Usefulness of Scintigraphic Swallowing Study in Brain Injury Patients with Laryngeal Aspiration

OBJECTIVE: We investigated the usefulness of the scintigraphic swallowing study in selecting the patients with low risk of aspiration pneumonia among those who showed small amount of laryngeal aspiration in videofluoroscopy. METHOD: Scintigraphic swallowing study was performed in 22 patients with brain injury who showed small amount of laryngeal aspiration in videofluoroscopy. Oral feeding was tried in the patients who showed airway clearing function or no aspiration in scintigraphic swallowing study, and they were followed up for possible aspiration pneumonia. RESULTS: Total of sixteen patients showed no aspiration in scintigraphic swallowing study. Five patients showed laryngeal aspiration, but preserved airway clearing function. One patient showed impairment of airway clearing function. Oral feeding was tried in 21 patients. Oral feeding was successful in 18 of 21 patients but not in 3 patients because of dysphagia or cough. Only 1 patient developed pneumonia after 246 days of follow up. CONCLUSION: Scintigraphic swallowing study is useful to select the patients with low risk of aspiration pneumonia among the patients who showed small amount of laryngeal aspiration in videofluoroscopy.

The Shoes Designed to Inhibit Excessive External Rotation of Hemiplegic Foot with Plastic Ankle Foot Orthosis: A case report

Hemiplegic patients with an ankle foot orthosis (AFO) has a tendency to show external rotation of affected side foot. External rotation inhibiting shoes (ERIS) were designed to inhibit excessive rotation of hemiplegic foot. ERIS were applied to two hemiplegic patients who were able to walk independently with a plastic AFO. Both of them showed an excessive external rotation of hemiplegic foot after AFO apply. Each patient tried to walk with a pair of common shoes first and ERIS later. The external rotation angle, step length, stride length, cadence, speed were measured by footprint method. The external rotation angle of hemiplegic foot was significantly decreased with ERIS than with common shoes. However they did not show consistent improvement in the step length, stride length, cadence and speed. We reported that hemiplegic patients who walked with ERIS showed remarkable reduction in excessive external rotation of hemiplegic foot.