# Palpation as a Method To Predict Spatial Instrumental Hyolaryngeal Excursion Measures

## TL;DR

This study explores whether a physical exam technique used by speech-language pathologists can predict hyoid bone movement during swallowing, as measured by imaging.

## Contribution

The study introduces a method to predict instrumental hyolaryngeal excursion measures using palpation ratings during clinical swallow evaluations.

## Key findings

- Palpation ratings, bolus consistency, and number of swallows significantly predicted superior hyoid peak position.
- No significant predictors were found for anterior hyoid peak position.
- The results suggest palpation may provide useful insights into superior hyolaryngeal excursion during clinical assessments.

## Abstract

The purpose of this study is to determine if speech-language pathologists’ (SLP) ratings of palpated hyolaryngeal excursion (pHLE) during a clinical swallow evaluation (CSE) are predictive of spatial measures of hyolaryngeal excursion determined by instrumentation (iHLE). Adults between the ages of 18–99 were recruited with a physician referral to complete a CSE and videofluoroscopy swallow study. Four SLP investigators completed ratings of pHLE palpation during a CSE. Spatial measures of hyoid peak elevation were taken from videofluoroscopy swallow studies. Statistical analyses included multiple linear regression to determine the best-fitting model to predict iHLE from palpated ratings. Data from 77 volunteers (44 female, mean age 71.6) were used for statistical analyses. The linear regression model indicated three significant predictors of superior (upward) hyoid peak position, including palpation, bolus consistency, and the number of swallows. There were no significant predictors of anterior (forward) hyoid peak position from the tested factors. The emergence of these significant predictors suggests that palpation may provide insight into superior HLE movements during a CSE. Next steps will be to determine if palpation improves SLPs’ diagnostic accuracy and clinical decision-making during swallow assessment without instrumentation.

The online version contains supplementary material available at 10.1007/s00455-025-10880-w.