koopman WJ, Moosa T, Smith D, Bach D, Nicolle M. A prospective assessment of the characteristics of dysphagia in myasthenia gravis. Dysphagia. 2002;17(2):147-151.
• [30] Kawai S, Tsukuda M, Mochimatsu I, et al. A study of the early stage of Dysphagia in amyotrophic lateral sclerosis. Dysphagia. 2003;18(1):1-8.