Ann Rehabil Med.  2013 Jun;37(3):320-327. 10.5535/arm.2013.37.3.320.

The Accuracy of the Swallowing Kinematic Analysis at Various Movement Velocities of the Hyoid and Epiglottis

• Lee SH
• Oh BM
• Chun SM
• Lee JC
• Min Y
• Bang SH
• Kim HC
• Han TR

• KMID: 2219528
• DOI: http://doi.org/10.5535/arm.2013.37.3.320

Abstract

OBJECTIVE
To evaluate the accuracy of the swallowing kinematic analysis.
METHODS
To evaluate the accuracy at various velocities of movement, we developed an instrumental model of linear and rotational movement, representing the physiologic movement of the hyoid and epiglottis, respectively. A still image of 8 objects was also used for measuring the length of the objects as a basic screening, and 18 movie files of the instrumental model, taken from videofluoroscopy with different velocities. The images and movie files were digitized and analyzed by an experienced examiner, who was blinded to the study.
RESULTS
The Pearson correlation coefficients between the measured and instrumental reference values were over 0.99 (p<0.001) for all of the analyses. Bland-Altman plots showed narrow ranges of the 95% confidence interval of agreement between the measured and reference values as follows: 0.14 to 0.94 mm for distances in a still image, -0.14 to 1.09 mm/s for linear velocities, and -1.02 to 3.81 degree/s for angular velocities.
CONCLUSION
Our findings demonstrate that the distance and velocity measurements obtained by swallowing kinematic analysis are highly valid in a wide range of movement velocity.

Keyword

Reproducibility of results; Biomechanics; Deglutition

MeSH Terms

Biomechanics
Deglutition
Epiglottis
Mass Screening
Reference Values
Reproducibility of Results

Figure

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  Fig. 1 The whole process of the swallowing kinematic analysis.

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  Fig. 2 (A) The slider-crank and belt-pulley mechanisms. The model of swallowing, representing movement of the epiglottis and the hyoid bone in swallowing (left) and fluoroscopic image of the model of swallowing (right). (B) The circular movement (dashed circle) and linear movement (square) of the model represent the rotational movement of the epiglottis, and the back-and-forth movement of the hyoid bone, respectively. (C) Calculation of the velocity of the end-tip of slider-crank mechanism.

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  Fig. 3 Fluoroscopic images of different kinds of objects. The length of different types of object was measured by swallowing kinematic analysis to assure the validity of method.

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  Fig. 4 (A) Positive correlation of the reference and the measured values for the length of objects in a scatter diagram. (B) Bland-Altman plot for the length of objects: the graph shows the relation between the mean of the two values (reference and measured value) for the length of objects (the x-axis) and the difference between the two values for the length of objects (the y-axis). (C) Positive correlation of the reference and the measured values for the linear velocities in a scatter diagram. (D) Bland-Altman plot or the linear velocities: the graph shows the relation between the mean of the two values for linear velocity (the x-axis) and the difference between the two values for linear velocity (the y-axis). (E) Positive correlation of the reference and the measured values for the angular velocities in a scatter diagram. (F) Bland-Altman plot for the angular velocities: the graph shows the relation between the mean of the two values for angular velocity (the x-axis) and the difference between the two values for angular velocity (the y-axis). In all Bland-Altman plots, middle among the three horizontal lines represents the mean value of the difference between the reference and measured vales. Upper and lower lines represent two standards deviations of the mean.

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