Kinematic Visual Biofeedback Improves Accuracy of Learning a Swallowing Maneuver and Accuracy of Clinician Cues During Training.
Alba M Azola, Kirstyn L Sunday, Ianessa A Humbert
PMID 27677733WHAT IT FOUND
Healthy adults learning a swallowing hold were more accurate with x-ray video feedback and x-ray-based cues than with muscle-signal feedback and cues based on it.
X-ray first then muscle-signal training did not maintain accuracy.
Key findings
01When training paired videofluoroscopy feedback with videofluoroscopy-based clinician cues, the laryngeal vestibule closure hold lasted 3.162 seconds; with paired submental EMG feedback and EMG-based cues it lasted 2.41 seconds, and with paired mixed feedback and cues based on it it lasted 2.35 seconds.
02The 2-second vLVC hold was accurate 92% of the time with paired videofluoroscopy feedback and videofluoroscopy-based cues, 67% with paired submental EMG feedback and EMG-based cues, and 57% with paired mixed feedback and cues based on it.
03Clinician cues about correct vLVC performance were accurate 83% of the time with videofluoroscopy feedback and 61% of the time with submental EMG or mixed feedback.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study was done in healthy adults, not patients with dysphagia, so it does not show what happens in the people who need swallowing therapy. It tested one training session of 20 saliva trials, so it does not show whether accuracy is learned or retained over repeated clinical sessions. One clinician with 2 years of experience provided the verbal cues, so cue accuracy may differ with other clinicians. Participants who could not first demonstrate the vLVC maneuver within five attempts were excluded, so the findings apply only to people able to perform it initially. Videofluoroscopy was used as feedback, not as therapy, and the paper notes radiation exposure, limited availability and cost. Verbal cues and visual feedback were always paired, so the study does not separate the effect of the display from the effect of the clinician's cues.
Declared interests
No author conflicts of interest are reported. The article is classified as supported by NIH extramural research.
The easy way to misread this
Do not read this as a recommendation to use videofluoroscopy routinely in swallowing therapy. It tested feedback during a single training session in healthy adults, and the paper states that videofluoroscopy is not used as a therapeutic technique because of radiation exposure, limited availability and greater cost.