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The Test of Mastication and Swallowing Solids and the Timed Water Swallow Test: Reliability, associations, age and gender effects, and normative data

BACKGROUND: Quantitative measures can increase precision in describing swallowing function, improve interrater and test–retest reliability, and advance clinical decision‐making. The Test of Mastication and Swallowing Solids (TOMASS) and the Timed Water Swallow Test (TWST) are functional tests for sw...

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Autor principal: Sella‐Weiss, Oshrat
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10087873/
https://www.ncbi.nlm.nih.gov/pubmed/36036753
http://dx.doi.org/10.1111/1460-6984.12768
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author Sella‐Weiss, Oshrat
author_facet Sella‐Weiss, Oshrat
author_sort Sella‐Weiss, Oshrat
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description BACKGROUND: Quantitative measures can increase precision in describing swallowing function, improve interrater and test–retest reliability, and advance clinical decision‐making. The Test of Mastication and Swallowing Solids (TOMASS) and the Timed Water Swallow Test (TWST) are functional tests for swallowing that provide quantitative results. AIMS: To explore the relationship between TOMASS and TWST; evaluate test–retest and interrater reliability; explore age and gender effects; and gather normative data. METHODS & PROCEDURES: Healthy community dwelling participants (n = 298, ≥ 20 years old) were recruited. Of those, 126 were included in the reliability study. Participants completed the TWST and TOMASS. OUTCOMES & RESULTS: Associations between TWST and TOMASS measures were found using Pearson's correlation coefficient. Age was positively associated with an increase in the number of bites (n = 292, r = 0.15, p = 0.009), masticatory cycles (n = 291, r = 0.33, p < 0.0001) and duration (n = 292, r = 0.32, p < 0.0001) for the TOMASS. For the TWST, age was positively associated with an increase in duration (n = 296, r = 0.23, p < 0.0001), and negatively associated with volume (n = 296, r = −0.205, p < 0.0001), and swallowing capacity (n = 296, r = −0.24, p < 0.0001). Females required more bites, masticatory cycles, swallows and longer time than males in TOMASS. In TWST, females required more swallows, longer time, and had lower volume per swallow and reduced swallowing capacity than males. Intraclass correlation coefficient (ICC) revealed good test–retest reliability and moderate to excellent interrater reliability. CONCLUSIONS & IMPLICATIONS: This study provides support for the validity of the TOMASS and TWST. Reduced efficiency in one of the tests might indicate a need to evaluate performance in the other. Extended chewing time and increased number of masticatory cycles might be compensatory behaviours for reduced oral processing abilities that are motor, sensory and/or mechanical. WHAT THIS PAPER ADDS: The TOMASS and TWST are functional tests of swallowing that provide quantitative results. They are easy to incorporate as part of the clinical evaluation of swallowing due to low cost and quick administration. Age and gender effects were found for the TWST and TOMASS, but they were only tested on relative measures rather than absolute measures. Different types of crackers used for TOMASS led to differences in performance and in normative values. WHAT IS ALREADY KNOWN ON THE SUBJECT: Associations between performance during TWST and TOMASS were found: time, number of swallows and time per swallow were correlated, meaning that need for more time and more swallows is reflected in both drinking and chewing. The study provides further support for age and gender effects in TWST and TOMASS, on both relative and also on absolute measures, which were not investigated previously. Longer durations in TOMASS and TWST with an increase in age, are likely to be the result of compensatory behaviours to allow safe swallowing. Normative data for a country‐specific cracker are presented (Israel). WHAT ARE THE POTENTIAL OR ACTUAL CLINICAL IMPLICATIONS OF THIS WORK? Reduced efficiency in one of the tests might indicate a need to evaluate performance in the other. Establishing country specific norms for commonly available crackers is necessary, since crackers size and ingredients, such as fat content and moisture, influence chewing and swallowing. There is a balancing act between safety and efficiency in older adults’ swallowing behaviour. Reducing pace in eating and drinking probably supports safer swallowing.
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spelling pubmed-100878732023-04-12 The Test of Mastication and Swallowing Solids and the Timed Water Swallow Test: Reliability, associations, age and gender effects, and normative data Sella‐Weiss, Oshrat Int J Lang Commun Disord Research Reports BACKGROUND: Quantitative measures can increase precision in describing swallowing function, improve interrater and test–retest reliability, and advance clinical decision‐making. The Test of Mastication and Swallowing Solids (TOMASS) and the Timed Water Swallow Test (TWST) are functional tests for swallowing that provide quantitative results. AIMS: To explore the relationship between TOMASS and TWST; evaluate test–retest and interrater reliability; explore age and gender effects; and gather normative data. METHODS & PROCEDURES: Healthy community dwelling participants (n = 298, ≥ 20 years old) were recruited. Of those, 126 were included in the reliability study. Participants completed the TWST and TOMASS. OUTCOMES & RESULTS: Associations between TWST and TOMASS measures were found using Pearson's correlation coefficient. Age was positively associated with an increase in the number of bites (n = 292, r = 0.15, p = 0.009), masticatory cycles (n = 291, r = 0.33, p < 0.0001) and duration (n = 292, r = 0.32, p < 0.0001) for the TOMASS. For the TWST, age was positively associated with an increase in duration (n = 296, r = 0.23, p < 0.0001), and negatively associated with volume (n = 296, r = −0.205, p < 0.0001), and swallowing capacity (n = 296, r = −0.24, p < 0.0001). Females required more bites, masticatory cycles, swallows and longer time than males in TOMASS. In TWST, females required more swallows, longer time, and had lower volume per swallow and reduced swallowing capacity than males. Intraclass correlation coefficient (ICC) revealed good test–retest reliability and moderate to excellent interrater reliability. CONCLUSIONS & IMPLICATIONS: This study provides support for the validity of the TOMASS and TWST. Reduced efficiency in one of the tests might indicate a need to evaluate performance in the other. Extended chewing time and increased number of masticatory cycles might be compensatory behaviours for reduced oral processing abilities that are motor, sensory and/or mechanical. WHAT THIS PAPER ADDS: The TOMASS and TWST are functional tests of swallowing that provide quantitative results. They are easy to incorporate as part of the clinical evaluation of swallowing due to low cost and quick administration. Age and gender effects were found for the TWST and TOMASS, but they were only tested on relative measures rather than absolute measures. Different types of crackers used for TOMASS led to differences in performance and in normative values. WHAT IS ALREADY KNOWN ON THE SUBJECT: Associations between performance during TWST and TOMASS were found: time, number of swallows and time per swallow were correlated, meaning that need for more time and more swallows is reflected in both drinking and chewing. The study provides further support for age and gender effects in TWST and TOMASS, on both relative and also on absolute measures, which were not investigated previously. Longer durations in TOMASS and TWST with an increase in age, are likely to be the result of compensatory behaviours to allow safe swallowing. Normative data for a country‐specific cracker are presented (Israel). WHAT ARE THE POTENTIAL OR ACTUAL CLINICAL IMPLICATIONS OF THIS WORK? Reduced efficiency in one of the tests might indicate a need to evaluate performance in the other. Establishing country specific norms for commonly available crackers is necessary, since crackers size and ingredients, such as fat content and moisture, influence chewing and swallowing. There is a balancing act between safety and efficiency in older adults’ swallowing behaviour. Reducing pace in eating and drinking probably supports safer swallowing. John Wiley and Sons Inc. 2022-08-29 2023 /pmc/articles/PMC10087873/ /pubmed/36036753 http://dx.doi.org/10.1111/1460-6984.12768 Text en © 2022 The Authors. International Journal of Language & Communication Disorders published by John Wiley & Sons Ltd on behalf of Royal College of Speech and Language Therapists. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Research Reports
Sella‐Weiss, Oshrat
The Test of Mastication and Swallowing Solids and the Timed Water Swallow Test: Reliability, associations, age and gender effects, and normative data
title The Test of Mastication and Swallowing Solids and the Timed Water Swallow Test: Reliability, associations, age and gender effects, and normative data
title_full The Test of Mastication and Swallowing Solids and the Timed Water Swallow Test: Reliability, associations, age and gender effects, and normative data
title_fullStr The Test of Mastication and Swallowing Solids and the Timed Water Swallow Test: Reliability, associations, age and gender effects, and normative data
title_full_unstemmed The Test of Mastication and Swallowing Solids and the Timed Water Swallow Test: Reliability, associations, age and gender effects, and normative data
title_short The Test of Mastication and Swallowing Solids and the Timed Water Swallow Test: Reliability, associations, age and gender effects, and normative data
title_sort test of mastication and swallowing solids and the timed water swallow test: reliability, associations, age and gender effects, and normative data
topic Research Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10087873/
https://www.ncbi.nlm.nih.gov/pubmed/36036753
http://dx.doi.org/10.1111/1460-6984.12768
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