1998 Volume 2 Issue 1 Pages 23-28
We developed a scale to evaluate the swallowing function in the patients with disturbance of consciousness and studied its clinical usefulness.The subjects were 17 inpatients treated in this medical center. All these patients suffered from prolonged consciousness disorder due to severe traumatic brain injury and depended totally on tube feeding. The newly developed evaluation scale for prolonged disturbance of consciousness comprised the following five categories: 1) mode of feeding, 2) lip closing function, 3) chewing function, 4) swallowing function and 5) coughing and reflux of nutritional supplement. The degree of impairment was evaluated on a scale of one to four: severe (10 points), moderate (8 points),mild (5 points) and extremely mild (0 point). According to this evaluation scale, a patient with the severest impairment was given a maximum score of 50.The patients were classified by their total scores into the following four groups: severe group of a score range of over 40 (n=0), moderate group of a score range of from 30 to 39 (n=5), mild group of a score range of from 20 to 29 (n=11) and extremely mild group of a score range of under 19 (n=1).Regarding category 1, all the patients were given the maximum score because they were placed on tube feeding. As for other categories, the degrees of impairment were rated as mild or extremely mild in more than half of the cases. These results suggested that we could separately employ effective treatment depending on the severity of each criterion. The newly developed evaluation scale seemed to be useful for introducing the swallowing training into the treatment for prolonged consciousness disorder.