2.7.4. Modified Water Swallowing Test (MWST)

MWST was used with cervical auscultation to evaluate swallowing function [23,24]. Following the conventional method, 3 mL of cold water were injected into the floor of the mouth using a 5 mL syringe, and the participant was instructed to swallow. Subsequently, the sound before and after swallowing and changes in the respiratory sound were evaluated. If moist or foamy sounds were present in the pharyngeal swallowing sound or wheezing or gag reflex was present, the swallowing sound was classified as abnormal [23]. Based on the method of Sakai et al. [25], participants who could not complete the test, those who got an MWST score of 3 or lower, and those who had abnormal results in the cervical auscultation test were evaluated as ‘poor’. Those with an MWST score of 4 or higher were evaluated as ‘good’.