Shanie Elkarif

Test Re-Test Reliability of Peak Hyolaryngeal Excursion During Swallowing in Healthy Adults.

Shanie Elkarif, BHS-CMS
Emily K. Plowman, PhD., CCC-SLP
Justine J. Allen, MS, CCC-SLP, BCS-S
Lauren DiBiase, MS, CCC-SLP
Amber Anderson, MS, CCC-SLP
Maddy Lee, BHS-CMS


Purpose: Although hyoid excursion is a common outcome of interest in both clinical and research settings, inherent hyoid movement variability across different testing time points in healthy adults has not yet been determined. We, therefore, examined the test-retest reliability of normalized peak anterior, superior and anterior superior hyoid measurements during swallowing of a 10ml water bolus in young, healthy adults.

Methods: Ten young adults with no history of dysphagia or conditions that could impact swallowing attended two testing sessions, spaced one week apart. Participants underwent identical standardized videofluroscopic swallowing examinations (VFSE) that included ten 10ml water bolus trials, each administered 12 seconds apart. Peak anterior and peak superior hyoid distance from C4, normalized to C2-4 distance, were derived in a blinded randomized fashion for each swallow (100 test 1, 100 test 2). A two-way mixed intraclass coefficient (ICC) was performed.

Results: Intra-rater reliability was considered excellent across all three hyoid positions. Inter- rater reliability was considered excellent for two positions and considered good for the third position. The test-retest reliability for peak anterior (X), peak superior (Y) and peak anterior- superior (XY) across the 10 swallowing trials for test 1 and test 2 had a low group mean difference indicating that there is little change from swallow to swallow in each individual. In other words, this tool is reliable. The test-retest reliability intraclass correlation coefficient data presented to be 0.94 for peak anterior (X), 0.92 peak superior (Y), and 0.89 peak anterior- superior (XY).

The use of peak hyoid position metrics as a percentage of C2-C4 vertebrae are valid and reliable in measuring hyolaryngeal excursion across healthy young patients. This was demonstrated through low mean differences in the test-retest reliability which was validated by excellent inter and intra rater reliability.