Skip to main content

Advertisement

SpringerLink
Log in

Establishing Reference Values for Temporal Kinematic Swallow Events Across the Lifespan in Healthy Community Dwelling Adults Using High-Resolution Cervical Auscultation

  • Original Article
  • Published:
Dysphagia Aims and scope Submit manuscript

Abstract

Few research studies have investigated temporal kinematic swallow events in healthy adults to establish normative reference values. Determining cutoffs for normal and disordered swallowing is vital for differentially diagnosing presbyphagia, variants of normal swallowing, and dysphagia; and for ensuring that different swallowing research laboratories produce consistent results in common measurements from different samples within the same population. High-resolution cervical auscultation (HRCA), a sensor-based dysphagia screening method, has accurately annotated temporal kinematic swallow events in patients with dysphagia, but hasn’t been used to annotate temporal kinematic swallow events in healthy adults to establish dysphagia screening cutoffs. This study aimed to determine: (1) Reference values for temporal kinematic swallow events, (2) Whether HRCA can annotate temporal kinematic swallow events in healthy adults. We hypothesized (1) Our reference values would align with a prior study; (2) HRCA would detect temporal kinematic swallow events as accurately as human judges. Trained judges completed temporal kinematic measurements on 659 swallows (N = 70 adults). Swallow reaction time and LVC duration weren’t different (p > 0.05) from a previously published historical cohort (114 swallows, N = 38 adults), while other temporal kinematic measurements were different (p < 0.05), suggesting a need for further standardization to feasibly pool data analyses across laboratories. HRCA signal features were used as input to machine learning algorithms and annotated UES opening (69.96% accuracy), UES closure (64.52% accuracy), LVC (52.56% accuracy), and LV re-opening (69.97% accuracy); providing preliminary evidence that HRCA can noninvasively and accurately annotate temporal kinematic measurements in healthy adults to determine dysphagia screening cutoffs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  1. Humbert IA, Robbins J. Dysphagia in the elderly. Phys Med Rehabil Clin N Am. 2008;19(4):853–66. https://doi.org/10.1016/j.pmr.2008.06.002.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Namasivayam-MacDonald AM, Riquelme LF. Presbyphagia to dysphagia: multiple perspectives and strategies for quality care of older adults. Semin Speech Lang. 2019;40:227–42. https://doi.org/10.1055/s-0039-1688837.

    Article  PubMed  Google Scholar 

  3. Lof GL, Robbins J. Test-retest variability in normal swallowing. Dysphagia. 1990;4:236–42. https://doi.org/10.1007/BF02407271.

    Article  CAS  PubMed  Google Scholar 

  4. Robbins J, Hamilton JW, Lof GL, Kempster GB. Oropharyngeal swallowing in normal adults of different ages. Gastroenterology. 1992;103:823–9.

    Article  CAS  Google Scholar 

  5. Mancopes R, Gandhi P, Smaoui S, Steele CM. Which physiological swallowing parameters change with healthy aging? OBM Geriat. 2021. https://doi.org/10.21926/obm.geriatr.2101153.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Jardine M, Miles A, Allen J. A systematic review of physiological changes in swallowing in the oldest old. Dysphagia. 2020;35:509–32. https://doi.org/10.1007/s00455-019-10056-3.

    Article  PubMed  Google Scholar 

  7. Humbert IA, Sunday KL, Karagiorgos E, Vose AK, Gould F, Greene L, et al. Swallowing kinematic differences across frozen, mixed, and ultrathin liquid boluses in healthy adults: age, sex, and normal variability. J Speech Lang Hear Res. 2018;61:1544–59. https://doi.org/10.1044/2018_JSLHR-S-17-0417.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Martin-Harris B, Brodsky MB, Michel Y, Castell DO, Schleicher M, Sandidge J, et al. MBS measurement tool for swallow impairment–MBSImp: establishing a standard. Dysphagia. 2008;23:392–405. https://doi.org/10.1007/s00455-008-9185-9.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Mulheren RW, Azola AM, Kwiatkowski S, Karagiorgos E, Humbert I, Palmer JB, et al. Swallowing changes in community-dwelling older adults. Dysphagia. 2018;33:848–56. https://doi.org/10.1007/s00455-018-9911-x.

    Article  PubMed  Google Scholar 

  10. Robbins J, Coyle J, Rosenbek J, Roecker E, Wood J. Differentiation of normal and abnormal airway protection during swallowing using the penetration-aspiration scale. Dysphagia. 1999;14:228–32. https://doi.org/10.1007/PL00009610.

    Article  CAS  PubMed  Google Scholar 

  11. Garand KLF, Hill EG, Amella E, Armeson K, Brown A, Martin-Harris B. Bolus airway invasion observed during videofluoroscopy in healthy, non-dysphagic community-dwelling adults. Ann Otol Rhinol Laryngol. 2019;128:426–32. https://doi.org/10.1177/0003489419826141.

    Article  PubMed  Google Scholar 

  12. Steele CM, Peladeau-Pigeon M, Barbon CAE, Guida BT, Namasivayam-MacDonald AM, Nascimento WV, et al. Reference values for healthy swallowing across the range from thin to extremely thick liquids. J Speech Lang Hear Res. 2019;62:1338–63. https://doi.org/10.1044/2019_JSLHR-S-18-0448.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Vose AK, Kesneck S, Sunday K, Plowman EK, Humbert I. A survey of clinician decision making when identifying swallowing impairments and determining treatment. J Speech Lang Hear Res. 2018;61:2735–56. https://doi.org/10.1044/2018_JSLHR-S-17-0212.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Beall J, Hill EG, Armeson K, Garand KLF, Davidson KH, Martin-Harris B. Classification of physiologic swallowing impairment severity: a latent class analysis of modified barium swallow impairment profile scores. Am J Speech Lang Pathol. 2020;29:1001–11. https://doi.org/10.1044/2020_AJSLP-19-00080.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Dudik JM, Coyle JL, Sejdić E. Dysphagia screening: contributions of cervical auscultation signals and modern signal-processing techniques. IEEE Trans Hum Mach Syst. 2015;45:465–77. https://doi.org/10.1109/THMS.2015.2408615.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Sejdić E, Steele CM, Chau T. Classification of penetration–aspiration versus healthy swallows using dual-axis swallowing accelerometry signals in dysphagic subjects. IEEE Trans Biomed Eng. 2013;60:1859–66. https://doi.org/10.1109/TBME.2013.2243730.

    Article  PubMed  Google Scholar 

  17. Dudik JM, Jestrovic I, Luan B, Coyle JL, Sejdic E. A comparative analysis of swallowing accelerometry and sounds during saliva swallows. Biomed Eng Online. 2015;14(1):3.

    Article  Google Scholar 

  18. Dudik JM, Kurosu A, Coyle JL, Sejdić E. A comparative analysis of DBSCAN, K-means, and quadratic variation algorithms for automatic identification of swallows from swallowing accelerometry signals. Comput Biol Med. 2015;59:10–8. https://doi.org/10.1016/j.compbiomed.2015.01.007.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Jestrović I, Dudik JM, Luan B, Coyle JL, Sejdić E. Baseline characteristics of cervical auscultation signals during various head maneuvers. Comput Biol Med. 2013;43:2014–20. https://doi.org/10.1016/j.compbiomed.2013.10.005.

    Article  PubMed  Google Scholar 

  20. Dudik JM, Coyle JL, El-Jaroudi A, Mao Z-H, Sun M, Sejdić E. Deep learning for classification of normal swallows in adults. Neurocomputing. 2018;285:1–9. https://doi.org/10.1016/j.neucom.2017.12.059.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Yu C, Khalifa Y, Sejdic E. Silent aspiration detection in high resolution cervical auscultations. IEEE EMBS Int Conf Biomed Health Inform (BHI). 2019;1–4.

  22. Mao S, Zhang Z, Khalifa Y, Donohue C, Coyle JL, Sejdic E. Neck sensor-supported hyoid bone movement tracking during swallowing. R Soc Open Sci. 2019;6:181982. https://doi.org/10.1098/rsos.181982.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Donohue C, Mao S, Sejdić E, Coyle JL. Tracking hyoid bone displacement during swallowing without videofluoroscopy using machine learning of vibratory signals. Dysphagia. 2020. https://doi.org/10.1007/s00455-020-10124-z.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Mao S, Sabry A, Khalifa Y, Coyle JL, Sejdic E. Estimation of laryngeal closure duration during swallowing without invasive X-rays. Future Gener Comput Syst. 2021;115:610–8. https://doi.org/10.1016/j.future.2020.09.040.

    Article  PubMed  Google Scholar 

  25. Khalifa Y, Donohue C, Coyle JL, Sejdic E. Upper esophageal sphincter opening segmentation with convolutional recurrent neural networks in high resolution cervical auscultation. IEEE J Biomed Health Inform. 2020. https://doi.org/10.1109/JBHI.2020.3000057.

    Article  PubMed  Google Scholar 

  26. Donohue C, Khalifa Y, Perera S, Sejdić E, Coyle JL. How closely do machine ratings of duration of UES opening during videofluoroscopy approximate clinician ratings using temporal kinematic analyses and the mbsimp? Dysphagia. 2020. https://doi.org/10.1007/s00455-020-10191-2.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Khalifa Y, Donohue C, Coyle J, Sejdic E. On the robustness of high-resolution cervical auscultation-based detection of upper esophageal sphincter opening duration in diverse populations. Proc. SPIE 11730, Big Data III: Learning, Analytics, and Applications. 2021;117300M.

  28. Kurosu A, Coyle JL, Dudik JM, Sejdic E. Detection of swallow kinematic events from acoustic high-resolution cervical auscultation signals in patients with stroke. Arch Phys Med Rehabil. 2019;100:501–8. https://doi.org/10.1016/j.apmr.2018.05.038.

    Article  PubMed  Google Scholar 

  29. Donohue C, Khalifa Y, Perera S, Sejdić E, Coyle JL. A preliminary investigation of whether HRCA signals can differentiate between swallows from healthy people and swallows from people with neurodegenerative diseases. Dysphagia. 2020. https://doi.org/10.1007/s00455-020-10177-0.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Oppenheim AV, Schafer RW, Buck JR. Discrete-Time Signal Processing. 2nd ed. Upper Saddle River, New Jersey: Prentice Hall Inc; 1999.

    Google Scholar 

  31. Takahashi K, Groher ME, Michi K. Methodology for detecting swallowing sounds. Dysphagia. 1994;9:54–62. https://doi.org/10.1007/BF00262760.

    Article  CAS  PubMed  Google Scholar 

  32. Shrout PE, Fleiss JL. Intraclass correlations: Uses in assessing rater reliability. Psychol Bull. 2005;86(2):420–28.

    Google Scholar 

  33. Dudik JM, Jestrović I, Luan B, Coyle JL, Sejdić E. A comparative analysis of swallowing accelerometry and sounds during saliva swallows. Biomed Eng Online. 2015;14:3. https://doi.org/10.1186/1475-925X-14-3.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Sabry A, Mahoney AS, Mao S, Khalifa Y, Sejdić E, Coyle JL. Automatic estimation of laryngeal vestibule closure duration using high-resolution cervical auscultation signals. Perspect ASHA Spec. 2020;5:1647–56. https://doi.org/10.1044/2020_PERSP-20-00073 (Interest Groups).

    Article  Google Scholar 

Download references

Acknowledgements

People: Thanks are due to Tara Smyth, M.A., Dan Kachnycz, B.A., and Erin Lucatorto, M.A. for assistance with data collection and coding.

Funding

Research reported in this publication was supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health under Award Number R01HD092239, while the data was collected under Award Number R01HD074819. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Author information

Authors and Affiliations

  1. Department of Communication Science and Disorders, School of Health and Rehabilitation Sciences, University of Pittsburgh, 6035 Forbes Tower, Pittsburgh, PA, 15260, USA

    Cara Donohue & James L. Coyle

  2. Department of Electrical and Computer Engineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, 15260, USA

    Yassin Khalifa, Shitong Mao & Ervin Sejdić

  3. Division of Geriatrics, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, 15261, USA

    Subashan Perera

  4. Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, 15260, USA

    Ervin Sejdić

  5. Department of Otolaryngology, School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, 15260, USA

    James L. Coyle

  6. Department of Biomedical Informatics, School of Medicine Intelligent Systems Program, School of Computing and Information, University of Pittsburgh, Pittsburgh, PA, 15260, USA

    Ervin Sejdić

Authors
  1. Cara Donohue
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yassin Khalifa
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Shitong Mao
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Subashan Perera
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ervin Sejdić
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. James L. Coyle
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to James L. Coyle.

Ethics declarations

Conflict of interest

We have no conflicts of interest to declare.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Donohue, C., Khalifa, Y., Mao, S. et al. Establishing Reference Values for Temporal Kinematic Swallow Events Across the Lifespan in Healthy Community Dwelling Adults Using High-Resolution Cervical Auscultation. Dysphagia 37, 664–675 (2022). https://doi.org/10.1007/s00455-021-10317-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00455-021-10317-0

Keywords

Search

Navigation