Journal
DYSPHAGIA
Volume 37, Issue 5, Pages 1103-1111Publisher
SPRINGER
DOI: 10.1007/s00455-021-10368-3
Keywords
Dysphagia; Videofluoroscopy; Machine learning; Cervical auscultation; Biofeedback; Treatment; Deglutition; Deglutition disorders
Categories
Funding
- Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health [R01HD092239, R01HD074819]
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There is a growing interest in developing inexpensive and portable methods for accurately assessing swallowing during dysphagia treatment. High-resolution cervical auscultation (HRCA) is a novel method using acoustic and vibratory signals from non-invasive sensors to quantify swallowing physiology. The study found that HRCA can accurately differentiate between non-effortful and effortful swallows, but there were no differences in Modified Barium Swallow Impairment Profile (MBSImP) scores between the two types of swallows.
There is growing enthusiasm to develop inexpensive, non-invasive, and portable methods that accurately assess swallowing and provide biofeedback during dysphagia treatment. High-resolution cervical auscultation (HRCA), which uses acoustic and vibratory signals from non-invasive sensors attached to the anterior laryngeal framework during swallowing, is a novel method for quantifying swallowing physiology via advanced signal processing and machine learning techniques. HRCA has demonstrated potential as a dysphagia screening method and diagnostic adjunct to VFSSs by determining swallowing safety, annotating swallow kinematic events, and classifying swallows between healthy participants and patients with a high degree of accuracy. However, its feasibility as a non-invasive biofeedback system has not been explored. This study investigated 1. Whether HRCA can accurately differentiate between non-effortful and effortful swallows; 2. Whether differences exist in Modified Barium Swallow Impairment Profile (MBSImP) scores (#9, #11, #14) between non-effortful and effortful swallows. We hypothesized that HRCA would accurately classify non-effortful and effortful swallows and that differences in MBSImP scores would exist between the types of swallows. We analyzed 247 thin liquid 3 mL command swallows (71 effortful) to minimize variation from 36 healthy adults who underwent standardized VFSSs with concurrent HRCA. Results revealed differences (p < 0.05) in 9 HRCA signal features between non-effortful and effortful swallows. Using HRCA signal features as input, decision trees classified swallows with 76% accuracy, 76% sensitivity, and 77% specificity. There were no differences in MBSImP component scores between non-effortful and effortful swallows. While preliminary in nature, this study demonstrates the feasibility/promise of HRCA as a biofeedback method for dysphagia treatment.
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