Lof and Robbins(3636 Lof GL, Robbins J. Test-retest variability in normal swallowing. Dysphagia. 1990;4(4):236-42. http://doi.org/10.1007/BF02407271. PMid:2209099. http://doi.org/10.1007/BF02407271...
), 1990, USA |
To determine whether temporal swallowing parameters in healthy subjects remain stable in test-retest. |
Sample size: |
Videofluoroscopy |
Oral transit duration (OTD); |
Utensil: spoon |
OTD = 50% (Lq), 43% (Ss); |
8 women and 8 men |
Transition stage duration (TSD); |
Consistency: liquid (Lq) and semi-solid (Ss) barium |
TSD = 1.14% (Lq), 17.67% (Ss); |
Age range: |
Pharyngeal transit duration (PTD); |
Volume: 3x 2 ml of each consistency |
PRD = 21% (Lq), 36% (Ss); |
group 1: 43-45 years |
Pharyngeal response duration (PRD); |
|
PTD = 18% (Lq), 59% (Ss); |
group 2: 63-67 years |
Palate velum excursion duration (DOVE); |
|
DOVE =28% (Lq), 41% (Ss); |
Diagnosis: healthy |
Duration of maximum hyoid elevation (DOHME); |
|
DOHME = 48% (Lq), 63% (Ss); |
|
Duration of maximum hyoid anteriorization (DOHMA); |
|
DOHMA = 45 (Lq), 38% (Ss); |
|
Duration of upper esophageal sphincter opening (DOOUES); |
|
DTOUES = 38% (Lq), 38% (Ss); |
|
Duration to upper esophageal sphincter opening (DTOUES). |
|
DOOUES = 50% (Lq), 43% (Ss). |
Takahashi et al.(3737 Takahashi K, Groher ME, Michi K. Symmetry and reproducibility of swallowing sounds. Dysphagia. 1994;9(3):168-73. http://doi.org/10.1007/BF00341261. PMid:8082325. http://doi.org/10.1007/BF00341261...
), 1994, USA |
To investigate the symmetry and reproducibility of swallowing sounds detected bilaterally in healthy individuals. |
Sample size: 5 women and 5 men |
Sonography and accelerometers |
Duration of sounds (in seconds); |
Utensil: NR |
Sound duration: |
Age range: |
Signal-to-noise ratio (in decibels); |
Consistency: liquid (water) |
Left: 18.7%-61.4% (mean: 34.0%); |
men - 35.4 years (mean) |
Peak 1 of the acoustic signal (< 110 hertz); |
Volume: 30x 5 ml |
Right: 17.9%-66.3% (mean: 35.3%); |
women - 29.4 years (mean) |
Peak 2 of the acoustic signal (110-2000 hertz). |
|
Signal-to-noise ratio: |
Diagnosis: |
|
|
Left: 5.7%-11.6% (mean: 16%); |
healthy |
|
|
Right: 6.1%-13.0% (mean: 16%); |
|
|
|
Acoustic signal peak 1: |
|
|
|
Left: 19.9%-46.6% (mean: 37.3%); |
|
|
|
Right: 22.9%-44.4% (mean: 38.7%); |
|
|
|
Acoustic signal peak 2: |
|
|
|
Left: 26.6%-81.7% (mean: 54.6%); |
|
|
|
Right: 25.1%-81.8% (mean: 54.6%) |
Kjellin et al.(3838 Kjellin O, Ekberg O, Olsson R, Nilsson H. Quantitative assessment of swallowing in dysphagic patients: a pilot study. Scand J Logop Phoniatr. 1994;19(3):113-6. http://doi.org/10.3109/14015439409102355. http://doi.org/10.3109/14015439409102355...
), 1994, Sweden |
To elucidate whether the Rapid Oral Suction Swallow (ROSS) test can differentiate between normal and altered swallowing and whether it can strengthen the hypothesis that sequential swallowing (ROSS) is more automatic than single bolus swallowing. |
Sample size: 35 people in three groups: |
Pressure sensor in the straw and microphone to capture swallowing sounds |
Suction duration; |
Utensil: straw attached to a cup. |
Results presented in graphs without mentioning the exact CV values for each measurement investigated; |
G1 - healthy (9 men and 3 women); |
Sub-atmospheric peak suction pressure; |
Consistency: liquid (water). |
Food bolus transit time: in the ROSS test, the CV of G1 (CV<20%) was significantly lower than that of G2 and G3 (both CV>20%). |
G2 - with complaints of swallowing disorders and normal VFD (10 men and 5 women); |
Suction speed; |
Volume: |
Overall average of the CVs of all measures investigated with the 1st and 2nd tests together: the CV of G1 (CV<20%) was significantly lower than that of G2 and G3 (both CV>20%). |
G3 - with complaints of swallowing disorders and altered VFD (6 men and 2 women). |
Food bolus volume; |
1st test (single bolus): suck 2x through the straw and swallow the volume calmly; |
In general, the CVs followed a pattern: higher for G3, lower for G1, and intermediate for G2. |
Age range: |
Food bolus transit time; |
2nd test (ROSS): empty the cup as quickly as possible |
|
G1: 45 (median); 27-66 (min-max); |
Interval time between sucking-swallowing cycles. |
Total volume of liquid in the cup: NR. |
|
G2: 48 years (median); 37-79 (min-max); |
|
|
|
G3: 63 years (median); 20-83 (min-max); |
|
|
|
Diagnosis: |
|
|
|
Healthy people, gastroesophageal reflux, stroke, CNS tumor, multiple sclerosis, frontal lobe lesion. |
|
|
|
Hughes et al.(3939 Hughes TAT, Liu P, Griffiths H, Wiles CM. The repeatability and variability of electrical impedance tomography indices of pharyngeal transit time in normal adults. Physiol Meas. 1995;16(3, Suppl A):A79-86. http://doi.org/10.1088/0967-3334/16/3A/008. PMid:8528129. http://doi.org/10.1088/0967-3334/16/3A/0...
), 1995, United Kingdom |
To measure two pharyngeal transit time indices (FW20 and FW50) by electrical impedance tomography. |
Sample size: 20 people in 3 groups divided by age. |
Electrical impedance tomography |
Pharyngeal transit time (FW20, FW50 and mean maximum amplitude) |
Utensil: NR |
FW20: |
G1: 3 men and 4 women |
Consistency: liquid (water) and Dioralyte (liquid drug to measure conductivity); |
5ml: male (22.2%); female (25.8%) |
G2: 3 men and 3 women |
Volume: 5x each volume for each type of liquid: 5ml, 10ml, and |
10ml: male (25.9%); female (34.1%) |
G3: 4 men and 3 women |
20 ml (total: 30 swallows per participant) |
20ml: male (22.5%); female (28.2%) |
|
|
FW50: |
Age range: |
|
5ml: male (32.4%); female (19.9%) |
G1: mean of 29.6 years |
|
10ml: male (18.3%); female (25.8%) |
G2: mean of 49.0 years |
|
20ml: male (17.6%); female (14.5%) |
G3: mean of 59.9 years |
|
Maximum average amplitude: |
|
|
5ml: male (25.7%); female (22.4%) |
Diagnosis: |
|
10ml: male (21.5%); female (16.8%) |
healthy |
|
20ml: male (15.9%); female (23.1%) |
Hughes et al.(4040 Hughes TAT, Liuf P, Griffithst H, Wilest CM. Repeatability of indices of swallowing in healthy adults: electrical impedance tomography compared with a simple timed test of swallowing. Med Biol Eng Comput. 1996;34(5):366-8. http://doi.org/10.1007/BF02520007. PMid:8945862. http://doi.org/10.1007/BF02520007...
), 1996, Wales |
To compare the repeatability of pharyngeal transit time indices (FW20 and FW50) using electrical impedance tomography with the clinical swallowing capacity test |
Sample size: 8 people (6 men and 2 women) |
Electrical impedance tomography |
Pharyngeal transit time (FW20 and FW50) |
Utensil: NR |
FW20: 19.0% (9.4%-54.2%); |
Age range: 25 to 61 years |
Consistency: liquid (water) and Dioralyte (liquid drug to measure conductivity); |
FW50: 15.1% (7.2%-26.8%) |
Diagnosis: |
Volume: 10x 20ml of each type of liquid (total: 20 swallows per participant) |
|
healthy |
|
|
Nilsson et al.(4141 Nilsson H, Ekberg O, Olsson R, Kjellin O, Hindfelt B. Quantitative assessment of swallowing in healthy adults. Dysphagia. 1996;11(2):110-6. http://doi.org/10.1007/BF00417900. PMid:8721069. http://doi.org/10.1007/BF00417900...
), 1996, Sweden |
To establish normative values and variations in swallowing assessed by the Rapid Oral Suction Swallow (ROSS) test |
Sample size: 292 people (177 men and 115 women) |
Pressure sensor in the straw; piezoelectric sensor; Doppler probe; thermodetector. |
Peak suction pressure; |
Utensil: straw attached to a cup. |
1st test (single bolus): |
Age range: 18 to 64 years (mean: 38±10 years) |
Suction time; |
Consistency: liquid (water). |
Peak suction pressure: 37% |
Diagnosis: |
Bolus volume; |
Volume: |
Suction time: 52% |
healthy |
Oropharyngeal transit time; |
1st test (single bolus): suck through the straw and swallow once at the participant's usual volume and speed (2x); |
Bolus volume: 33% |
|
Breathing time; |
2nd test (ROSS): swallow the rest of the volume as quickly as possible in repeated ingestion cycles. |
Oropharyngeal transit time: 64% |
|
Feeding interval; |
Total volume of liquid in the cup: 200ml. |
Time for breathing: 42% |
|
Ingestion cycle time; |
|
2nd test (ROSS): |
|
Swallowing capacity. |
|
Suction time: 60 |
|
|
|
Bolus volume: 39% |
|
|
|
Oropharyngeal transit time: 48% |
|
|
|
Feeding interval: 95% |
|
|
|
Swallowing cycle time: 51% |
|
|
|
Swallowing capacity: 29% |
Jones and Ciucci(66 Jones CA, Ciucci MR. Multimodal swallowing evaluation with high-resolution manometry reveals subtle swallowing changes in early and mid-stage Parkinson disease. J Parkinsons Dis. 2016;6(1):197-208. http://doi.org/10.3233/JPD-150687. PMid:26891176. http://doi.org/10.3233/JPD-150687...
), 2016, USA |
Using predictive modeling to determine which quantitative swallowing variables best differentiate individuals with early to mid-stage Parkinson's disease from healthy controls. |
Sample size: SG: 26 individuals with Parkinson's disease (13 men and 13 women); |
High-resolution manometry |
Pressure during swallowing in the velopharynx, mesopharynx, and upper esophageal sphincter regions (CV was calculated in each region considering each sensor from the beginning to the end of swallowing) |
Utensil: syringe |
Velopharyngeal pressure: |
CG: 26 healthy individuals (13 men and 13 women). |
Consistency: diluted liquid barium; |
SG: 64% |
Age range: |
Volume: 10x of 10 ml |
CG: 102% |
SG: 50–88 years (69±16 years) |
|
Mesopharyngeal pressure: |
CG: 49–86 years (mean: 69.8±17 years) |
|
SG: 97% |
Diagnosis: |
|
CG: 160% |
SG: early to mid-stage Parkinson's disease |
|
Upper esophageal sphincter pressure: |
CG: healthy individuals |
|
SG: 63% |
|
|
CG: 106% |
|
|
Total CV (sum of all regions): |
|
|
SG: 466% |
|
|
CG: 762% |
|
|
The original article presented the CV as the result of the ratio between mean and standard deviation. The % was calculated by the authors of this review. |
Balasubramanian et al.(2626 Balasubramanian G, Sharma T, Kern M, Mei L, Sanvanson P, Shaker R. Characterization of pharyngeal peristaltic pressure variability during volitional swallowing in healthy individuals. Neurogastroenterol Motil. 2017;29(11):1-19. http://doi.org/10.1111/nmo.13119. PMid:28635131. http://doi.org/10.1111/nmo.13119...
), 2017, USA |
To characterize the intraindividual and interindividual variability and the recording site of pharyngeal peristaltic pressure in healthy individuals. |
Sample size: |
High-resolution manometry |
Peak peristaltic pressure during swallowing at positions 2, 3, 4, 5, 6, 7, and 8 cm above the upper margin of the upper esophageal sphincter identified manometrically. |
Utensil: syringe |
P2: 12% (dry); 14% (5ml); 12% (10ml); |
32 individuals (20 men and 12 women); |
“Pharyngeal integral contractility” (PhCI): mean pressure amplitude x duration of contractions x length of the region of interest |
Consistency: dry swallow and water; |
P3: 12% (dry); 10% (5ml); 13% (10ml); |
Age range: 21-83 years (mean: 34±16 years) |
|
Volume: 3x dry swallow, 5 ml and 10 ml |
P4: 8% (dry); 9% (5ml); 9 (5ml); |
Diagnosis: |
|
|
P5: 7% (dry); 9% (5ml); 7% (10ml) |
healthy |
|
|
P6: 6% (dry); 6% (5ml); 7% (10ml) |
|
|
|
P7: 7% (dry); 9% (5ml); 5% (10ml) |
|
|
|
P8: 11% (dry); 11% (5ml); 11% (10ml); |
|
|
|
PhCI: 11% (dry); 17% (5ml); 12% (10ml) |
|
|
|
CV ranged from 1% to 40% among the different anatomical regions evaluated, considering the three tasks tested; |
|
|
|
The CV means were <15% in all anatomical regions evaluated in the three tasks; |
|
|
|
In general, there was more variability in the proximal and distal regions of the UES and less variability in the intermediate regions; |
|
|
|
The CV means of the PhCI were not different between the evaluations in the supine and sitting positions; |
|
|
|
In none of the measures were the CV means different when comparing the group of younger individuals (20 to 35 years; n=20) with the total group (n=32) |
Hedström et al.(4242 Hedström J, Tuomi L, Andersson M, Dotevall H, Osbeck H, Finizia C. Within-Bolus variability of the penetration-aspiration scale across two subsequent swallows in patients with head and neck cancer. Dysphagia. 2017;32(5):683-90. http://doi.org/10.1007/s00455-017-9814-2. PMid:28593510. http://doi.org/10.1007/s00455-017-9814-2...
), 2017, Sweden |
To investigate the variability in the penetration and aspiration scale (PAS) score between two consecutive offers of the same volume and consistency in people with head and neck cancer and dysphagia |
Sample size: |
Videofluoroscopy |
PAS score |
Utensil: |
Thin liquid: |
38 individuals (26 men and 12 women). |
syringe or spoon; cup for 20 ml of thin liquid only. |
3ml: 29.2% |
Age range: 44-80 years (mean: 63.7±8.0 years). |
|
5ml: 25.4% |
Diagnosis: |
Consistency: |
10ml: 16.8% |
head and neck cancer and dysphagia |
Thin liquid, mildly thick liquid, and extremely thick liquid. |
20ml: 45.8% |
|
Volume: |
Mildly thick liquid: |
|
2x each supply of: |
5ml: 45.8% |
|
Thin liquid (IDDSI level 0): 3, 5, 10 and 20 ml; |
Extremely thick liquid: |
|
Mildly thick liquid (IDDSI level 2): 5 ml |
3ml: 75.9% |
|
Extremely thick liquid (IDDSI level 4): 3 ml |
|
Jones et al.(4343 Jones CA, Hoffman MR, Lin L, Abdelhalim S, Jiang JJ, McCulloch TM. Identification of swallowing disorders in early and mid-stage Parkinson’s disease using pattern recognition of pharyngeal high-resolution manometry data. Neurogastroenterol Motil. 208;30(4):e13236. http://doi.org/10.1111/nmo.13236. PMid:29143418. http://doi.org/10.1111/nmo.13236...
), 2017, USA |
To determine whether an artificial neural network classification technique could differentiate patients with early to intermediate stage Parkinson's disease (PD) from healthy controls taking into account videofluoroscopy data combined with manometry. |
Sample size: SG: 31 individuals with Parkinson's disease (17 men and 14 women); |
High-resolution pharyngeal manometry and simultaneous videofluoroscopy. |
Pressure during swallowing in the velopharynx, tongue base, hypopharynx, tongue base with hypopharynx, and upper esophageal sphincter regions (CV was calculated for each sensor in the region of interest. The mean CV was calculated based on all CVs in the region of interest. The total CV was calculated by summing the mean CVs of all regions of interest) |
Utensil: |
Velopharyngeal pressure: |
CG: 31 healthy individuals (17 men and 14 women). |
syringe; straw only for swallowing liquid in a comfortable volume. |
SG: 78% (2ml); 101% (10ml); 110% (free sips) |
Age range: |
Consistency: |
GC: 53% (2ml); 62% (10ml); 57% (free sips) |
SG: 68.7 ± 9.9 years (mean) |
diluted liquid barium. |
Tongue base pressure: |
CG: 69.6 ± 10.1 (mean) |
Volume: |
SG: 87% (2ml); 155 (10ml); 97% (free sips) |
Diagnosis: |
10x each supply of: |
GC: 79% (2ml); 91% (10ml); 86% (free sips) |
SG: early to intermediate stage Parkinson's disease |
2 ml, 10 ml, and free sips |
Hypopharyngeal pressure: |
CG: healthy |
|
SG: 108% (2ml); 88% (10ml); 128% (free sips) |
|
|
GC: 88% (2ml); 190% (10ml); 83% (free sips) |
|
|
|
|
|
Mesopharyngeal pressure: |
|
|
SG: 403% (2ml); 617% (10ml); 111% (free sips) |
|
|
GC: 617% (2ml); 173% (10ml); 86% (free sips) |
|
|
Upper esophageal sphincter pressure: |
|
|
SG: 82% (2ml); 98% (10ml); 215% (free sips) |
|
|
GC: 80% (2ml); 95% (10ml); 106% (free sips) |
|
|
Total CV (sum of all regions): |
|
|
SG: 355% (2ml); 543% (10ml); 550% (free sips) |
|
|
GC: 300% (2ml); 366% (10ml); 331% (free sips) |
|
|
In all volumes, for all regions, the CV was higher for patients with PD except for the mesopharynx in the 2ml swallow. |
|
|
The original article presented the CV as the result of the ratio between mean and standard deviation. The calculation in % was performed by the authors of this review |
Park et al.(3131 Park MW, Lee D, Seo HG, Han TR, Lee JC, Kim HC, et al. Reliability of suprahyoid and infrahyoid electromyographic measurements during swallowing in healthy subjects. J Korean Dysphagia Soc. 2021;11(2):128-36. http://doi.org/10.34160/jkds.2021.11.2.007. http://doi.org/10.34160/jkds.2021.11.2.0...
), 2021, South Korea |
To evaluate the reliability of surface electromyography (SEMG) of the suprahyoid and infrahyoid regions during swallowing |
Sample size: 10 healthy individuals (9 men and 1 woman). |
Surface electromyography (SEMG) |
Onset latency, offset latency, duration, peak amplitude latency, maximum amplitude during swallowing and area under the curve of the rectified electromyographic signal |
Utensil: |
Suprahyoid region: |
Age range: |
NR |
Onset latency: 38.0% (dry); 37.4% (2ml); 34.0% (5ml); 35.5% (20ml); 45.7% (total) |
29.50±1.18 years (mean) |
Consistency: |
Offset latency: 14.7% (dry); 12.9% (2ml); 14.3% (5ml); 12.8% (20ml); 17.5% (total) |
Diagnosis: |
dry swallow and water. |
Duration: 12.9% (dry); 12.0% (2ml); 12.5% (5ml); 13.7% (20ml); 15.8% (total) |
healthy |
Volume: |
Peak amplitude latency: 30.1% (dry); 25.1% (2ml); 56.5% (5ml); 36.7% (20ml); 57.6% (total) |
|
5x each of: |
Maximum amplitude during swallowing: 17.5% (dry); 19.0% (2ml); 19.0% (5ml); 17.7% (20ml); 24.9% (total) |
|
dry swallow, 2 ml, saliva, 2 ml, 5 ml and 20 ml of water. |
Area under the curve of the rectified electromyographic signal: 30.3% (dry); 25.9% (2ml); 26.1% (5ml); 26.7% (20ml); 36.9% (total) |
|
Total: 20 swallows |
Infrahyoid region: |
|
|
Onset latency: 33.6% (dry); 30.7% (2ml); 25.4% (5ml); 25.7% (20ml); 33.2% (total) |
|
|
Offset latency: 15.2% (dry); 13.5% (2ml); 12.5% (5ml); 12.3% (20ml); 16.5% (total) |
|
|
Duration: 14.7% (dry); 14.6% (2ml); 14.0% (5ml); 12.5% (20ml); 17.2% (total) |
|
|
Peak amplitude latency: 33.2% (dry); 24.2% (2ml); 36.0% (5ml); 34.1% (20ml); 44.0% (total) |
|
|
Maximum amplitude during swallowing: 19.4% (dry); 15.2% (2ml); 18.4% (5ml); 14.2% (20ml); 20.9% (total) |
|
|
Area under the curve of the rectified electromyographic signal: 27.5% (dry); 25.2% (2ml); 25.3% (5ml); 20.6% (20ml); 30.9% (total) |
|
|
CV < 30% in both regions: offset latency, duration and maximum amplitude. |
Diaz and Stegemöller(2424 Diaz K, Stegemöller EEL. Electromyographic measures of asymmetric muscle control of swallowing in Parkinson’s disease. PLoS One. 2022;17(2):e0262424. http://doi.org/10.1371/journal.pone.0262424. PMid:35180221. http://doi.org/10.1371/journal.pone.0262...
), 2022, USA |
To examine the electromyographic activity of the submental and laryngeal regions during swallowing in people with Parkinson's disease, considering the most affected (MAS) and least affected side (LAS) by the disease |
Sample size: 35 individuals (15 men and 20 women). |
Surface electromyography (SEMG) |
Area under the curve and electromyographic peak. |
Utensil: |
Submental region: |
Age range: |
NR |
Area under the curve: |
67.7 ± 7.9 (mean) |
Consistency: |
Thin fluid: 42% (MAS); 47% (LAS) |
Diagnosis: |
Thin liquid (water) and thick liquid (pudding). |
Thickened fluid: 54% (MAS); 48% (LAS) |
Parkinson's disease |
Volume: |
Electromyographic peak: |
|
3x of: |
Thin fluid: 36% (MAS); 39% (LAS) |
|
10 ml thin liquid |
Thickened fluid: 39% (MAS); 45% (LAS) |
|
10 ml thick liquid |
Laryngeal region: |
|
|
Area under the curve: |
|
|
Thin fluid: 32% (MAS); 44% (LAS) |
|
|
Thickened fluid: 39% (MAS); 50% (LAS) |
|
|
Electromyographic peak: |
|
|
Thin fluid: 21% (MAS); 36% (LAS) |
|
|
Thickened fluid: 29% (MAS); 41% (LAS) |
|
|
The only significant difference in CV between MAS and LAS was in the electromyographic peak measurement, in the laryngeal region, during the swallowing of thin liquid |
Ohmori et al.(3030 Ohmori N, Watanabe S, Momose H, Endo H, Chikai M, Ino S. Investigation of variation factors in EMG measurement of swallowing: instruction can improve EMG reproducibility. Med Biol Eng Comput. 2022;60(10):2825-40. http://doi.org/10.1007/s11517-022-02590-4. PMid:35879527. http://doi.org/10.1007/s11517-022-02590-...
), 2022, Japan |
To analyze the difference between the SEMG obtained when instructing participants on the tipper (fast) and dipper (slow) swallowing methods and to investigate the effect of the distinction on the reproducibility of the SEMG |
Sample size: 9 |
Surface electromyography (SEMG) |
SEMG duration and waveform amplitude between start and end |
Utensil: Syringe |
CV in duration with distinction of method |
Participants (8 men and 1 woman) |
Consistency: Liquid (water) |
In tipper: |
Age range: 45±10 years |
Volume: |
17.8% to 19.7% |
Diagnosis: healthy |
4 x 10 |
In dipper: |
|
swallows (4 ml of water) with 5 fast swallows (tipper) and 5 slow (dipper). |
20.1% to 22.1% |
|
Total: 40 swallows |
CV in duration without distinction of method |
|
|
25.6% to 26% |
|
|
CV in amplitude with distinction of method |
|
|
In tipper: |
|
|
15.7% to 26.2% |
|
|
In dipper: |
|
|
20.6% to 38.6% |
|
|
CV in amplitude without distinction of method |
|
|
21.2% to 38.7% |
|
|
Lower variability with distinction of swallowing method (tipper and dipper) than without distinction. |
|
|
The original article presented the CV as a result of the ratio between mean and standard deviation. The % was calculated by the authors of this review. |