MBS Measurement Tool for Swallow Impairment—MBSImp: Establishing a Standard

Abstract

The aim of this study was to test reliability, content, construct, and external validity of a new modified barium swallowing study (MBSS) tool (MBSImp) that is used to quantify swallowing impairment. Multiple regression, confirmatory factor, and correlation analyses were used to analyze 300 in- and outpatients with heterogeneous medical and surgical diagnoses who were sequentially referred for MBS exams at a university medical center and private tertiary care community hospital. Main outcome measures were the MBSImp and index scores of aspiration, health status, and quality of life. Inter- and intrarater concordance were 80% or greater for blinded scoring of MBSSs. Regression analysis revealed contributions of eight of nine swallow types to impressions of overall swallowing impairment (p ≤ 0.05). Factor analysis revealed 13 significant components (loadings ≥ 0.5) that formed two impairment groupings (oral and pharyngeal). Significant correlations were found between Oral and Pharyngeal Impairment scores and Penetration-Aspiration Scale scores, and indexes of intake status, nutrition, health status, and quality of life. The MBSImp demonstrated clinical practicality, favorable inter- and intrarater reliability following standardized training, content, and external validity. This study reflects potential for establishment of a new standard for quantification and comparison of oropharyngeal swallowing impairment across patient diagnoses as measured on MBSS.

Cognitive and Motor Aspects of Parkinson’s Disease Associated with Dysphagia

“…25 This validated and reliable tool utilizes an ordinal scoring scheme that permits quantification of impairment of the oral, pharyngeal, and esophageal components of swallowing. The oral phase is composed of lip closure, hold position/tongue control, bolus preparation/mastication, bolus transport/lingual motion, oral residue, and initiation of the pharyngeal swallow.…”

Locais de início da fase faríngea da deglutição: meta-análise

“…To perform the meta-analysis, the onset locations of the pharyngeal phase of swallowing cited by the authors were classified according to the MBSImp (15) and grouped as onset A (levels zero or one of the MBSImp) and onset B (levels two or three of the MBSImp) for application of statistical tests ( Figure 2). Level four of the protocol was not included in the grouping of the articles, since the observation of the onset of the pharyngeal phase of swallowing was one of the inclusion criteria used in the selection of publications.…”

“…In order to perform the meta-analysis, even after applying the inclusion and quality criteria, only articles were included describing the absolute and/or relative frequency of individuals who had the pharyngeal phase of swallowing started without verbal command or change in head posture and description subject to classification according to the protocol of the Modified Barium Swallowing -Measurement Tool for Swallowing Impairment (MBSImp) (15) .…”

“…Of the 12 articles selected, only seven described the absolute and/or relative frequency of individuals as to the onset location of the pharyngeal phase of swallowing, specifying regions that could be classified by MBSImp (15) . Due to the clinical differences of the individuals (mainly related to age and to the existence of symptomatic and asymptomatic populations regarding the swallowing function) and the methodological differences of the studies (such as use of different consistencies and volumes), articles included in the statistical calculations showed high heterogeneity (83%) (Figure 4).…”

Análise qualitativa e quantitativa da deglutição orofaríngea na Síndrome de Down

“…The inter-rater agreement mean was calculated for oral and pharyngeal transit times. The following parameters were considered in the VFSE qualitative analysis: presence or absence of oral incoordination, labial sphincter sealing incompetence, oral residue, posterior oral spillage, and laryngotracheal penetration and aspiration (6) . Quantitative temporal analysis of swallowing was conducted using specific software (7) to measure, in milliseconds (ms), the total oral transit time (TOTT) and pharyngeal transit time (PTT).…”