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First, I would like to thank the MannaQure team for donating a copy of the MannaQure assessment for review on Dysphagia Ramblings!

The MannaQure assessment is a comprehensive, norm-referenced English to Spanish assessment of dysphagia and dysarthria.  The test was normed using 145 participants 21 years and older with with 95 of the participants speaking English as a second language.  Participants had a wide variety of neurological diagnoses.

The MannaQure is scored by sections.  Each section is then totaled and divided by the number of assessments in the section.  The percentage can then be interpreted as WFL, mild, moderate, severe or profound.

Test items needed include:

  • tongue depressor
  • pen light
  • stopwatch
  • cold, wet cloth
  • iced spoon
  • lemon, peppermint or vanilla extract
  • gloves
  • straw
  • teaspoon
  • cup
  • trial texture consistencies
  • trial liquid consistencies

The sections assessed in this test include:

  • Receptive Language
  • Expressive Language/Speech Production
  • Cognition
  • Oral Mechanism Function (Labial Structure, Lingual Structure, Laryngeal, Soft Palate, Respiration)
  • Bedside Evaluation (Oral Phase, Pharyngeal Phase)
  • Total Dysphagia/Dysarthria Degree of Severity
  • (For Profound Deficits only)-Oral-Facial Stimulability Probe and Bedside Evaluation Total.

The first section, Receptive Language is a series of yes/no questions related to orientation and directions for the patient to follow.

Expressive Language consists of orientation and automatic speech tasks.

The cognition section is a series of questions related to orientation and general information such as a summer month.

The Oral Mechanism Function is a basic oral motor assessment, smile, pucker your lips, stick out your tongue.  Each task also includes information about which cranial nerve is involved.  The Laryngeal section includes:  dry swallow, cough, clear throat, humming, increasing volume while counting to 5.

Oral-facial stimulability involves response to:

  • cold wet cloth on facial structures
  • iced spoon response on lip
  • response to smell
  • swallow elicitation with laryngeal massage
  • response to touch on the facial structures
  • eye tracking
  • presence of a gag reflex

The pros of this test:

  • It is very quick and easy to administer.
  • All instructions are translated to Spanish with a pronunciation guide.
  • Cranial nerves are involved (they are near and dear to my heart)!
  • It is very comprehensive.
  • It is portable and easy to carry.  You really only need to protocol.


The cons of this test:

  • The pharyngeal phase is assessed, however this phase is nearly impossible to assess without instrumentation.
  • Signs/Symptoms of aspiration listed include watery eyes and runny nose.  There is no evidence to support this.  I also don’t know that I would place pocketing, fatigue or cognitive decline as a s/s aspiration.  They may be contributing factors to dysphagia/aspiration.

Overall the authors did a very nice job of putting together an easy to use assessment guide that gives a severity rating for your patient.

For more information on MannaQure visit their website here.




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