Validation of the adapted Borg-CR-10 effort scale as it relates to swallowing and patients with dysphagia
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The aim of this study was to validate the adapted Borg-CR-10 exertion scale, a self-report scale associated with a specific activity for swallowing with the hopes of enabling speech language pathologists to quantify effort in patients with dysphagia, facilitate uniformity in research, and to help guide treatments. An additional aim was to investigate the relationship between quality-of-life and perception of effort to clarify relative contribution of effort in patient’s perception of impairment. Thirty-two participants, with or without dysphagia, swallowed various consistencies of solid foods and liquids. Following the completion of each swallow, they filled out Borg-CR-10 exertion scale adapted for swallowing. In order to validate this scale, we compared the scores of the Borg scale with two different scales: a quality-of-life scale relating to swallowing disorders (a self-report scale reflecting more general impressions of swallowing) and a clinician-driven rating scale on specific swallowing behavior. We found evidence of modest to strong correlations between the Borg scale and the other scales. These findings suggest that despite its unique contributions (personal perceptions of specific swallowing behavior) it has good agreement with other, well-validated swallowing measures. Additionally, we found that individuals consistently rated the larger amounts of liquids swallowed with more effort than smaller amounts of liquid. They also rated liquids with higher viscosity more effortful than lower viscosity liquids. These findings are in keeping with intuitive predictions that larger amounts and stickier liquids would require more effort. Unfortunately, the data do not show such findings with puree and solid consistencies. Despite the lack of findings in data with puree and solid consistencies, it is important to see the findings from other consistencies will aid in directing future research.