Swallowing Assessment in Post-Comatose Patients: A Feasibility Study on the SWADOC Tool

Area of Science:

• Neurology
• Rehabilitation Medicine
• Speech-Language Pathology

Background:

• Severe brain injury can lead to disorders of consciousness (DoC) and significant swallowing impairments (dysphagia).
• Effective evaluation and management of swallowing are critical for patient recovery and quality of life.
• Existing assessment tools may lack quantitative measures for DoC patients.

Purpose of the Study:

• To evaluate the SWallowing Assessment in Disorders of Consciousness (SWADOC) tool for bedside swallowing assessment in post-comatose patients.
• To validate the quantitative items of the SWADOC tool.
• To describe preliminary results and identify limitations of the SWADOC.

Main Methods:

• Fourteen post-comatose patients were assessed using the SWADOC and the Simplified Evaluation of CONsciousness Disorders (SECONDs) tools.
• The SWADOC's internal consistency and test-retest reliability were evaluated.
• SWADOC scores were compared with the Facial Oral Tract Therapy Swallowing Assessment of Saliva (F.O.T.T-SAS) and SECONDs scores.

Main Results:

• The SWADOC demonstrated good internal consistency for its oral and pharyngeal subscales.
• High test-retest reliability was observed for most SWADOC items and scores, indicating stability.
• SWADOC scores showed a significant positive correlation with SECONDs scores, supporting its validity in assessing DoC patients.

Conclusions:

• The SWADOC tool shows promising psychometric properties for assessing dysphagia in patients with DoC.
• The tool is relevant, feasible, and offers quantitative insights for bedside swallowing evaluations.
• Further validation is supported by preliminary findings on the SWADOC's reliability and correlation with consciousness measures.