title: Preliminary investigation of the effect of pulse rate on judgments of swallowing impairment and treatment recommendations.
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.
authors.affiliation: Department of Health Science and Research, Medical University of South Carolina, 77 President St, Charleston, SC, 29425, USA, bonilhah@musc.edu.
authors.forename: Heather Shaw
authors.initials: HS
authors.lastname: Bonilha
authors.forename: Julie
authors.initials: J
authors.lastname: Blair
authors.forename: Brittni
authors.initials: B
authors.lastname: Carnes
authors.forename: Walter
authors.initials: W
authors.lastname: Huda
authors.forename: Kate
authors.initials: K
authors.lastname: Humphries
authors.forename: Katlyn
authors.initials: K
authors.lastname: McGrattan
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Michel
authors.forename: Bonnie
authors.initials: B
authors.lastname: Martin-Harris
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001466:Barium Sulfate; D003287:Contrast Media; D003657:Decision Making; D003680:Deglutition Disorders / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005471:Fluoroscopy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011829:Radiation Dosage; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D003287:Contrast Media; D001466:Barium Sulfate
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