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. 2013 Dec;28(4):528-38.
doi: 10.1007/s00455-013-9463-z. Epub 2013 Apr 5.

Preliminary investigation of the effect of pulse rate on judgments of swallowing impairment and treatment recommendations

Heather Shaw Bonilha  1 , Julie Blair, Brittni Carnes, Walter Huda, Kate Humphries, Katlyn McGrattan, Yvonne Michel, Bonnie Martin-Harris
Affiliations

Preliminary investigation of the effect of pulse rate on judgments of swallowing impairment and treatment recommendations

Heather Shaw Bonilha et al. Dysphagia. 2013 Dec.

Abstract

Reducing fluoroscopic pulse rate, a method used to reduce radiation exposure from modified barium swallow studies (MBSSs), decreases the number of images available from which to judge swallowing impairment. It is necessary to understand the impact of pulse rate reduction on judgments of swallowing impairment and, consequentially, treatment recommendations. This preliminary study explored differences in standardized MBSS measurements [Modified Barium Swallow Impairment Profile (MBSImP™©) and Penetration Aspiration Scale (PAS) Scores] between two pulse rates: 30 and simulated 15 pulses per second (pps). Two reliable speech-language pathologists (SLPs) scored all five MBSSs. Five SLPs reported treatment recommendations based on those scores. Differences in judgments of swallowing impairment were found between 30 and simulated 15 pps in all five MBSSs. These differences were in six physiological swallowing components: initiation of pharyngeal swallow, anterior hyoid excursion, epiglottic movement, pharyngeal contraction, pharyngeal-esophageal segment opening, and tongue base retraction. Differences in treatment recommendations were found between 30 and simulated 15 pps in all five MBSSs. These findings suggest that there are differences in both judgment of swallowing impairment and treatment recommendations when pulse rates are reduced from 30 to 15 pps to minimize radiation exposure.

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Conflict of interest statement

CONFLICT OF INTEREST

This work was supported by the following grants: grant number K23 DC005764-05 funder NIH/NIDCD, grant number KL2 UL1 RR029880 funder NIH/NCRR, and funder Bracco Diagnostics (no grant number). Other financial or material support was provided by Evelyn Trammell Voice and Swallowing Institute and Northern Speech Services.

Figures

Figure 1
Figure 1
Flowchart of components scored (right side) and number of resulting scores (left side) for comparisons between 30 and simulated 15pps.
Figure 2
Figure 2
Fluoroscopic images of 30 and simulated 15pps MBSS demonstrating the difference in the scoring of Initiation of Pharyngeal Swallow. Figure 2a is a still image from the 30pps recording and Figure 2b is a still image from the simulated 15pps recording. Both images were captured at 23 seconds into the recording at the beginning of the anterior hyoid excursion.
See this image and copyright information in PMC

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