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The Impact of Videofluoroscopic Pulse Rate on Duration and Kinematic Measures in Infants and Adults with Feeding and Swallowing Disorders

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Abstract

This investigation assessed the impact of temporal resolution during a videofluoroscopic evaluation of swallowing (VFSS) on measures of duration and kinematics. Thirty adult and ten infant swallow studies, all acquired at 30 frames and 30 pulses per second, were obtained from a New Mexico hospital. All swallow studies were altered to simulate 15 and 5 pulses per second. Duration measures included pharyngeal response time, duration of upper esophageal sphincter (UES) opening, velopharyngeal closure duration and total swallow duration. Kinematic measures were assessed in adults only and included peak hyoid position and extent of UES opening during the swallow. Analysis of outcome measures was performed and compared across the three temporal resolutions (30, 15, and 5 pulses per second). For data points where normative values are available, we evaluated the impact of temporal resolution on clinical determination (i.e., did a change in pulse rate alter the clinical classification). Kinematic and duration measures were altered with changes in pulse rate and these changes increased as temporal resolution decreased. For outcome measures where normative values are available, accuracy of clinical determination decreased with decreased pulse rate. Temporal resolution impacts duration and kinematic measures. However, the direction of these changes is unpredictable, indicating sensitivity and specificity are both affected. Without a predictable impact, the use of lower pulse rates may alter clinical impressions and treatment recommendations yielding inappropriate treatment goals and treatment duration.

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Data Availability

Raw data are available from the DysphagiaBank which is stored in the TalkBank repository and located at https://aphasia.talkbank.org/access/English/Other/Dysphagia/UNM-access/UNM.html.

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Acknowledgements

The authors wish to acknowledge TIMS for their donation of viewing software and to all the individuals whose assessments were used in this project, Brian MacWhinney PhD and the team at TalkBank for allowing us to develop and store a repository database to support research like this, Philip Dale PhD for his advice throughout this project, Camella Rosenberg for her statistics consults, and to the students in the UNM Swallow Disorders Research Lab for their guidance, time, and assistance throughout this endeavor.

Funding

This study was not funded.

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Authors and Affiliations

  1. University of New Mexico Hospital, Albuquerque, NM, MSC01 1195, 87131-0001, USA

    Shauna C. Murray & Taite Winter

  2. Presbyterian Healthcare Services, Albuquerque, NM, USA

    Aaron H. Padilla

  3. University of New Mexico, Albuquerque, USA

    Phyllis M. Palmer, Mahshid Rashidi & Andrea Martinez-Fisher

Authors
  1. Phyllis M. Palmer
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  2. Aaron H. Padilla
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  3. Shauna C. Murray
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  4. Mahshid Rashidi
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  5. Andrea Martinez-Fisher
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  6. Taite Winter
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Contributions

All authors contributed to the study conception and design. All authors contributed to data collection and analysis. The first draft of the manuscript was written by [Phyllis Palmer] and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Phyllis M. Palmer.

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Ethical Approval

No animals were used in this study. Human data involved retrospective data that was collected for clinical purposes. All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was waived.

Conflict of Interest

Author A declares that she has no conflicts. Author B declared that he has no conflicts. Author C declares that she has no conflicts. Author D declares that she has no conflicts. Author E declares that she has no conflicts. Author F declares that she has no conflicts.

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Palmer, P.M., Padilla, A.H., Murray, S.C. et al. The Impact of Videofluoroscopic Pulse Rate on Duration and Kinematic Measures in Infants and Adults with Feeding and Swallowing Disorders. Dysphagia (2024). https://doi.org/10.1007/s00455-024-10709-y

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