Quantitative objective videofluoroscopic swallowing measures in children

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dc.contributor.advisor Miles, A en
dc.contributor.advisor Allen, J en
dc.contributor.author Henderson, AK en
dc.date.accessioned 2016-07-27T21:39:56Z en
dc.date.issued 2016 en
dc.identifier.citation 2016 en
dc.identifier.uri http://hdl.handle.net/2292/29631 en
dc.description Full text is available to authenticated members of The University of Auckland only. en
dc.description.abstract Background: Reproducible quantitative swallowing data in children is scarce and could aid clinical decision making. The present study investigated the feasibility of utilising objective measures of timing and displacement in children undergoing a videofluoroscopic swallowing study (VFSS). Methods: One hundred and thirty-three children (mean age 36 mth, range 9 d–21 y, SD 4 y) consecutively referred for a VFSS over 12 months were recruited. Children presented with varying causes of dysphagia: 38% neurological, 26% structural 20% unknown, 10% respiratory, 4% cardiac and 3% other. All children received a standardised protocol including a mid-feed 20-second loop recorded at 25 frames per second. All videos were analysed using objective digital measures of timing and displacement previously described by Leonard and Kendall (1997). Results: Mean radiation time was 1.58 minutes (range 0.15–3.47, SD .66) and mean radiation dose was 30.16 cGycm2 (range 6.5–85 SD, 15.17). Radiation dose (p = .21) and radiation time (p = .72) were not significantly different using the increased frame rate compared with an age-matched cohort (N:133) prior to protocol change. Thirty-five per cent of children aspirated. Younger children were significantly more likely to silently aspirate than older children (p < .01). Mean pharyngeal transit time was .99 s (range 0.27–10.6, SD 1.8). Mean pharyngoesophageal segment opening was 0.52 cm (range 0.17–.98, SD .20). Mean pharyngeal constriction ratio was 0.02 (range 0–0.53, SD.07). Inter-rater reliability was substantial (ICC .88). PES maximum opening (p < .001) and PES opening duration (p < .001) significantly increased with age, whereas pharyngeal transit time significantly decreased with age (p < .05). Higher penetration-aspiration scale scores were associated with longer bolus transit scores (p < .05). Conclusion: Few studies have examined objective videofluoroscopic measures of swallowing in children. This novel study demonstrates the feasibility of recording reproducible and reliable objective data. The relationship between displacement measures and increasing age is consistent with findings in adults and suggests internal validity. Radiation exposure time is within normal range. This approach ensures studies have been optimised to obtain as much information as possible. Objective measures may provide clinicians with greater predictive value of risk than observation of aspiration alone. In time, objective measures may guide clinicians to develop informed management plans. en
dc.publisher ResearchSpace@Auckland en
dc.relation.ispartof Masters Thesis - University of Auckland en
dc.relation.isreferencedby 99264870404402091 en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights Restricted Item. Available to authenticated members of The University of Auckland. en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/3.0/nz/ en
dc.title Quantitative objective videofluoroscopic swallowing measures in children en
dc.type Thesis en
thesis.degree.discipline Speech Science en
thesis.degree.grantor The University of Auckland en
thesis.degree.level Masters en
dc.rights.holder Copyright: The Author en
pubs.author-url http://hdl.handle.net/2292/29631 en
pubs.elements-id 536416 en
pubs.record-created-at-source-date 2016-07-28 en

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