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J Speech Lang Hear Res. 2017 Jul 12;60(7):1855-1863. doi: 10.1044/2017_JSLHR-S-16-0117.

Identification of Swallowing Tasks From a Modified Barium Swallow Study That Optimize the Detection of Physiological Impairment.

Author information

1
Medical University of South Carolina, College of Health Professions, Department of Health Sciences and Research, CharlestonMedical University of South Carolina, College of Medicine, Department of Otolaryngology-Head and Neck Surgery, CharlestonAppalachian State University, Beaver College of Heath Sciences, Department of Communication Sciences and Disorders, Boone, NC.
2
Medical University of South Carolina, College of Medicine, Department of Public Health Sciences, Charleston.
3
Medical University of South Carolina, College of Health Professions, Department of Health Sciences and Research, CharlestonMedical University of South Carolina, College of Medicine, Department of Otolaryngology-Head and Neck Surgery, Charleston.
4
Medical University of South Carolina, College of Health Professions, Department of Health Sciences and Research, CharlestonMedical University of South Carolina, College of Medicine, Department of Otolaryngology-Head and Neck Surgery, CharlestonNorthwestern University, School of Communication, Department of Communication Sciences and Disorders, Evanston, IL.

Abstract

Purpose:

The purpose of this study was to identify which swallowing task(s) yielded the worst performance during a standardized modified barium swallow study (MBSS) in order to optimize the detection of swallowing impairment.

Method:

This secondary data analysis of adult MBSSs estimated the probability of each swallowing task yielding the derived Modified Barium Swallow Impairment Profile (MBSImP™©; Martin-Harris et al., 2008) Overall Impression (OI; worst) scores using generalized estimating equations. The range of probabilities across swallowing tasks was calculated to discern which swallowing task(s) yielded the worst performance.

Results:

Large-volume, thin-liquid swallowing tasks had the highest probabilities of yielding the OI scores for oral containment and airway protection. The cookie swallowing task was most likely to yield OI scores for oral clearance. Several swallowing tasks had nearly equal probabilities (≤ .20) of yielding the OI score.

Conclusions:

The MBSS must represent impairment while requiring boluses that challenge the swallowing system. No single swallowing task had a sufficiently high probability to yield the identification of the worst score for each physiological component. Omission of swallowing tasks will likely fail to capture the most severe impairment for physiological components critical for safe and efficient swallowing. Results provide further support for standardized, well-tested protocols during MBSS.

PMID:
28614846
PMCID:
PMC5831085
DOI:
10.1044/2017_JSLHR-S-16-0117
[Indexed for MEDLINE]
Free PMC Article

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