Preferred Name
Kelsey Letzring Murray
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
ORCID
https://orcid.org/0000-0001-5350-9677
Date of Graduation
8-9-2024
Document Type
Dissertation
Degree Name
Doctor of Philosophy (PhD)
Department
Department of Communication Sciences and Disorders
Advisor(s)
Erin Kamarunas
Carol Dudding
Sarah Szynkiewicz
Emily Zane
Abstract
This study investigated current practices of subjective hyolaryngeal excursion (sHLE) assessment during a clinical swallow evaluation (CSE) among speech-language pathologists (SLPs) using a survey-based approach. A sample of 77 SLPs in the United States completed an online survey rating their perceived importance and practice of sHLE assessment during a CSE. Additionally, the survey inquired about inferred interpretations from assessing sHLE. Results indicated a strong positive correlation between the rated importance of sHLE assessment and the reported frequency with which it is completed, rs(46) = .720, p < .001. However, the findings also suggested that some SLPs are not assessing sHLE during a CSE. This offers valuable insight into the prevailing practices of HLE assessment among SLPs, considering the limited evidence for HLE assessment and interpretation. Interpretation and generalizations of the findings is limited due to the small sample size. Findings, however, do support the need for future research investigating the validity of sHLE assessment performed during a CSE, with the aim of providing evidence to guide clinical best practices.
Keywords: hyolaryngeal excursion, speech-language pathologist, clinical swallow evaluation, dysphagia, palpation
Abstract 2
PURPOSE: The purpose of this study is to determine if speech-language pathologists’ (SLP) ratings of subjective hyolaryngeal excursion (sHLE) via palpation during a clinical swallow evaluation (CSE) are predictive of kinematic objective measures of objective hyolaryngeal excursion (oHLE). The findings from this study will provide evidence to support or refute palpation as a diagnostic clinical tool for assessing hyolaryngeal excursion.
PARTICIPANTS: Adults between 18-99 years-of-age were recruited with a physician referral to complete a CSE and videofluoroscopy swallow study at the James Madison University Voice and Swallow Service center or Sentara RMH Medical Center (SRMH).
METHODS: Four SLP investigators completed ratings of sHLE(palpation) during a CSE extent of elevation assessment. The videofluoroscopy images (30 frames per second) were de-identified to complete objective kinematic of hyoid peak measures for elevation. Statistical analyses included multiple linear regression to determine the best-fitting model to predict oHLE from sHLE (palpation).
RESULTS: Data from 77 volunteers (44 female, mean age 71.6) were used for statistical analyses. The linear regression model indicated three significant predictors of objective superior (upward) hyoid peak position, including sHLE(palpation), bolus consistency, and the number of swallows. There were no significant predictors of objective anterior (forward) hyoid peak position.
CONCLUSION: The emergence of these significant predictors suggests that these might provide insight into superior HLE movements during a CSE. This may improve SLPs diagnostic accuracy and clinical decision-making during swallow assessment.
Keywords: hyolaryngeal excursion, clinical swallow evaluation, dysphagia, palpation
Recommended Citation
Murray, Kelsey, "Bridging the gap between clinical practice and evidence for hyolaryngeal excursion assessment during a clinical swallow evaluation" (2024). Dissertations, 2020-current. 159.
https://commons.lib.jmu.edu/diss202029/159
