Date of Award

August 2018

Degree Type


Degree Name

Master of Science


Communication Sciences and Disorders

First Advisor

Barbara R Pauloski

Committee Members

Marylou P Gelfer, Sabine Heuer, Barbara R Pauloski


Dysphagia, MBSImP, Swallowing, Videofluoroscopy


MBSImP® is an ordinal rating scale designed to evaluate 17 swallowing events from Videofluoroscopic Swallowing Study. Use of an ordinal scale to judge swallowing impairment involves subjectivity and could affect the reliability of judgements. There is a need to validate the ordinal levels of ratings in MBSImP® with objective data, in order to improve confidence of clinical judgements. The hypothesis was that discrete objective data could be obtained for each level of rating in MBSImP® that are statistically different from the data of the subsequent rating level, which would objectively support the concept of the MBSImP® tool. Two hundred 5ml thin liquids swallows were analyzed and each swallow was rated for MBSImP® Component 9- Anterior Hyoid Excursion. As the corresponding objective measure, the anterior excursion of the hyoid in normalized scalar units was measured for each swallow using ImageJ. Statistical analysis of the data with a one way ANOVA revealed a statistically significant difference (p<0.001) in the mean of anterior hyoid excursion in normalized scalar units among the MBSImP® ratings levels with R2 value of 0.20. Multiple paired comparisons performed using Bonferroni adjustment in SPSS revealed significant differences among all ratings levels. The study aimed to find if quantifiable data could be applied to different levels ratings of MBSImP® components. As expected, there was a decrease in the mean anterior hyoid excursion in normalized scalar units as the level of MBSImP® rating increased for Component 9. However, the R2 value of the ANOVA revealed that only 20% of the variation in the objective data of anterior hyoid excursion in normalized scalar units could be explained by different levels of rating on the component of interest of MBSImP® tool. Though this study could not satisfactorily prove the concept of the tool, the objective data of anterior hyoid excursion in normalized scalar units categorized by rating levels of MBSImP® show the potential to achieve this in the future.