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20
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20 S7
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S26
20 S27
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S29
S34
1 S40
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S1
PL
PT
OTST
1992 4
1994 6
200012
PTOT
2000 12
14
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1 1
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2
IL1
Mechanisms and Strategies for Altering and Modu-lating Swallowing and What Seems Promising
Department of Orofacial Sciences, School of Dentistry,
University of California at San Francisco
Arthur J. Miller, PhD
Research into modulating and evoking swallowing in
subjects with dysphagia has involved researchers from
around the world including from Japan, which has made
some major contributions to concepts in neuroplasticity
and swallowing disorders. External intervention includes
enhancing peripheral stimulation of the pharynx with elec-
trical stimulation, air puffs, and foods with acidic tasting
material. Studies in rats have shown that acetic and citric
acids as sour stimuli have the highest efficiency of eliciting
183S1S304, 2014
20
26 9 2627
NS
S2
reflex swallowing as compared to water. In humans, sour
lemon juice elicits stronger contraction of supra-hyoid
muscles in swallowing. Enhancing pharyngeal stimulation
with direct electrical stimulation can modify the sensorimo-
tor cortex as tested with transcranial magnetic stimulation.
Transcranial magnetic stimulation, either as single or
repeated pulses, can excite or suppress the sensorimotor
cortex depending on the frequency of stimulation. Repeated
tongue protrusion exercises in trained monkeys alter the
sensorimotor cortex for representation of that type of
tongue movement suggesting potential exercises to
strengthen muscles used in swallowing. Surface neck stimu-
lation can improve the Functional Oral Intake Score in
patients who had a cerebral stroke raising a question of
what external surface stimulation for several days really
accomplishes. Multiple studies evaluating the swallowing
central pathway using functional magnetic resonance in
humans have been complemented by using transcranial
magnetic stimulation as well as near infrared spectroscopy
and electromagnetic brain mapping or magnetoen-
cephalography. These multiple research techniques are
providing creative approaches to diagnosing and treating
dysphagia.
Bibliography:
Martin RE, Neuroplasticity and swallowing, Dysphagia, 24:
218229, 2009.
Shaker R, et al, Principles of Deglutition, Springer, New
York, 2013.
IL2
Functional Outcomes after Head and Neck Cancer Treatment
Department of Otolaryngology Head & Neck Sur-
gery, Icahn School of Medicineat Mount Sinai, NY,
Thyroid Head and Neck Research Center, Thyroid
Head and Neck CancerTHANCFoundation,
Department of Otolaryngology Head & Neck Sur-
gery, Mount Sinai Beth Israel, NY
Cathy Lazarus, PhD, BCS-S, FASHA
This talk focuses on functional outcomes after treatment
for head and neck cancer. Surgery and chemoradiotherapy
can have a profound effect on voice, speech, swallowing
and overall quality of life. Outcome variables and scales
used to assess voice, speech, swallowing and quality of life
will be reviewed. Specific types of oral outcomes assessed
in head and neck cancer patients treated with surgery and
primary chemoradiotherapy will be reviewed. Data from
surveys regarding typical protocols used by speech patholo-
gists working with head and neck cancer patients will be
reviewed. Research on use of prophylactic PEGs and
outcomes in the primary chemoradiotherapy population
will be discussed. Long-term effects of radiotherapy on
cranial nerve function and voice, speech and swallowing
will be reviewed. Data on effects of prophylactic swallow
exercise programs in patients treated with primary chemo-
radiotherapy will be discussed. Future research needs will
be addressed.
EL1
VF
videofluoroscopic examination of swallowing
VFVF X
X
VF
VF
VF
VF
X
20
S3
X C
VF
DVD
VF
VF
VF
EL2-1
8
EL2-2
STPT
10 70
5 95
STPT
183S1S304, 2014
S4
EL3
1985
intermittent use of oral catheter for feeding
19911992
1993 Taylor
oro-esophageal tube feeding1988 OE
1994 intermittent
tube feedingITF
1997
IOC1998
OE IOE
OGIOG
ING ICintermittent catheteri-
zation
2010
Zenker
IC
INGIC
IOGIOE
IC
CNG
IC
IC IC
IC
IOC
IOC 3
IC
IOC
H26
IC
IC
IC
EL4-1
2007 8.9
5%4
QOL
STPT
ST
20
S5
EL4-2
12
1 2
Franchin, 2009
Atasoy, 2011
Buntzel, 2012
Ishizuka, 2012
Mctey, JCO, 2008
Langmore, 2011
20102014
72
1
Kotz, 2003,
Kathryn, 2008, Pauloski, 2006
1
Ozawa, 2009, Maruo, 2013
Eisbruch, 2002
QOL
1
2
NST3
EL5-1
12
3
12
34
2012
183S1S304, 2014
S6
ELS5-2
EL6
MRIMEGNIRS
fMRIMEGPETfNIRS
SMA
20
S7
20
MS-1
I
30
1980
VF
2008 CT
/
PDCA
check Check
KRKP 2
KR
KP
VF
CT
Role of evaluation methods in dysphagia rehabili-tation
Vice President, Fujita Health University, Professor
and Chairperson, Department of Rehabilitation Medi-
cine I, School of Medicine, Fujita Health University
Eiichi Saitoh M.D., D.M.Sc.
The dysphagia rehabilitation in Japan only has a short
history of about thirty years. However, its development
has been so smooth and fast, and now, this area becomes
one of the most important categories in rehabilitation
medicine.
The role of evaluation methods in the formation of
this area is so critical. Actually the introduction of
videofluorography VFopened the door of dysphagia
rehabilitation. After that, videoendoscopyVEprovided
more convenient checking ways in clinical interventions.
And then, emergence of swallowing CTSCTin 2008 that
enables precise and quantitative assessment of dynamic
swallowing process is making a new edge of this area.
Here, I will discuss the role of evaluation methods in
dysphagia rehabilitation in context of clinical setting.
In general, impact of evaluation is determined in the
order corresponding to its properties of discoverability,
quantitative capability, and recordability / communicability.
However, more than these aspects, for clinical usability, the
aspect in direct guidance of intervention, that is, clinical
oriented aspect is actu-ally important. It is the check proc-
ess in the PDCA cycle. The checkfeedbackprocess
consists of KRknowledge of resultsand KPknowledge
of performance. In motor learning, that is centered in swal-
low exercise, the most important KR is to find out limit
difficulty tasks, and the most important KP is to find out
tips in exercise. In this talk, I will revisit to the concept of
motor learning and then discuss how VF contributes to
these two checks and also how SCT is making new findings
in these two checks.
MS-2
2013
2013
tDCS
rTMS
183S1S304, 2014
S8
20
UDF
2013
MS-3
K-pointK-point
1
K
K
K
K -method
MS-4
1987
1993
20
20
S9
MS-5
2000
ADL
6.820143
75
5 4 1
3
1
Gr. 6n641
3
57% 2014
71%
SY1-1
1
VF
VE
2
3
183S1S304, 2014
S10
SY1-2
2013
2013 0
1 0j 0t
/
SY1-3
2
1
BMITSF
AMC
GNRI
2
6
3
20
S11
SY2
12
1 2
DVD
all Japan
SY3-1
QOL
17
2021
22
DVD
3,000
2030
25
SY3-2
QOL
23
24
25
183S1S304, 2014
S12
SY3-3
24 7
4
1
2
3
4
SY4-1
1
SY4-2
QOL
20
S13
2013
QOL
SY4-3
stage two transport
SY4-4
texture
QOL
183S1S304, 2014
S14
SY4-5
SY5-1
1234567
12345 67
6
20
S15
SY5-2
1
PTOT
ST
H 26.45
5/31W73KA
6/2M77TA
0W83ME
7/7M82NK
0W77KK
0W84MN
SY5-3
TOUCH
2012
3,350 85%
41%
212,555
59
TOUCH 18
183S1S304, 2014
S16
21
TOUCH
SY5-4
SY6-1
30
NPO
KTSM
SY6-2
40
20097
20
S17
31
2
3 10
NST
325,000 65,000
10,000
SY6-3
SY6-4
1
183S1S304, 2014
S18
SY6-5
123 KTSM456789
1011
123 24 235
26 26 237
38 39 310
311
ST
PEG
6
SY7-1
SY7-2
20
S19
36
173060
25% 39% 20%
16%
SY7-3
SY7-4
4
183S1S304, 2014
S20
SY7-5
SY8-1
Oral careAustin H,
Kutscher2007.6The Terminal PatientOral care
1973
SY8-2
20
S21
24
1
SY8-3
462 65 15%85
40%
1015
SY8-4
23 3
65
95%7
Stroke Care UnitSCU SCU
Oral Health
Assessment ToolOHAT
OHAT8 3
OHAT
183S1S304, 2014
S22
SY9-1
3
1
23
1 1 3 2
150365
1202
34
5
Ns.
PT.OT.ST.DH.RD.
4
3 3 8
2 20
312
3
4
SY9-2
591
8
31
2
3
3
3
SY9-3
173
6 9 10
20
S23
320131j4
PA1-1
2
18 23
21 910 28
18
21 82%28
23 18
10.86.5 2.8
21 17.66.8
6.05.9
PA1-2
29
2025
10
26
4 5 6
PA1-3
183S1S304, 2014
S24
1980 12
DMFT
5.92010 1.4
1020
PA1-4
2003
PA2-1
1
23
201336.8%
IT
WG
20
15 55
5
3 1
WG
20
S25
PA2-2
IT
IT
Excel
12.8%6.0%2013
ADLFIM
PA2-3
VFVE
VEVF
2002
VF
VHS
2004DVD
DVDHDD
HD
2008
VEVF
2014
PA2-4
183S1S304, 2014
S26
MSW
/ VE/VF
URL
ID
/
TL-1
1234
1 2 1 1
3 4
PD
PD
PD
Troche et al, Dysphagia 2011, 26218224
20
22
c22500490
Deglutition 20121400412European Society
of Swallowing DisorderBarcelona2012, 10PD
PD 205987 76.3
Hohen-Yahr 14 2.5
202587 64.3
3 ml
BIOPAC System
MP150WSW
3
0.61 Hz 66
PD
18% PD
31%37%
PD 33%
36% PD
28%32%
PD
TL-2
12
1 2
paradoxical
gait
20
S27
22 14
8 2022
Rolando
4
1
4
a
b
c 3
3
4
a
b
p1106
c
p0.0275
20
PP
12
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ADL QOL
1
URL
/NPO
183S1S304, 2014
S28
SS
1
2
1 2
10
/
SP1-1
20
S29
SP1-2
6
ICU
3
PTOT6
PTOT
11
50%
PC
ST
1
SP2
26 Q & A
PC
1
EM1-1
40%
70%
183S1S304, 2014
S30
10%
EM1-2
1 PT
23
ST
1
2ST
3PT
4
5 6
6
NST
EM1-3
80
QOL
EM1-4
QOL
5%
20
S31
EM1-5
/
6123
45
6
EM1-6
2012 462
5
Produced by
EM1-1
EM1-2EM1-3
EM1-4
EM1-5
EM1-6
2
EM2
6 10
183S1S304, 2014
S32
12 4
65
/
3STPTOT
EM3-1
10
50
6
1
3STPTOT
EM3-2
ADL
3
DSS 4
DSS 34 /
46.3%
20
S33
DSS 12 /
10.3%
4
EM4
2
TVCM
1
1
/
EM
2
183S1S304, 2014
S34
LS1
Chew Swallow Managing food
I
2
1 3
41
stage II transport
2
Chew Swal-
low Managing food
Chew Swallow Managing food
LS2
23
8
20
S35
LS3
LS4
9
2013
1
2013
2013
1
3
2013
UDF
LS5
2025
183S1S304, 2014
S36
LS6-1
QOL
300400 kcal
1,0005,000 mPas
150
18 Fr
2014
LS6-2
LS7
PES
2014 4
12,7298653,189
865 25.1% 4
1 65
20136
462
20
S37
ADAlzheimer
Deschaintre Y
BPSD
AD
GNRIGeriatric Nutri-
tional Risk Index
12
BPSD3BPSD
PES
LS8
LS9
23
4
QOL
AP-PLE 34
25
183S1S304, 2014
S38
LS10
3
173
8
23
2013 100
2013 3
3
LS11-1
10
6.82014 3
LS11-2
POS
LS11-3
6
ADL
2
20
S39
LS12
FIM ADL
ADL
1 1
153
53.6%
183S1S304, 2014
S40
1
1KD-O1-01
2013 4 12014 3 31
2 ST
9 5 4
80.082.6
76.8
93
9 6
3 5 1
3
2014
7
VE
1KD-O1-02
1
23
1 2 3
3 1 1
VF
70
13VF
2 VF
3 VF
4
VF
VF
20
S41
1KD-O1-03
123
13 1 1
1 1 23
79
A2 ICU
30
16Fr
10Fr
1ST
MPT 34
MPT 8
A
1KD-O1-04
12345
1 2 2
3 4 4
5 5
2013 48
190
160
214
8398%
160 13785.6%
16
72314.4%
1452
154 5737.0%
21 18
0.86 0.71
0.61
0.56
2
1KD-O1-05
i-EALD
i-EALD
2012 10 2014 3
37 22 15
84.1110.24
i-EALD
i-EALD
i-EALD 3.002.94
5.132.47 6.913.11
183S1S304, 2014
S42
i-EALD
i-EALD 6
1KD-O1-06
20
77.215
12 1
123
0 54
5
1234
2
1
r0.63
2713
1
2
1KD-O1-07
12
1 1 1
1 2
83 509781.68.0
53 30
22
t
5
05 6
42 41
35.518.6 47.821.7
p0.01
5
20
S43
1KE-O2-01
1
2 I
3
1 2 3
2 2 2
1
VFVE
VFVE
VFVE
Penetration Aspiration ScalePAS
50 74
35 ml35 ml
4 gVF VE
PASVFVE
VF 103 64
27 12VE
4875% 2178%
8 67% 26VF PAS 1
VE PAS 3 1425%
VFVE
2
2042% 210% 514%
VEVF
VE
VF
1KE-O2-02
LST1
LSTLine Spread Test
LST
20
P
III1 3
LST 3
2013
T1T2T3 30
4050 w/v% Steel
Adwassp0.01
Spearmanp0.01
T1T2T3
rsT10.7T20.9T30.9
LST
LSTT2
40 A50 w/v% 3 mm 2 mmT3
30 A40 w/v% 3 mm 1 mm
LSTrs
0.9
LST
1KE-O2-03
LST2
LSTLine Spread Test
183S1S304, 2014
S44
B
LST
III
2013
T1T2T3
P304050 w/v%
Bp0.01
rs30 w/v%0.840 w/v%0.950 w/v%0.9
50 w/v% B
p0.01 70% 279 mPas
LST B 13% 5 mmT1
50 w/v% B
p0.01rs
0.9T3
LST
LST
1KE-O2-04
VF
7
6 1 27.93.1
1 cm
20
50100150 gf
1KE-O2-05
123
1 1 1
1 2 2
1 3
VE
VF
VEVF
VE
10
20
S45
1KE-O2-06
320 CT
1
I23
4
12 1 1
3 1 1
4 2
Wallenberg syndromeWS
5191%
UES
VFVF
WS
UES
WS 5 3 69.0
5.1 320 CT
Aquilion One
3D0.11
2UES3
UES
UES
UES
CPG
UES
1KE-O2-07
CT
1
I2
34
1 2 1
1 1 1
3 4
320 CT320ADCT
3
8 2 6
397 45
5%w/v10 mlthickthin
1 320-
ADCTCT 10
/Air
Bolus 3DACT
AirBolusAirBolus
AirBolus /
thick thin
AirBolus thick 0.9 mlthin 0.4
ml thick 97.9%thin 95.5%
thickthin
Bolus thinAir thick
thick thin
Air Bolus
thick thin
183S1S304, 2014
S46
1KE-O3-01
1234
1 1 1
2 2 2
3 4
1 RSST
2013 10 2014 2
1,581
RSST 619
2
31
RSST
RSST
2.411.33RSST 1.57
1.31 RSST
b0.349p0.001RSST
RSST
RSST
RSST
1KE-O3-02
7
75%
RSST
SRTSRTRSST
RSST RSST
10
1060 SRTRSST 60 RSST
60 SRT
RSST
RSST 60 RSST
5
SRTRSST
10
1KE-O3-03
3DCG
1
23
4
1 1 2
3 4 4
3DCG
25 CT
Mimics
3DCG3dsMax
20
S47
1KE-O3-04
1
12
1 1 2
2 2 2
2
Swallow Vision
Swallow Vision
CT
VF3 CG
3ds Max Particleworks
4.0 Particleworks
78
25
Swallow Vision
1KE-O3-05
2
12
1 1 1
1 1 2
2
Swallow Vision
4
183S1S304, 2014
S48
1KE-O3-06
3
12
1 1 1
1 1 2
2
Swallow Vision
Swallow Vision
SP 2%
Swallow Vision
1KE-O4-01
21
123
1 2 3
2
17 2
8VP
17
40
2
2
1KE-O4-02
LP
12
1 2
LP
60X2 4
20
S49
X 6
3
X 11X1 1
VFLEDT
1
LP
1KE-O4-03
1 1
1
2
1 1 1
2 2 2
2
1
301
1 5 kg
67
8
13VF
44
68VF
119
126
4
1KE-O4-04
123
1 2 3
4 3
30
3
3 6
4
QOL
QOD
183S1S304, 2014
S50
1KE-O5-01
12345
1 1 1
2 3 4
5
77
1
600 kcal1,335 kcal
UP
1,000 kcal600 kcal
1KE-O5-02
4 4
6
123
45
456
LSTLine Spread
TestStable MicroSystems
6
LST
1KE-O5-03
4
50%
4
20
S51
4
14
2
1
3
4
1KE-O5-04
3
12
1 1 1
1 1 1
2
24
30%
3
70
H2H9
Alb 2.2
VF
ST
3
Alb 3.0
3
1KE-O5-05
12
1 2 1
2013
Line spread test
1 22
50
2013
n922.33.1 mm
n918.82.6 mmn3226.53.8 mm
2013
24 mm
VF
1KE-O5-06
183S1S304, 2014
S52
15
7
12/15
1KE-O5-07
2
1234
1 1 2
3 4
20112010
1,230
7,0051 10.5% 85.18.06
46 110 2 9
2,40934.4%
3,81654.5%
2,62437.5%
1,74724.9%
2,61337.3%
2,35333.6% 1,73024.7%
5
1KF-O6-01
123
1 2 3
200 ml
1/212 3
2
1
1/2
20
S53
1KF-O6-02
VF
2013 E
311518 mPas
2013
105216 mPas
VF
1KF-O6-03
12
345 Team21Shinei
145 15 1
1 24 24
34 14
2010 4 30
2014 1 16 4 15
3
8
86 103
86
55.8% 44.2%
55.8% 23.3%
17.4% 3.5%JCS
175.6%220.9%33.5%
4.7% 1.2%
2.3% 33.7% 48.8%
9.3% 1
183S1S304, 2014
S54
1KF-O6-04
123456
14 24 34
4 4 45
46
H 23
H 25.5
1
H 25.5H 26.41
2
1KF-O6-05
NST
NST 25 4
NST
25 4 26 3
59
83.961102
Alb
Gr.
69%
Alb 3.5 98%97%
11 Gr.
51% 25% 24%
59%76%
75%61%
NST
1KF-O6-06
123 NTT
1 2 3
22 11
20
S55
25 11 1
5
038
1KF-O6-07
6
12
1 2 1
6
20 5
1
21 3
226
PLPPAP
24 6
NST
25 12
1KG-O7-01
12
1 2 12
IC
26 81.07.1
52
2
A
BA B
B
183S1S304, 2014
S56
1KG-O7-02
1
234
12 3 4
30 5 25 86.15.9
3
3 cc 5
123
456
Tukey p0.05
3
1KG-O7-03
40 155
15547
FFQg Vre3.5
5
21 6 23
IBM SPSS
Statistics22t
63.67.0Age Matched
111.811.7% 2.70.5BMI 22.82.8
1
5.90.96.01.05.81.0
p0.001
1KG-O7-04
2
1234
12 1 2
3 1 1
4 2
19
5 g 3 ml
0% 24
wt% 3
3
20
S57
32%6/19
1KG-O7-05
1
/2
3
45
1 2 1
3 4 5
3 1
1
68 767.7
39
6 U 15 MHz
r0.39p0.0001
r0.37p0.002
r0.30p0.012
1KG-O7-06
123
ESR
1 2 2
1 3
9
2
HO
O2 1O2
HO Fe2/H2O2 13.579.51%H2O2-UV
2.821.44O2 2.562.17%1O2
5.112.07% HO O2 1O2
183S1S304, 2014
S58
1KG-O8-01
12
1 1 1
1 1 2
2 2
31 65.816.5
7
Panasonic
12
319101920
1KG-O8-02
1
12
1 1 2
81
2
ADL
1
14 kg ADL
44
4VE
VE
3
131
1KG-O8-03
PTOTST
3
2010 4 2014 3
ST 344 197
147 83.212.1
2010 4 2012 3A2012 4 2014
3 B
A 2.5B 1.7
p0.05 A
5B 3.9p0.05
3 A 169 101
59.8%B 175 12672%
A 32.6B 24.1p
0.05 4
3A 101 79
20
S59
78.2%B 126 10583.3%
3
4
3
1KG-O8-04
1234
5678
1 2 3
4 5 6
7 8
VF & VE 62
WBC CRP
BMI
CRP
WBC
BMI
36.7
BMI
1KG-O8-05
12
1 1 1
2
24
72
ST
60
2012 9 112 36
84.19.4 18 2013
9 111 5085.87.3 222
31,000 kcal /
2 A 1DROP
DSSST
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p0.03 16.76%p0.11
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QOL
1KG-O8-06
34
183S1S304, 2014
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2
25 6
9
8
8
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1KG-O9-01
1KG-O9-02
40
30
1KG-O9-03
1
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156
4
1KG-O9-05
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1
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33
36
183S1S304, 2014
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1KG-O10-01
123
1 2 3
2013 12 2014 3
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83.67.5 16 77
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24 ST ST
60 ST2
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ST 62.5%15/24ST 36.7%22/60
p0.03ST
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1KG-O10-02
123
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1KG-O10-04
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1KG-O10-06
1
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1KG-O10-07
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2006
135449185.8
17 11
227411
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1KH-O11-01
1234
1 2 2
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1KH-O11-02
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127
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1KH-O11-05
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1KH-O11-06
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RSSTMWST 3
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19.0
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1KH-O11-07
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260
1KH-O11-08
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259
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10.9 2 6 24 52.9
17.5
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ASD
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1KH-O12-04
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1KH-O12-05
3
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1.610.43 s 1.870.47 s
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1.440.28 s
1KH-O13-03
1234
1 2 1
3 4 1
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Gr. 19 Gr. 10
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1KH-O13-04
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8
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113.2 mPas13.5208 mPas 198.7 mPas
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234
NST56
12 13 16
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2011
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280
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183S1S304, 2014
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1NI-O15-01
2
170 46
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1NI-O15-04
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1NI-O15-05
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2012 1 10 46
76.99.620131
7 23 79.916.4
48.1%
4
7
p0.033
1NM-P5-02
12
1 2 1
1 1 1
1 1
183S1S304, 2014
S104
SCTSCT
SCT
MWSTFT
43
16 27 8013
SCT 30
MWSTFT4
3
SCT
MWST FT
SCT 0.86
0.64 MWST
0.58 0.92FT 0.37
0.963
0.84
0.54
3
1NM-P5-03
1
VE
70
12
ST
VE
37
54
VE 3
Logemann
VE
1NM-P5-04
123
1 2 3
1 1 2
2 3
3
RH ST
2012 1 12 1
DPC
93
80.7 63 30
51.493RH
55 ST 38
ST 80.9 28
10 51.3ST
17
20
S105
1NM-P5-05
12
1 2 1
MCT
MCT
MCT
MCT
MCT
13
4 928.94.7
ST
12.5 ml
CT
13 CT 6.83.3
3 13.6ST 16.56.2
8 25.1CT ST
RS
0.553 MCT
1NM-P5-06
j7
510
1
5 3
1NM-P5-07
30
1
2
1 2 1
1
30
2013 11 16 2014 4 16
6 30
2 6
30
4/6
3/6
183S1S304, 2014
S106
1NM-P5-08
ST
2013
PT
ST
ST
3.4%
2013 1 ST 377
13
13 5/3111.6%
8/6612%
JCS 10
80ALB2.9 g/dl
1 4
ST
1NM-P5-09
VF 9
12
1 2 1
24 4 26 3 2
VF 87
9
VF 9
5
3 2 3
1
2 3
2 2
73.4 241.7
VF
1NM-P5-10
12
1 1 2
26
22 12 25 12
3 6 3
325
75.714.3
3
Wilcoxon p0.0001
a0.05
6
20
S107
1NM-P5-11
SSPT
12
1 2 2
1
SSPT
A 3 Fr 4 Fr
SSPT
1234
56
124 4 Fr
356
4 Fr
SSPT
1NM-P6-01
2
12
1 1 2
4 4
10% 10% 20%
1NM-P6-02
1234
1 2 2
2 3 4
ST
183S1S304, 2014
S108
25 7 ST
8
1 810
10
ST
ST
ST
1NM-P6-03
123
1 1 1
2 3
80
38
5
4
2 /
ADL
1 6
MWST
G-UP155
7VF
G-UP 15
14VF
28
1NM-P6-04
0
123
1 1 1
2 3
MWST
0
68
4
3
ADL
1
742 30
0 MWST 4
0 15
60 MWST
495
20
S109
0
1NM-P6-05
123
1 1 1
2 3
MWST
G-UP
60
38
ADL
1
5MWST
0 3
4
30 20
19
15G-UP
28
G-UP
1NM-P6-06
12
12 1 1
12 1 1
1 2
2010 11 2011 5
47 35 12
79
DSS
4DMFDecayed Missed Filled
25 4
13DSS1422573
DMF 24 1.1
22 3
2DSS14115711DMF
24 3.5
DSS
1NM-P6-07
183S1S304, 2014
S110
70
80
1NM-P6-08
2013
12
1 1 2
2004
4
20102013
2013 9 19
2013 2013 2013
2013 0t
1j
2010
2013 9 232014 2
0 jt 1j234 5
3
2013
1NM-P6-09
1.90
SpO2 932%
VEVE
SpO2 952%
2.90
VE
VE
VE
VE
20
S111
1NM-P6-10
2
12
1 2 1
1 1 1
400
20122
2012 3 1
2013 4 2
2013 11
2 5
1
6 2
5
20136
1NM-P6-11
12
12 12 12
1 2 12
1
17
19 4
19 4 25 3
6
19 4 1 25 3 31
653
Eichner
DSS
653 69.413.6
30.9%
63.7%
60.9%
82.8%
13.6%
2.6%
69.1%
49.9% 11.6%
Eichner B3B4C1-3 55.6%
18.8%
DSSDSS 1461.7%
57.0%
DSS14
183S1S304, 2014
S112
1NM-P7-01
12
3
1 2 1
1 1 1
3
25 7 30 11 13
65 112 33 79 79
RSST
14.3% 23.1%
15.4% RSST 2
16.1%
1NM-P7-02
1
12
1 1 1
1 1 1
12 1
2010 6 2014 2
216
82.4
96 44.4% 84
38.9%
Eichner indexEIClass ABC
EI ClassClass A
19 8.8%Class B28 13.0%Class C169
78.2% Class C
Class BC197
15578.7%
155 140
90.3%44
28.4%
20
S113
1NM-P7-03
2
12
12 1 1
1 1 1
1 1
2010 6 2014 2
216
82.4
96 44.4% 84
38.9%
Eichner indexEI
modified EIMEI Class
ABC Functional Oral
Intake ScaleFOISLevel 17
EIClassFOISA4.5
2.219B4.32.228C4.61.8169
EI FOIS
p0.925MEI Class FOIS
A4.71.8173B3.61.615
C3.81.828 FOIS
p0.005
1NM-P7-04
0
12
1 1 1
1 2
VF
0
0
170 5
FILSLv. 745
VF020
270PD 5FILSLv.
8VF0
30
12VF0
20300
30
VF 0
VF0
1NM-P7-05
MMASA
1
234
56
1 1 2
3 4 4
5 6
The Modified Mann Assessment of Swallowing
AbilityMMASA
MMASA
VE
MMASA MASAVE
183S1S304, 2014
S114
MMASA
94MMASA
MASA
VE
50VE MMASA MASA
ROC
MMASA 94
0.79 0.27 1.08MASA
178 0.90 0.27 1.23
MMASA 70
0.54 0.91 6.00AUC
MASA
MMASA
1NM-P7-06
2012 2014 18
13 68.8
AlbBMI
16
PA Scale
Stasis
Score
AlbBMI
6
PA Scale
Stasis Score 4
PA Scale
Stasis Score
1NM-P7-07
123
12 3 3
VF
2
VF
HD
L0L0L3L3
L0 TesCup 1.5 w/w%L3
R&E 2.9 w/w%
121 20
20 mm
5 mm 1 mm/s 2
L0HD 2,518 N/m2
0.45 58 J/m3
2,336 N/m2 0.40 62 J/m3L3
HD 416 N/m2 0.83
65 J/m3 458 N/m2
0.82 76 J/m3
L0L3L0
HDL3
1NM-P7-08
440
22VF
20
S115
22 2 25 3VF
133 72 / 61
73.41897
82PD 16PSP 5SCD 9ALS 12
SBMA 4 13 12
11 41 32 3
3 4 6CP 6 2
29
21.8%43
22 15
2015% 1310%
86% 54%
5944% 3123% 1612%
1612% 97% 21%
VF
1NM-P7-09
12
1 1 2
2008 4
2008 4 2013 3 6
250
100%
2008 9.8%2009 14%
20108.7%
2011 2013 16.2%21.1%
26.8%
75%15%
5%4%
6.5
6.2p0.01
1NM-P7-10
12
1 1 1
2
CT
CT VE
166 95 71 82.59.5
CT 1 54
0
1
2 3
Receiver Operating CharacteristicROC
CT2030
ROC 20301
0.6310.6930.692
123
302
0.7059 0.6719
CT 30 2
183S1S304, 2014
S116
1NM-P7-11
1
23
1 2 1
3 3 1
123
N
5
3 76.81.9
1NM-P8-01
VE
12
1 2 2
2
VE
VE
VE
28 83.57.5
RSST
VE
42.9% 25.0%
7.1% RSST 2
85.7% 7.1%
7.1%VE 82.1%
39.3% 7.1%VE
42.9%
32.1% 10.7%
32.1%
42.9% 10.7%
VE
VE
1NM-P8-02
12TMDU
3
12 23 23
1
1
6347 62
VE
9130
CT LDA
VE
CT
2
20
S117
1NM-P8-03
1
12
1 1 1
1 1 2
50
27 VF
39
41VF
51
62
69
VF
83
92
95
100 VF
106
1NM-P8-04
12
1 2 1
2 2 1
218 70 76
3838 491470
743737 78570
68 3533 816
3
9.7 kg
5.9 kg7.0 kg4.4 kg
4.5 kg 3.7 kg
3ANOVAp0.05
1NM-P8-05
183S1S304, 2014
S118
25 2 26 3
7
EC 10-012
1154
3
1
1NM-P8-06
10
VE
VE
VE
VE 9 44% 36%
04 3
1
582
1 8
1 5
912 3
70
VE
58
1NM-P8-07
MWST
VE
VE
VF
VE
MWST
VE
62
MWSTVE
3
1.
2. 3.
MWST
VE
MWST 55 88.7%
VE MWST
1NM-P8-08
NESSiE
20
S119
NESSiE
5 5
4 3 cc
NESSiE
NESSiEFG
CCD
FGCCD
1NM-P8-09
12
1 2 2
2
VF
24 6 26 4
VF 139
81.19.58563
VF
LES
3
3
VF
10.1%
73.4%LES 3.2%
VF
70%
1NM-P8-10
TMDU
3
1/5
3
2011 4 2012 3
videoendoscopic examination of swallowing:
VE 16 91
2014 3
46 18 28 4
VE
46 919.6%
VE
46 1839.1%
8
44.1%
VE
183S1S304, 2014
S120
1NM-P8-11
1 I
23
1 1 3
2 1 1
1 1
Dysphagia Severity ScaleDSSVF
DSSVF
DSS
DSS
VF 72
VF
4
normalmildmoderatesevere
4DSS
66.6DSS
DSS 23DSS 315DSS 429DSS 58
DSS 617 1
10 23 9 27
2DSS 3
DSS 4
DSS 3DSS 4
1NN-P9-01
1
1NN-P9-02
PT ST
PT 2ST 1
PT
PT ST
ST RSSTMWSTfoodtest
2518
1 ST
7
PT
20
S121
ST
ST
1NN-P9-03
ST
20114
ST
2
ST
185
291
ST
1NN-P9-04
20
NST
1
FAX
1
1NN-P9-05
1234
14 14 14
24 34 14
2013
4
183S1S304, 2014
S122
76
3 ST
18
33 VE
1j 21
40B
B 21
B 4
4
58
1NN-P9-06
1234567
1 2 3
4 4 5
6 7
6
1. 3782.
883.
34
5
/ /
/ / 76%
100% /72%100%
/
46%75% /
100%
1NN-P9-07
ST
4
60
20
S123
1NN-P9-08
1234
14 14 14
24 34 14
2013
2013
0 jt1j2
3 4
4
1 cm
1 cm
6
35 18
17
HP
1NN-P9-09
ST
ST
5
PC
ST
ST
1NN-P9-10
12345
12 2 3
4 4 5
1 2
20
3
1
21
20t 1 3 92 21 22
183S1S304, 2014
S124
2 1 3 8
1H2511
2 H26 4
12
1NN-P9-11
12
345
1 2 3
45
6
1 5
9
1NN-P9-12
12
1 2 1
QOL
1NN-P9-13
1234
1 2 3
4
18
20
S125
22 25 4
1
? 2
3
4
16910762
59%
1 2
3 4
1NN-P10-01
1NN-P10-02
12345678
1 2 3
4 5 6
7 8
2008
2012
2
183S1S304, 2014
S126
1NN-P10-03
1
2345678
1 2 3
4 5 6
7 8
2009
6332013
59 55
93.2% 2529 27%
2012
1NN-P10-04
NST
12
1 1 1
1 2 2
2 2
2009 NST
2013 4
1NST
2
3
12013 20 15
2
3
1 3
113
1
2
3
1NN-P10-05
12
1 1 2
20
S127
25 4 26 4
642498
1NN-P10-06
123
45678
1 2 3
4 5 6
7 8
60
& Ns & ST &
1NN-P10-07
A
1. A
2
80
2. A
A
ST
183S1S304, 2014
S128
1NN-P10-08
12 NPO34567
1 2 3
4 5 5
6 7
NPO
25
45 1
1
3040
162 151
93%
54%
9%8%
98.7%96%
91%
1NN-P10-09
2013
12345678
1 2 3
4 5 6
7 18
2013
2013
2 4
2013
2013
UDF
2
20
S129
1NN-P10-10
25
19 64
48
1NN-P10-11
12
12
130
ST
72
STST
40
45
1/467
93
3120
1NN-P10-12
VE
123
1 2 3
1 1 1
1
A 27% 11
2011
1
314
40
QOL
183S1S304, 2014
S130
1NN-P10-13
2
1
2345
1 23 4
5
2013
1NN-P11-01
12
1 12
Home care
team meeting 3
2
1NN-P11-02
12345
15 25 35
45 15 15
23 10
20
S131
2
23 10
25
2
24 4
25 8
1NN-P11-03
1234
5
1 2 3
4 5
5 2011
11
2013 34
2013
FAX
26 3
ST
1NN-P11-04
2
12 JA34 JA567
1 2 2
3 4 5
6 7
2011
45 2013 10
51.0%
78.3%
30.4%1
60.9%
78.3%
183S1S304, 2014
S132
91.3%
1NN-P11-05
12
1 1
200 ml
15 g
1 10 ml
1 50%
25
92
1
1NN-P11-06
2013
1
2
34
123 4
20132013
2013
20142
2013
78 52 110
66.7% 2013 42%
58%
33% 12% 18%
94% 2013
97%
2013
94%
2013
20
S133
1NN-P11-07
1234
12 13 13
14
I
25
I
I
1NN-P11-08
10,27365
4,006 39%
NST
1NN-P11-09
2013
12
12 12 1
1
20132013
2013
2
10jt4
QOL
183S1S304, 2014
S134
1NN-P11-10
123
1 2 3
1 1 1
1
A 27% 11
2011
2012 2 1
2 2013 2
1 2
100
1NN-P11-11
2013 1
2
QOLADL
1NN-P11-12
1
ADL
20
S135
87X 11
X 12
447.5 kg
B2 3B
/X1 1
21.8 kg
5 /
2,000 cc7 49 kg
X2 6
8 /10
/1
QOLADL
1NN-P11-13
SNS
12WOC3456Harvard School of Public Health
12 2 3
56 45 15
face to
face
ADLQOL
H26.5.1 10 13
5 8 4
2 2 2
1 1 4
SNS
SNS
1NN-P12-01
12
1 1 1
1 1 1
2
11
16
17
18 22
8
183S1S304, 2014
S136
1NN-P12-02
12
1 1 1
2 1 1
2A 4
B
2013
PT
OTSTA1
452
203PTOT
554ST
55B1
702
ST80
4
B
A 46B 24 A
5182%B2235
26%A
B
1NN-P12-03
ST
19ST
21
NST
137
21
10
ST
ST
ST
ST
1NN-P12-04
23 25 3
161
3
1. 2. 3.
4.
5.
161
70 35
18 14 1
1 1 83%
11%6%
86%
5% 33%2 62%
3 19%4 6 1%
7 80%
20
S137
74%
11%
RST
1NN-P12-05
12345
1 2 3
3 4 5
5
QOL
1.
2.
3.
1.
2.
3.
1NN-P12-06
1. 2.
3. 16
4.
5.
1
90%
55%
86%
6
96%
85%
95%
100%
1NN-P12-07
QC
12
1 2 2
24 TQMTotal
Quality Management
QC
QC
183S1S304, 2014
S138
QC
24
249
10
DPC
9
QC
QC
QC
0
1NN-P12-08
1 PL2 PL3 PL4 PL
1 1 1
14 24 34
2005
2012
2012 6 278
96.7% 76.6%
MWSTFT 48%
20142
291
96.2%MWST
FT 74.1%
90.3%
21%56
1.8%5
1NN-P12-09
1234
1 2 2
3 1 4
45
79 24 5
9
25 1
1 3 RSST2
MWSTFT5
1 1 4VF
1 2 1 2
1 3
120
VF
ST
20
S139
1NN-P12-10
1
27
4
1NN-P12-11
123
4
1 2 3
3 1 1
1 4
2013
1
2013 1 2014 3
2013 4
13 4412
3
414
193
4 5.02.6
4 14.83.9
13274.2%
92 51.7% 44
24.7%
1NN-P12-12
1
1
234
1 2 2
34
ST
1
ST
1
125 31
94
38 20
183S1S304, 2014
S140
ST 63
5 53 2
5
2 0
ST
1
1NN-P13-01
ST
123
12 12 2
3
ST
504
ST
ST
25 1 12
334 1 14
41%
65%
1
2.5
ST
QOL
1NN-P13-02
12
1 2
521
2012 9
10
NST
VF
2012 10 2014 3
157 81.7 100
2676
185040
9 8 8 8
7COPD 6 6 15
VE
1NN-P13-03
12 LSM
1 2 2
2
2012 5
2012 7
20
S141
2
ADL
102
1
51%
28% 20% 48% 48%
4% 13% 13%
74%
6
ADL
1
1NN-P13-04
2VF
170
29
VF L2 3
VF L4
260
1017
VF L3
24 VF
L3
VF
1NN-P13-05
1
23
4
1 1 2
2 3 4
4
24 1 VE
STCNCN
1DrST CN
1ST
CN 1
CN
VE
VE
NSTCNNST
VE
NST
183S1S304, 2014
S142
1NN-P13-06
12
12 1 1
12 1 1
1 1
555
2DR2DH
2ST13
9 12DH
20134
1
2 ST
3ST
430 DH
155
2013 10 206
129 90 29 71
1 7.7
1 20
1NN-P13-07
1234
1 2 2
3 3 4
4 4
166 21
25 12 26 4
134
9 78.5
RSSTMWSTFTFOIS
BMI
BMI
1NN-P13-08
24 10
26 10
87
95.4%83
5
20
S143
1NN-P13-09
1
234567
1 2 2
4 5 3
6 7
23
23 9 25 2
10% 81 87.26.6
47%
88
3
1NN-P13-10
12
1 2 1
A
B
2324 2 125
1 1 5
24
A
23 23%24 23%25
26%24
16 1925 22 70
246
10 525
12 12 3
1NN-P13-11
2009
25 8 26 3
183S1S304, 2014
S144
73 52.1% 47.9%
76.9 31.5%
20.5% 11.0% 14
38.4%
26.0% 17.8%
1NN-P13-12
NRT
NRT
2
NRT
NRT
1NN-P13-13
461
2014 4 6
8 2
365VFVE
2013 4 2014 3
150
806 56 5,559
92
1NN-P14-01
ADL 1
12345
1 1 2
3 4 5
477 3
25 3
20
S145
6
ADL QOL
1NN-P14-02
ADL
12
12
ADL
73
2010 11
20129
11
2013 6
12
6
1NN-P14-03
!
1234
1 2 2
2 3 4
7524
6
29 VF
210
51
8
68
183S1S304, 2014
S146
1NN-P14-04
1234
1 1 2
3 3 3
4
2013
PT
95
5
PT
19
26
52
59
PT
1NN-P14-05
1
2
1 1 2
ST 1
A 80
FIM7/35
A
ST
ST
ST
1
A
1NN-P14-06
123
1 1 2
3
90
20
S147
ADL 153 cm
41 kgBMI 17.5
1
1 2
810
22
1NN-P14-07
2
12
1 2
2
IOC
QOL 2
2
21 6
IOC
IOC
IOC QOL
1NN-P14-08
1
123
1 2 1
3
1
802010 6
ADL10
A
9
4A
3
QOL
183S1S304, 2014
S148
1NN-P14-09
80
ST
ST
45 0t
1 3
40t4
1NN-P14-10
70
1A
B
2
3 CABG
4
1
4
VF
1
3
1NN-P15-01
24 2
24 4
1
149 146
260
2.88 2.56 2.60
5.14 4.63 4.52 26 3
1122.4%1532.6%
1935.4%3
6
2
2
20
S149
1NN-P15-02
2
12
1 1 2
4
1
4
2
1NN-P15-03
26
35%1
2.3%81.3%
24 4 26 3
1,826
309
298 11
171 14
66 15 32
38%
67%79%
39% 21%
27%
35%
1NN-P15-04
6073 7
66.65.6 7,000 350 /
3
3000
PVM-2703
CE
7
5
p0.05
183S1S304, 2014
S150
1NN-P15-05
12345 II
1 2 2
3 4 2
5
80 48.1 kgBMI 19.1
BMR 1,240 kcal 21.7 kg 11 ST
52
530 kcal500 m
62
48.4 kg 1,200 kcalBMR 1,228 kcal
21.2 kg 100 m
1NN-P15-06
OAG
ST
ST
OAG
254
6 Ns
18 69
10
OAG
112
89.2%72%
11% 11
OAGNs
5
OAG
1NN-P15-07
123
1 1 2
3
2
VF
2
1
20
S151
111 3
18 10
20 50
VF 30
63%
9
10%
1NN-P15-08
7 600
12
1 2
80.1
7
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19 25
6031
2.6
473
48
58
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1NN-P15-09
80 2
1
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2
2
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183S1S304, 2014
S152
1NN-P15-10
Oral Assessment GuideOAG
12
1 2
OAG
A B C
20 12 21 2 2C
20
2072.305.85
11 9
OAGOral Assessment GuideEILERS
8
1 2 3
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Cronbach a
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OAG 8 OAG
9Cronbacha0.784 a0.6
OAG
2009
1NN-P15-11
CPA
23 3
5
18
2011 4 2013 3 CPA
2011CPA 275201225
4 50 90
9 3 5
1 3
9 4 3
8 COPD
CPA2
1NN-P15-12
123
1 2 3
3
A70X
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HDS-R 3
MWST 4FT 4RSSTVF
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S153
X 4
1NN-P16-01
12345
1 23 4
5 5 3
RSST
24 40
RSST
4,998RSST 3
RSST
RSST 5.4%
28 2027
101959 RSST
4
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RSSTp0.05
28
RSST
1NN-P16-02
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1
23
1 2 1
1 3 3
30
VE
VE
VE 30
2013 11 2014 3
VE83
5 87.112.5
301.5%
1 ccVE
2 cc
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30 0 cc 4
3 cc 37 cc 1 5 cc 47 cc
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183S1S304, 2014
S154
1NN-P16-03
12
1 2 2
2 2 1
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3 ml
White out
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1NN-P16-04
1
234
1 1 2
1 1 3
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1NN-P16-05
12
1 2 1
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28 69100
82.0MMSE 24 823 20
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1NN-P16-06
1234
1 2 3
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9 10
746.0
2
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123
1 2 3
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183S1S304, 2014
S156
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12 12 12
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No.
01150
1076.4 30
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4
Processing
PFATVATHTT
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ing PFATVAT
HTT
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20
S157
1NO-P17-01
1
2
34
1 1 2
2 3 4
2006
2013
NST
1NO-P17-02
CONUT
Alb
Alb
CONUT
Gr. 7
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7 AlbTLCT-Cho
103 48 55
79.911.2 52 33
18c
c 2 48
3470.8% 55 2749.1%2
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1NO-P17-03
183S1S304, 2014
S158
1
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1
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1NO-P17-04
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1NO-P17-07
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183S1S304, 2014
S160
2013
7
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LST
LST
1
5
LST
LST
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1NO-P17-09
12
1 1 2
2
A
B
C
9820
10 40 mm 15 mm
20 45 2
1
tp0.05
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2,8311,596B4,9564,125C4,2012,093 N/m2
A0.60.1B0.50.1C0.50.1
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A BCA
45
1NO-P17-10
1
2
3
1 2 3
ST
ST
10
2011 5 5 2014 4 30
ST
2011 2014
1.4
2
20
S161
1NO-P17-11
12
3
1 1 2
3 1
10
20 250 ml
2.5 g 90
3
3
107
90
0.333.0 Hz
0.53
1NO-P18-01
1NO-P18-02
123
1 2 2
3
60
2
2012 4 2014 3
43
7 5
VF
183S1S304, 2014
S162
1NO-P18-03
12
1 2 1
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1
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5
S
5
1NO-P18-04
2
1
234
1 124 13
1 24 4
4 1
17 6 11
84.8
4
1NO-P18-05
12
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20
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BMI
2
25 10 26 2 4
15 0 15
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3 10
132
BMI 14101
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1NO-P18-06
2013
1234
1 3 1
4 2 1
2013
10
100
2013SPSS.19.0J
1j 34 1j
4 0j2
1
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3
1NO-P18-07
1234
1 123 23
4 4
4
57
25 10 25 11
1
1
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88.27.0
p0.05
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183S1S304, 2014
S164
1NO-P18-08
90
1NO-P18-09
1
12
1 1 1
2
13
B
No.312 rpm
11.62 kcal/ml 3 28
3%30
530
10
3,0007,000 mPas
2 kcal/ml
1NO-P18-10
123
1 1 2
3
10
20
S165
1 2
3
3
1NO-P18-11
12
1 1 2
2
5
NST
NST
1NO-P19-01
ST
12 NST3JA4JA
1 1 2
2 2 2
3 4
ST
ST2012 4 2014 3
VEVF 20
FIM
9 0 73.2
9 2 68.5
HbTPAlb
BMI16.718.6
FIM32.254.5
2
7
BMIFIM
ADL
1NO-P19-02
A 24
183S1S304, 2014
S166
104
91.3%95
46.3%17.2%
97.1%
73.2%355.0%
90.1%
84.2%
1NO-P19-03
1
12345
12 12 13
14 15
26
26 34 254
123
4
56
100126742
20 6630 2940 53 53
50 35 54
50 38 126 69 24
7
7
5
QOL
1NO-P19-04
A 58
50%
66%
67% 66%
60% 44% 33%
26%
66% 67%
20
S167
1NO-P19-05
5
5
21 4 26 3
18
24
321%
79%
54%
50% 39
041%
72%
85%
41%
73%
1NO-P19-06
22 5 25 10
48142
26
2 BMI
FIMALBCRP13
ALBCRP2
Mann-Whitney U
20 6 23%
2
BMIFIM
FIM0.57BMI0.46CRP
0.420.28
1NO-P19-07
5
3
1
20131
330 26867.5
14.9
124
26 26 23 18
15 8 7 21
ST 17.121.7
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13 110 45Gr. 46 46
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JCS Gr. MWST
Gr.
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183S1S304, 2014
S168
ST
1NO-P19-08
5
2425
5VEVE
VE
VE
152
VE5
VE
5
99%
5
97%
100%
97%
VE
1NO-P20-01
OCM
3 10
326OCM
OCM
46%SOAPIE
66%
48.6%
27.0%
37%
OCM
OCM
OCM
OCM
1NO-P20-02
1234
1 1 1
1 2 3
3 4
2 3
13
1 3 15
3815 5
2
20
S169
5
QOL
1NO-P20-03
2
2
170
260
133
1
2
2
1NO-P20-04
1
12
1 1 1
1 2 1
25 7 26 3
215
33.56.8
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3 123 5 25
106101
1NO-P20-05
12
1 1 1
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183S1S304, 2014
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22 4 26 4 4
126
3225.4% 26
20.6% 2318.3%
1NO-P20-06
12345
12 3 4
4 5 12
23
73.08.4 17 78.07.1
1 34
4DNA
Real Time PCR
1NO-P20-07
12
1 2
1
603
1 1
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GCS
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4
20
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1NO-P20-08
1 /
2 /
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1 2 2
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1/3 10
10 10 10
39.37.3 kPa
41.88.8 kPap0.05
25.82.3
28.11.7p0.01
1NO-P20-09
NST
25 10 29 3
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NST 30
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3.
4. 5.
1.
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2
1NO-P20-10
1234
1 2 3
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B
183S1S304, 2014
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12
3 4
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CRP
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3
1NO-P20-11
OAG
1 2
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1 2 3
ADL
Eilers Oral
Assessment GuideOAG
1 OAG
OAG
13 /151
1 /
1 /
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1NO-P20-12
123
1 2 2
3
9
20
S173
2
2KD-O19-01
PCAPS
1
23
1 2 3
1
PCAPS
3
CPC
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2KD-O19-02
123
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3
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183S1S304, 2014
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Brs.VI
RSST 0MWST 4 4
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12345
1 1 1
2 3 4
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65 1.5
RE2 333005B2
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2KD-O19-06
12345678
1 25 6
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103 848
18 85 95
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58.612.8 mg/ml 44.94.0 mg/mlp0.001
1 2 49 59 mg/ml 1
4 59 55 mg/ml 2
1 1 59 65 mg/ml 1 56 50 mg/ml11 mg/3
2KD-O20-01
Neuromuscular Electrical Stimula-tion NMES
12
3
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Neuromuscular Electrical StimulationNMES
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183S1S304, 2014
S176
2KD-O20-02
1
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2,500
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123
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123
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1 2 3
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21 31 12
19 81.35.39
5 8
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PCFBarthel Index
POMS EMST 4
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183S1S304, 2014
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12
345
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12
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3
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2012
2KD-O21-01
12
1 2
2013
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3 4 77.4%46
25 11 3 4
20
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98 78.99.55642
BMIAlb A
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BMIkg/m2 20.5
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1234
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183S1S304, 2014
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2KD-O21-04
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1 2
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128
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27 28
45
1/2
1 20 gE100 kcalP11 g
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20
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1
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TPU2D/2CL
1 2 2
2012
3
2012 12
2.8% 4.9%
2013
2KD-O22-01
1234
5678
1 2 3
4 5 6
7 8
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2KD-O22-02
183S1S304, 2014
S182
40
3 43 48
8
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2KD-O22-03
12
1 2 2
2 2 2
400
2013 4 2014 3
60 3
3 66.7% 33.3%
52.3 C-2
66.7%B-2 33.3%
66.7%
33.3%
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3
2KD-O22-04
1
234
12 2 1
1 3 3
4 4
1
14 9 5
62.810.8
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2KD-O22-05
FIM Gr.
12
1 1 1
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12.5
ST
20.5
FIM
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2
4 2 57 23 34
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320-ADCT
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183S1S304, 2014
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2KE-O23-01
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183S1S304, 2014
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12
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52%A 39%B 68%VF
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2KE-O24-01
1234
1 1 2
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71
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183S1S304, 2014
S188
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2KE-O24-05
123
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2KE-O24-06
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ALS
2013
ALS
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ALSFRS-R
Standardised
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12
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5
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2KE-O24-08
QOL
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123
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30
183S1S304, 2014
S190
2013 6 8
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062.31
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2KE-O25-02
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12
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2KE-O25-04
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183S1S304, 2014
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2KE-O25-06
123
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Likert scale
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3
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2KH-O26-01
320 CT
1234
1 12 1
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Okada et al, 2013
26 4616
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183S1S304, 2014
S194
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865
85 36265
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865 77 384 481
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86 vs. 7018 vs. 11
291/47861%
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123/48825% 239/327
73% 344/50269%
47/36313%
244/36267% 134/34239% 12/161
8% 60%
ST
55 14%
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ST
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2KH-O26-03
123
1 1 2
2 2 3
3 3
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VE
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134
VF
0 2 3
3
50
30 20
2
FLAC
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2KH-O26-04
VE
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15
VE
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20
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2KH-O26-05
12
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10
5 28.5 3.6 mm
3.6 mm 2.4 mm
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2KH-O26-06
1234
1 123 23
12 4 4
20
1,530 73.95.5
1 56.5%2
29.9%3 10.5%43.1%
p0.01
p0.05 Time Up
& Go
p0.05
H 24 002
2KH-O26-07
1
2
3
4
1 2 3
1 4
MNA-SF
MNA-SF
FIM
183S1S304, 2014
S196
25 11 26
5 65
MNA-SFThe Mann Assess-
ment of Swallowing AbilityMASAADL
FIM
CRP
MNA-SF 7