Detection of Swallow Kinematic Events From Acoustic High-Resolution Cervical Auscultation Signals in Patients With Stroke

Abstract

ObjectiveTo examine whether there were any associations between high-resolution cervical auscultation (HRCA) acoustic signals recorded by a contact microphone and swallowing kinematic events during pharyngeal swallow as assessed by a videofluoroscopic (VF) examination. DesignProspective pilot study. SettingUniversity teaching hospital, university research laboratories. ParticipantsPatients (N=35) with stroke who have suspected dysphagia (26 men + 9 women; age = 65.8±11.2). MethodsVF recordings of 100 liquid swallows from 35 stroke patients were analyzed, and a variety of HRCA signal features to characterize each swallow were calculated. Main Outcome MeasuresPercent of signal feature maxima (peak) occurring within 0.1 seconds of swallow kinematic event identified from VF recording. ResultsMaxima of HRCA signal features, such as standard deviation, skewness, kurtosis, centroid frequency, bandwidth, and wave entropy, were associated with hyoid elevation, laryngeal vestibule closure, and upper esophageal sphincter opening, and the contact of the base of the tongue and posterior pharyngeal wall. ConclusionsAlthough the kinematic source of HRCA acoustic signals has yet to be fully elucidated, these results indicate a strong relationship between these HRCA signals and several swallow kinematic events. There is a potential for HRCA to be developed for diagnostic and rehabilitative clinical management of dysphagia.