Use of an Anatomical Scalar to Control for Sex-Based Size Differences in Measures of Hyoid Excursion During Swallowing

Molfenter, Sonja M.; Steele, Catriona M.

doi:10.1044/2014_jslhr-s-13-0152

Cited by 84 publications

(96 citation statements)

References 27 publications

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“…The peak velocities (X,Y) and speed (XY) in (mm/s) were also identified within each movement trajectory. As reported elsewhere, strong inter and intra-rater reliability (i.e., intra-class correlation coefficients > 0.79) were obtained for superior and hypotenuse hyoid measurements based on repeat rating of a random selection of 10% of the recordings [6, 22]. Intra-class coefficients for inter- and intra-rater reliability of anterior hyoid displacement measures were slightly lower at 0.59 and 0.61, respectively.…”

Section: Methodssupporting

confidence: 62%

“…Data analysis involved frame-by-frame tracking of hyoid position in ImageJ freeware, using a coordinate system with an origin defined at the anterior-inferior corner of the C4-vertebrae, and the vertical axis defined by a line running from the origin upwards through the anterior-inferior corner of the C2-vertebrae (see Figure 2). The pixel-distance between the anterior-inferior corners of the C2 and C4 vertebrae was also measured as an anatomical scalar to enable us to control for differences in the size of the system (i. e. oropharynx and cervical spine) across participants during measurements of hyoid movement distance [6]. Using the frame-by-frame position history data, an algorithm in Microsoft Excel VBA software was used to index the onset and end positions of the anterosuperior hyoid movement for each swallow.…”

Section: Methodsmentioning

confidence: 99%

“…The term hyoid kinematics refers to measurements of hyoid movement, which can be derived from frame-by-frame hyoid position tracking across the movement trajectory [5]. Normalization of these hyoid measurements to the size of the system allows for uniform anatomical scaling and permits comparison across individual patients or study participants [6]. …”

Section: Introductionmentioning

confidence: 99%

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The Effect of Bolus Consistency on Hyoid Velocity in Healthy Swallowing

et al. 2015

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The aim of this study was to determine whether measures of hyoid velocity increase when swallowing liquids of thicker consistency at a constant volume. A gender-balanced sample of 20 healthy young participants (mean age 31.5) each swallowed 3 boluses of 5ml volume in 3 consistencies (ultrathin, thin, and nectar-thick barium). Using frame by frame tracking of hyoid position, we identified the onset and peak of the hyoid movement and derived measures of velocity (i.e., distance in anatomically normalized units, i.e., % of the C2–4 vertebral distance, divided by duration in ms) for the X, Y and XY movement directions. Peak hyoid velocity was also identified for each movement direction. Where significant differences were identified, the component measures of hyoid movement distance and duration were further explored to determine the strategies used to alter velocity. The results showed increased velocities and higher peak velocities with the nectar thick stimuli compared to thin and ultrathin stimuli. This was achieved by a primary strategy of larger hyoid movement distances per unit of time when swallowing nectar-thick liquids.. These results point to one mechanism by which thickened liquids may contribute to improved airway protection, by facilitating more-timely laryngeal vestibule closure.

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Section: Methodssupporting

confidence: 62%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Effect of Bolus Consistency on Hyoid Velocity in Healthy Swallowing

et al. 2015

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“…Videofluoroscopic recordings were digitized using Peak Motus version 9 while blinded to the study group and to the presence of perturbation. Three points were digitized for each swallow, including the anterior-inferior point of the hyoid bone (during both superior and anterior peak excursion), the subglottal air column for laryngeal position (superior peak), and a cervical vertebra used as a reference point to compare to hyoid position and to account for whole body (11)] peak hyo-laryngeal measures were adjusted for individual differences in range of hyo-laryngeal movement during swallowing to normalize differences due to variance across participants (26). Data were scaled ranging from 0 (lowest among 30 swallows) to 1 (highest among 30 swallows) individually for each participant.…”

Section: Discussionmentioning

confidence: 99%

The perturbation paradigm modulates error-based learning in a highly automated task: outcomes in swallowing kinematics

Anderson

Macrae

Taylor-Kamara

et al. 2015

Journal of Applied Physiology

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Traditional motor learning studies focus on highly goal-oriented, volitional tasks that often do not readily generalize to real-world movements. The goal of this study was to investigate how different perturbation paradigms alter error-based learning outcomes in a highly automated task. Swallowing was perturbed with neck surface electrical stimulation that opposes hyo-laryngeal elevation in 25 healthy adults (30 swallows: 10 preperturbation, 10 perturbation, and 10 postperturbation). The four study conditions were gradual-masked, gradual-unmasked, abrupt-masked, and abrupt-unmasked. Gradual perturbations increasingly intensified overtime, while abrupt perturbations were sustained at the same high intensity. The masked conditions reduced cues about the presence/absence of the perturbation (pre- and postperturbation periods had low stimulation), but unmasked conditions did not (pre- and postperturbation periods had no stimulation). Only hyo-laryngeal range of motion measures had significant outcomes; no timing measure demonstrated learning. Systematic-error reduction occurred only during the abrupt-masked and abrupt-unmasked perturbations. Only the abrupt-masked perturbation caused aftereffects. In this highly automated task, gradual perturbations did not induce learning similarly to findings of some volitional, goal-oriented adaptation task studies. Furthermore, our subtle and brief adjustment of the stimulation paradigm (masked vs. unmasked) determined whether aftereffects were present. This suggests that, in the unmasked group, sensory predictions of a motor plan were quickly and efficiently modified to disengage error-based learning behaviors.

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“…Given recent evidence that kinematic measures of pharyngeal swallowing benefit from size-normalization to reduce artifacts attributable to participant height [10], we incorporated anatomical scaling in pixel-based measures of pharyngeal constriction. Our research questions were as follows:

What reference values should be used as a basis for determining when measures of pharyngeal constriction are normal or abnormal during a 5 cc thin liquid swallowing task?

Do anatomically scaled measures of pharyngeal constriction differ in swallows that display post-swallow residue compared to those with good bolus clearance?

Is there a relationship between the degree of pharyngeal constriction seen in a swallow and the severity of post-swallow residue accumulation?

…”

Section: Introductionmentioning

confidence: 99%

The Relationship Between Pharyngeal Constriction and Post-swallow Residue

et al. 2015

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Pharyngeal constriction has been proposed as a parameter that may distinguish functional from impaired swallows. We employed anatomically normalized pixel-based measures of pharyngeal area at maximum constriction, and the ratio of this measure to area at rest, and explored the association between these measures and post-swallow residue using the normalized residue ratio scale (NRRS). Videofluoroscopy data for 5 ml boluses of 22 % (w/v) liquid barium were analyzed from 20 healthy young adults and 40 patients with suspected neurogenic dysphagia. The frames of maximum pharyngeal constriction and post-swallow hyoid rest were extracted. Pixel-based measures of pharyngeal area were made using ImageJ and size-normalized using the squared C2–C4 vertebral distance as a reference scalar. Post-swallow residue and the areas of the vallecular and pyriform sinus spaces were measured on the hyoid rest frame to calculate the NRRSv and NRRSp. The dataset was divided into swallows with residue within or exceeding the upper confidence interval boundary seen in the healthy participants. Mixed model repeated measures ANOVAs were used to compare pharyngeal area (rest, constriction) and the pharyngeal constriction ratio, between individuals with and without residue. Measures of pharyngeal area at maximum constriction were significantly larger (i.e., less constricted, p = 0.000) in individuals with post-swallow residue in either the valleculae or the pyriform sinus. These results support the idea that interventions targeted toward improving pharyngeal constriction have the potential to be effective in reducing post-swallow residue.

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Use of an Anatomical Scalar to Control for Sex-Based Size Differences in Measures of Hyoid Excursion During Swallowing

Cited by 84 publications

References 27 publications

The Effect of Bolus Consistency on Hyoid Velocity in Healthy Swallowing

The Effect of Bolus Consistency on Hyoid Velocity in Healthy Swallowing

The perturbation paradigm modulates error-based learning in a highly automated task: outcomes in swallowing kinematics

The Relationship Between Pharyngeal Constriction and Post-swallow Residue

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