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Detection of Swallow Kinematic Events From Acoustic High-Resolution Cervical Auscultation Signals in Patients With Stroke

      Abstract

      Objective

      To examine whether there were any associations between high-resolution cervical auscultation (HRCA) acoustic signals recorded by a contact microphone and swallowing kinematic events during pharyngeal swallow as assessed by a videofluoroscopic (VF) examination.

      Design

      Prospective pilot study.

      Setting

      University teaching hospital, university research laboratories.

      Participants

      Patients (N=35) with stroke who have suspected dysphagia (26 men + 9 women; age = 65.8±11.2).

      Methods

      VF recordings of 100 liquid swallows from 35 stroke patients were analyzed, and a variety of HRCA signal features to characterize each swallow were calculated.

      Main Outcome Measures

      Percent of signal feature maxima (peak) occurring within 0.1 seconds of swallow kinematic event identified from VF recording.

      Results

      Maxima of HRCA signal features, such as standard deviation, skewness, kurtosis, centroid frequency, bandwidth, and wave entropy, were associated with hyoid elevation, laryngeal vestibule closure, and upper esophageal sphincter opening, and the contact of the base of the tongue and posterior pharyngeal wall.

      Conclusions

      Although the kinematic source of HRCA acoustic signals has yet to be fully elucidated, these results indicate a strong relationship between these HRCA signals and several swallow kinematic events. There is a potential for HRCA to be developed for diagnostic and rehabilitative clinical management of dysphagia.

      Keywords

      List of abbreviations:

      BOT (base of the tongue), BOT-PPW (base of the tongue contact to the posterior pharyngeal wall), CA (cervical auscultation), HE (hyoid elevation), HRCA (high resolution cervical auscultation), LV (laryngeal vestibule), LVC (laryngeal vestibule closure), PPW (posterior pharyngeal wall), SLP (speech language pathologist), UES (upper esophageal sphincter), UESO (upper esophageal sphincter opening), VF (videofluoroscopic), VFSS (Videofluoroscopic swallow study)
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