The clinical swallowing evaluation is a noninstrumental assessment that is performed at bedside with various volumes and consistencies of material. If patient presents with normal swallow function, a statement such as the. During the study, we can modify the delivery system, the liquid viscosity, or therapeutic swallow maneuvers for example, external pacing or chin tuck to enhance the safety and efficiency of the swallow mechanism. This is the fifth of ten fact sheets regarding aspiration prevention. This investigation tested the construct validity of the first standardized assessment tool, the babyvfss impairment profile, babyvfssimp, developed for the quantification of swallowing observations made from videofluoroscopic swallow studies vfss in bottlefed babies. Video fluoroscopic swallowing exam vfse a video fluoroscopic swallowing exam vfse looks at your ability to swallow safely and effectively. It provides the most comprehensive information on anatomic and physiological malfunction in swallowing. Clinical research a prospective comparison between 02.
Subjective assessment of videofluoroscopic swallow studies. Vfss videofluoroscopic swallow study, also known as mbss modified barium swallow study, and fees. The different underlying causes of aspiration can often be identified with videofluoroscopy. The modified barium swallow impairment profile mbsimp is a standardized method for the assessment of swallowing physiology from videofluoroscopic imaging used by. Practical reasons can limit the use of videofluoroscopy in some patients. Swallowing and feeding team referral plan sample form pdf transitioning youth. Assessment of impaired coordination between respiration. A crosssectional, quantitative videofluoroscopic analysis. This retrospective study analyzed the imaging findings in 11 cats undergoing 15 videofluoroscopic swallow studies. A commonly used assessment tool for dysphagia is the videofluoroscopic swallowing study vfss, which is highly sensitive for aspiration and facilitates the precise assessment of complex abnormalities throughout the swallowing process 11.
Participant responses to the functional oral intake scale fois 26, eat10 17, sydney swallow questionnaire ssq 27 and mininutritional assessment mna 28 were within the normal range. Videofluoroscopic assessment of swallowing is widely used in clinical settings. Videofluoroscopic swallow study and objective metrics. Cpgs are particularly helpful in guiding complex procedures such as the videofluoroscopic swallowing study vfss for the assessment of dysphagia, but there is a suspected high level of variability among them. Construct validity of the measures was tested using descriptive methods and confirmatory factor analysis cfa. This procedure is also known as a modified barium swallow mbs. The clinical swallow examination cse is widely used by clinicians evaluating patients with dysphagia, yet this method remains controversial among many. Please attach relevant reports, diagnostics and medication profile. Videofluoroscopic evaluation of normal and impaired. Speech language pathology stroke quick reference guide. Quantitative analysis of videofluoroscopic swallowing. Contrast vfss was performed at 30 framess with a ge advantx or ge oec 9900 elite mobile c. Videofluoroscopic assessment of swallowing examinations was performed from january 7, 2000 to march 29, 2011 at kyushu university hospital.
Videofluoroscopic swallow studies, the current imaging standard for diagnosing and managing oropharyngeal dysphagia, aid radiologists in identifying and managing normal and abnormal mechanisms of swallowing and phases of deglutition, as well as diagnosing pathologic disorders that may contribute to swallowing dysfunction. Clinical swallowing assessment identified aspiration in 50% of patients and videofluoroscopy identified aspiration in 22% and penetration in 45% of patients 20. Clinical practice guidelines for videofluoroscopic. Videofluoroscopic swallow study the vfss is a radiographic procedure that provides a dynamic view of the swallowing mechanism.
Caslpo videofluoroscopy vfss is often referred to as a gold standard assessment method. With this test the risks of aspiration and complications with respiratory devices can be assessed. Assessment of feeding and swallowing problems based on the information obtained one or both of the following assessments are done. Dysphagia onset in older adults during unrelated hospital. Referral information what is a videofluoroscopic swallow study. Swallowing assessment assessment of swallowing consisted of a standardized bedside clinical assessment7 and a videofluoroscopic barium swallow assessment. Videofluoroscopic swallow assessment vsa also know as a modified barium swallow study informal swallow assessment. Request pdf on jun 1, 2018, fabiano bini and others published quantitative analysis of videofluoroscopic swallowing study for the assessment of laryngeal elevation. Fluoroscopic evaluation of oropharyngeal dysphagia. Videofluoroscopic assessment of pharyngeal stage delay. We evaluated the pharyngeal stage delay using motion analysis on videofluoroscopic swallowing examination in patients with normal swallowing and brain infarction patients divided into pathophysiologic. Dysphagia was determined by clinical presentations and videofluoroscopic swallow study findings as previously described.
Standardization of a videofluoroscopic swallow study. Assessment of swallowing function and muscle using. Hiatal hernia n 5, esophageal stricture n 3, and esophageal dysmotility n 7 were the most common diagnoses some cats having more than 1 diagnosis in dysphagic cats that underwent videofluoroscopic swallow studies. Association between clinical risk factors and severity of. Adequate validity was set at sensitivity 90% and negative predictive value 90%. Clinical bedside swallowing assessment iowa head and. Nineteen adults with a diagnosis of probabledefinite als elescorial criteriarevised underwent a videofluoroscopic swallowing study, involving up to. Pdf videofluoroscopic examination study procedure with. Developing alternative methods to videofluoroscopy swallowing study vfss for the evaluation of dysphagia is a public health necessity. New zealand speechlanguage therapy clinical practice guideline on videofluoroscopic study of swallowing vfss anna miles andrea benoit, melissa keesing, helen mclauchlan, esther ong. It is performed in conjunction with a moving xray and generally takes less than 10 minutes to perform.
All incomplete referral forms will be returned to referral source for completion. A prospective study of 20 sets of videofluoroscopic and endoscopic assessments of swallowing function were compared. The test assists in determining the safest diet and identifying the need for therapy. A videofluoroscopic swallow study vfss is an assessment that uses a moving dynamic xray image to evaluate a childs swallowing function. Pdf videofluoroscopic assessment of patients with dysphagia. Endoscopic assessment was found to be a highly sensitive and specific method of determining swallowing safety. Finally, an instrumental dysphagia study, such as the videofluoroscopic swallowing assessment, aims to.
Name, idmedical record number, date of birth, date of exam, referred by, reason for referral. These include disease processes such as cancer or treatment of disease processes ie, surgery or radiation therapy that may lead to difficulty swallowing safely. The overall conclusion was that the evidence is limited and further research is required. Videofluoroscopic assessment of swallowing springerlink.
Without sensory testing fees or with sensory testing feesst other resources. Videofluoroscopic assessment of patients with dysphagia. The clinical and videofluoroscopic assessment and diagnostic criteria for the presence and severity of a swallowing disorder and aspiration were developed by us and influenced by the work of ott and pikna,14 linden and siebens,15 and logemann. To explore the extent of this variation, this study aimed to systematically identify and appraise all vfss cpgs available worldwide. Video fluoroscopy is a diagnostic technique that will allow the assessment of your swallowing function. Recovery of swallowing after dysphagic stroke relates to. Videofluoroscopic swallowing studies are the gold standard for evaluating the pharyngeal phase of swallowing 7, 16, 17. Videofluoroscopic swallow study vfss fiberoptic endoscopic evaluation of swallowing. Vfss template 1 templates are consensusbased and provided as a resource for members of the american speechlanguagehearing association asha.
Secondary analyses explored the therapeutic effect of thickened liquids on swallowing safety and efficiency. Physician signature required for slp swallowing assessment and videofluoroscopic swallow study if appropriate date year month day note. Nineteen adults with a diagnosis of probabledefinite als elescorial criteriarevised underwent a videofluoroscopic swallowing study, involving up to 15 sips. Videofluoroscopic swallowing exam indentifying information may include the following. This noninvasive exam uses fluoroscopy to help identify the thicknesses of liquid and food that you can most safely eat. The videofluoroscopic swallowing study vfss is a standard tool for evaluating abnormalities in swallowing. The vfss videofluoroscopic swallowing study is the standard assessment for dysphagia. Intended outcomes readers will learn the definition and process of a videofluoroscopy or modified barium swallow study, items to bring to the study, and why an individual would be referred for such a study.
When a child needs an instrumental swallowing assessment. However, thus far, few studies have assessed the associations between clinical characteristics of ped. Pdf a swallowing clinical assessment score scas to. This method of assessment is ideal for revealing both the anatomy and physiology of swallowing, and for demonstrating pathophysiology in people with dysphagia.
Screening tests of swallowing function are useful in clinical practice, however, less accurate than videofluoroscopic swallowing study vf and videoendoscopic swallowing study ve. In addition, revisions to diet and compensatory strategies during swallowing can be established. Lee jw1, randall dr12, evangelista lm1, kuhn ma1, belafsky pc1. The pros and cons of videofluoroscopic assessment of. Given that assessment of only swallowing will miss silent aspiration, i. The functional dysphagia scale is a useful tool for. Because radiographic techniques of evaluating the upper, striatedmuscle portion of the esophagus differ significantly from those of evaluating the lower, smoothmuscle portion of the esophagus, a radiographic assessment of swallowing should be directed by the patients history. Videofluoroscopy allows precise assessment of the dynamic aspects of swallowing, especially of the pharyngeal stage of deglutition. The interpretation of such assessments depends on subjective visual judgments but the reliability of these judgments.