Abstract
Objective
To determine differences between continuous videofluoroscopic swallow studies (VFSS)
with a pulse rate and frame rate of 30 and the same swallows reduced to 15 frames
per second (fps) on measures of swallowing function in patients after acute ischemic
stroke.
Design
Blinded comparison.
Setting
Acute hospital.
Participants
Patients after ischemic stroke (N=20).
Interventions
Not applicable.
Main Outcome Measures
Single and sequential sips of thin liquids, single sips of nectar liquids, pudding,
and cookie boluses were rated on measures of timing of swallowing events, Modified
Barium Swallowing Impairment Profile component scores, and Penetration-Aspiration
Scale scores. The ratings for videos at 15 fps and 30 fps were compared by Wilcoxon
signed rank tests.
Results
Pharyngeal transit time was longer and bolus entry into the hypopharynx was later
for 30 fps than for 15 fps. Components of Oral Residue and Pharyngoesophageal Segment
Opening ratings were more severe for 15 fps than 30 fps, whereas Bolus Transport and
Initiation of Pharyngeal Swallow were rated as more severe for 30 fps than for 15
fps. There was no difference between 30 fps and 15 fps on the remaining measures,
including Penetration-Aspiration Scale scores.
Conclusion
Continuous VFSS recorded at 30 fps and their down-sampled 15 fps duplicates yielded
contrasting results on certain durational and functional measures of swallowing, though
not on others. VFSS should be administered continuously or at 30 pulses per second
for valid assessment of swallowing while using other methods to reduce radiation exposure.
Keywords
List of abbreviations:
CI (confidence interval), fps (frames per second), ICC (intra-class correlation coefficient), MBSImP (Modified Barium Swallowing Impairment Profile), pps (pulses per second), VFSS (videofluoroscopic swallowing study)To read this article in full you will need to make a payment
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References
- Fluoroscopy: patient radiation exposure issues.Radiographics. 2001; 21: 1033-1045
- MBS measurement tool for swallow impairment—MBSImp: establishing a standard.Dysphagia. 2008; 23: 392-405
- Perceptual comparison of pulsed and continuous fluoroscopy.Med Phys. 1994; 21: 245-256
- Kinematic and temporal factors associated with penetration–aspiration in swallowing liquids.Dysphagia. 2014; 29: 269-276
- Guidelines for speech-language pathologists performing videofluoroscopic swallowing studies.(Available at:) (Accessed March 5, 2017)
- Physiology and radiology of the normal oral and pharyngeal phases of swallowing.AJR Am J Roentgenol. 1990; 154: 953-963
- How I do it: examination of the patient with dysphagia.Dysphagia. 1989; 4: 162-172
- Can we use pulsed fluoroscopy to decrease the radiation dose during video fluoroscopic feeding studies in children?.Clin Radiol. 2009; 64: 70-73
- Preliminary investigation of the effect of pulse rate on judgments of swallowing impairment and treatment recommendations.Dysphagia. 2013; 28: 528-538
- Timing in the normal pharyngeal swallow. Prospective selection and evaluation of 16 normal asymptomatic patients.Invest Radiol. 1984; 19: 523-529
- Timing of major events of pharyngeal swallowing.Arch Otolaryngol Head Neck Surg. 1988; 114: 1413-1418
- Evaluation of swallowing using 320-detector-row multislice CT. Part II: kinematic analysis of laryngeal closure during normal swallowing.Dysphagia. 2011; 26: 209-217
- A penetration-aspiration scale.Dysphagia. 1996; 11: 93-98
- The influence of food texture and liquid consistency modification on swallowing physiology and function: a systematic review.Dysphagia. 2015; 30: 2-26
- Swallowing physiology of sequential straw drinking.Dysphagia. 2001; 16: 176-182
- Motor strategy in rapid sequential swallowing: new insights.J Speech Lang Hear Res. 2000; 43: 1481-1492
- Quantitative videofluoroscopic analysis of penetration-aspiration in post-stroke patients.Neurol India. 2010; 58: 42-47
- Stage transition duration in patients poststroke.Dysphagia. 2007; 22: 299-305
- Respiratory-swallow training in patients with head and neck cancer.Arch Phys Med Rehabil. 2015; 96: 885-893
Article info
Publication history
Published online: November 16, 2018
Footnotes
Current affiliation for Mulheren, Case Western Reserve University, Cleveland, OH.
This work was supported by the National Institutes of Health through the National Institute on Deafness and Other Communication Disorders (grant no. K23 DC 011056) and the National Institute of Child Health & Human Development—National Center for Medical Rehabilitation Research (grant no. 5T32HD007414-23). The content is solely the responsibility of the authors and does not necessarily represent the views of the National Institutes of Health.
Identification
Copyright
© 2018 by the American Congress of Rehabilitation Medicine
