Food for Thought: Physiological Implications for the Design of Videofluoroscopic Swallowing Studies Videofluoroscopy (VFSS) has been called our gold standard instrumental procedure for evaluating oropharyngeal swallowing function; yet, variations across clinicians both in the conduct and interpretation of VFSS call into question the standardized nature of the procedure. Two recent studies of clinician practices in swallowing assessment illustrate these discrepancies (Martino, ... Viewpoint
Viewpoint  |   March 01, 2006
Food for Thought: Physiological Implications for the Design of Videofluoroscopic Swallowing Studies
Author Affiliations & Notes
  • Catriona M. Steele
    Toronto Rehabilitation Institute Graduate Department of Speech-Language Pathology, University of Toronto, Toronto, Ontario
Article Information
Swallowing, Dysphagia & Feeding Disorders / Food for Thought
Viewpoint   |   March 01, 2006
Food for Thought: Physiological Implications for the Design of Videofluoroscopic Swallowing Studies
SIG 13 Perspectives on Swallowing and Swallowing Disorders (Dysphagia), March 2006, Vol. 15, 24-28. doi:10.1044/sasd15.1.24
SIG 13 Perspectives on Swallowing and Swallowing Disorders (Dysphagia), March 2006, Vol. 15, 24-28. doi:10.1044/sasd15.1.24
Videofluoroscopy (VFSS) has been called our gold standard instrumental procedure for evaluating oropharyngeal swallowing function; yet, variations across clinicians both in the conduct and interpretation of VFSS call into question the standardized nature of the procedure. Two recent studies of clinician practices in swallowing assessment illustrate these discrepancies (Martino, Pron, & Diamant, 2004; McCullough, Wertz, Rosenbek, & Dineen, 1999).
One of the ways in which VFSS protocols differ across clinicians and facilities is in the number, variety, and sequence of different stimuli that are included in the procedure. This is reflected in recent e-mails to dysphagia e-mail lists in which clinicians have requested input and advice regarding the composition of swallowingstudy trays or the amount of barium to be used in preparing test stimuli. In pondering this issue, I recently reviewed a selection of 12 peer-reviewed articles in the dysphagia literature that described protocols used for VFSS. The majority of these articles claimed to use a protocol adapted from that of Logemann (1993) . With specific reference to the kinds of stimuli included in VFSS, all 12 of the articles reviewed described a variety of at least two different stimulus consistencies (Barbosa Furia et al., 2000; Han, Paik, & Park, 2001; Kendall, Leonard, & McKenzie, 2001; Kuhlemeier, Yates, & Palmer, 1998; Logemann, Rademaker, Pauloski, Ohmae, & Kahrilas, 1998; Morgan, Ward, Murdoch, & Bilbie, 2002; Ohmae, Ogura, Kitahara, Karaho, & Inouye, 1998; Ott, Hodge, Pikna, Chen, & Gelfand, 1996; Palmer, Kuhlemeier, Tippett, & Lynch, 1993; Perie et al., 1998; Pikus et al., 2003; Robbins, Sufit, Rosenbek, Levine, & Hyland, 1987).
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