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Preliminary Investigation of the Effect of Pulse Rate on Judgments of Swallowing Impairment and Treatment Recommendations

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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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Acknowledgments

This work was supported by the following grants: NIH/NIDCD Grant No. K23 DC005764-05, NIH/NCRR Grant No. KL2 UL1 RR029880, and Bracco Diagnostics (NIH/NIDCD No. K24 DC012801). Other financial or material support was provided by Evelyn Trammell Voice and Swallowing Institute and Northern Speech Services.

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Authors and Affiliations

  1. Department of Health Science and Research, Medical University of South Carolina, 77 President St, Charleston, SC, 29425, USA

    Heather Shaw Bonilha, Katlyn McGrattan & Bonnie Martin-Harris

  2. Department of Otolaryngology, Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA

    Heather Shaw Bonilha & Bonnie Martin-Harris

  3. Evelyn Trammell Institute of Voice and Swallowing, Medical University of South Carolina, Charleston, SC, USA

    Julie Blair, Brittni Carnes, Kate Humphries, Katlyn McGrattan & Bonnie Martin-Harris

  4. Department of Radiology, Medical University of South Carolina, Charleston, SC, USA

    Walter Huda

  5. Biostatistics and Epidemiology, Medical University of South Carolina, Charleston, SC, USA

    Yvonne Michel

  6. Ralph H. Johnson VA Medical Center, Charleston, SC, USA

    Bonnie Martin-Harris

Authors
  1. Heather Shaw Bonilha
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  2. Julie Blair
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  3. Brittni Carnes
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  4. Walter Huda
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  5. Kate Humphries
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  6. Katlyn McGrattan
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  7. Yvonne Michel
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  8. Bonnie Martin-Harris
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Correspondence to Heather Shaw Bonilha.

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Bonilha, H.S., Blair, J., Carnes, B. et al. Preliminary Investigation of the Effect of Pulse Rate on Judgments of Swallowing Impairment and Treatment Recommendations. Dysphagia 28, 528–538 (2013). https://doi.org/10.1007/s00455-013-9463-z

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  • DOI: https://doi.org/10.1007/s00455-013-9463-z

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