Date of Award


Degree Type


Degree Name

Master of Science


Communication Sciences and Disorders


The primary aim of this thesis was to characterize the position of the bolus head (i.e., the leading edge of the bolus/barium) at the onset of the pharyngeal swallow in older adults who have dysphagia (i.e., swallowing difficulties) following cerebral hemispheric stroke. Lateral-view videofluoroscopic swallowing images were obtained from nine older adults (mean age ±SD: 79.33 years ± 6.86). For each swallow, the positions of the bolus head, tonguemandible intersection (TMI)1 and several anatomic landmarks were recorded digitally from the ‘swallow onset’ video frame. Vertical distance between the bolus head and the TMI was computed as well as bolus velocity. Each swallow was scored on a penetration-aspiration scale. Bolus head position at swallow onset ranged from 9.88 mm above to (-) 71.25 mm below the TMI (-32.33 ± 21.13; mean ± SD). Over 90% of the swallow triais analyzed were initiated with the bolus head below the TMI. This represents a common swallowing pattern in older adults with dysphagia following hemispheric stroke. Neither bolus head position nor bolus head velocity at swallow onset were associated with penetration/aspiration.



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