Validation of Clinical Observations of Mastication in Persons with ALS.
Validation of Clinical Observations of Mastication in Persons with ALS.
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DOI：
10.1007/s00455-015-9685-3
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发表时间：
2016-06
期刊：
影响因子：
2.6
通讯作者：
Green JR
中科院分区：
文献类型：
--
作者：
Simione M;Wilson EM;Yunusova Y;Green JR
肌萎缩侧索硬化症（ALS）是一种进行性神经系统疾病，可导致咀嚼困难，导致营养不良、窒息或误吸，以及生活质量下降。在评估咀嚼时，临床医生主要观察颌骨运动的空间和时间方面。检测颌运动异常的临床观察的可靠性和有效性尚不清楚。本研究的目的是确定的可靠性和有效性的咀嚼性能在神经典型的控制和不同程度的咀嚼功能障碍，由于ALS的人临床医生为基础的评级。成年人咀嚼固体食物的一致性，而全脸视频记录沿着与下颌运动学数据使用三维光学运动捕捉系统。五位经验丰富的语言病理学家观看了这些视频，并对咀嚼表现的空间和时间方面进行了评价。下颌运动学数据作为验证临床医生评级的金标准。结果表明，基于临床医生的咀嚼表现的时间方面的评级有很强的评分者间的可靠性和相关性以及可比的运动学措施。相比之下，对咀嚼的空间和时空方面进行评级的可靠性（即，下颌的运动范围、咀嚼模式的一致性）是混合的。具体来说，活动度的评级充其量只是中等可靠。咀嚼运动的一致性评级是可靠的，但只有微弱的相关性与下颌运动学的可比措施。这些研究结果表明，咀嚼的时间方面的临床评级是适当的临床使用，而咀嚼的空间和时空方面的评级可能是不可靠或有效的。
Amyotrophic lateral sclerosis (ALS) is a progressive neurological disease that can result in difficulties with mastication leading to malnutrition, choking or aspiration, and reduced quality of life. When evaluating mastication, clinicians primarily observe spatial and temporal aspects of jaw motion. The reliability and validity of clinical observations for detecting jaw movement abnormalities is unknown. The purpose of this study is to determine the reliability and validity of clinician-based ratings of chewing performance in neuro-typical controls and persons with varying degrees of chewing impairments due to ALS. Adults chewed a solid food consistency while full-face video were recorded along with jaw kinematic data using a 3D optical motion capture system. Five experienced speech-language pathologists watched the videos and rated the spatial and temporal aspects of chewing performance. The jaw kinematic data served as the gold-standard for validating the clinicians’ ratings. Results showed that the clinician-based rating of temporal aspects of chewing performance had strong inter-rater reliability and correlated well with comparable kinematic measures. In contrast, the reliability of rating the spatial and spatiotemporal aspects of chewing (i.e., range of motion of the jaw, consistency of the chewing pattern) was mixed. Specifically, ratings of range of motion were at best only moderately reliable. Ratings of chewing movement consistency were reliable but only weakly correlated with comparable measures of jaw kinematics. These findings suggest that clinician ratings of temporal aspects of chewing are appropriate for clinical use, whereas ratings of the spatial and spatiotemporal aspects of chewing may not be reliable or valid.