Takashi Tanaka, MD, DMSc, Hitoshi Kagaya, MD, DMSc, Yasunori Ozeki, MD, DMSc, Wataru Fujii, DDS, PhD, Takatoshi Iida, DDS, PhD, Seiko Shibata, MD, DMSc,
Saki Tomita, SLHT, Yuriko Ishiguro, SLHT, Kikuo Ota, MD, DMSc, Eiichi Saitoh, MD, DMSc
Jpn J Compr Rehabil Sci 7: 51-54, 2016
Objective: The purpose of this study was to reevaluate
the classification of aspiration before, during,
and after the swallow, and to verify the reliability of
the revised classification.
Methods: Aspirations occurring during swallowing
reflex were classified as during the swallow; aspiration
during the first swallowing reflex was subclassified as
type D-1, and aspiration during the second or
subsequent swallowing reflex as type D-2; aspirations
occurring prior to the first swallowing reflex were
classified as before swallow (type B); and aspirations
other than the above types were classified as after the
swallow (type A). In 212 patients (mean age, 66 years)
who underwent videofluoroscopic examinations of
swallowing (400 examinations), aspiration was
classified retrospectively. Inter- and intra-rater
reliability was analyzed using the data obtained from
the evaluation of 20 patients with aspiration by four
observers accredited by the Japanese Society of
Dysphagia Rehabilitation.
Results: The numbers of aspirations were in the order
of D-1>D-2>A>B. The frequency showed variability
depending on the bolus. The mean inter- and intrarater
kappa coefficients were 0.68 and 0.85,
respectively.
Conclusion: Our revised classification for aspiration
before, during, and after the swallow is easy and
adequately reliable.
Key words: videofluoroscopic examination of swallowing, aspiration, classification, reliability