Analysis of Cough in Post-stroke Individuals with Dysphagia
Introduction: Stroke is considered to be one of the major causes of morbidity and mortality globally, associated with numerous medical complications leading to an extended hospital stay and significant health care expenses. Dysphagia is one of the most common and life-threatening conditions seen...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2018-12-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/12326/37417_CE[Ra]_F(P)_(P_AJ)_PFA(AJ_RK)_PN(P).pdf |
| Summary: | Introduction: Stroke is considered to be one of the major causes
of morbidity and mortality globally, associated with numerous
medical complications leading to an extended hospital stay and
significant health care expenses. Dysphagia is one of the most
common and life-threatening conditions seen in nearly 65% of
stroke survivors. Stroke is reported to have an adverse effect
on cough function.
Aim: To analyse the cough in individuals with dysphagia.
Materials and Methods: The study was conducted in the
Department of Neurology, Kasturba Hospital, Manipal,
Karnataka, India. A cross sectional research design with the
convenient sampling was adopted. A total of 30 participants
were recruited in the age range of 40-70 years. All the
participants were tube dependent with a functional oral intake
scale score of ≥ Level 2. The clinical swallowing examination
was initiated using Manipal Manual for Swallowing Assessment.
The participants were asked to cough pre and post-swallow
and the cough was analysed perceptually and acoustically.
Perceptually it was rated by two experienced raters using
3-point rating scale and acoustically using Mel’s Frequency
Cepstral Coefficients.
Results: It was observed that the majority of the participants
were rated as having weak cough both pre and post-swallow
which is suggestive of overall effectiveness of cough being weak
among the stroke individuals. The results showed a moderate
agreement between the two raters for perceptual analysis of
cough pre and post-swallow. The acoustic analysis using the
Mel Frequency Cepstral Coefficients plots indicated that for
majority of the participants, the cough pre-swallow had a higher
likelihood value when compared to cough post-swallow.
Conclusion: It can be concluded that the cough can also serve
as a screening indicator, in identifying the signs of dysphagia.
Cough is easier to elicit as compared to phonation task or
speech, especially from post-stroke individuals. Since the
results of the present study followed a similar trend as that of
change of speech or voice post-swallow, cough also can be
effectively used in probing the signs of possible aspiration. |
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| ISSN: | 2249-782X 0973-709X |