An Alternate Method to Assess the Movement of Velum in a Clinical Setup

Accurate evaluation of velum movement is important in the assessment of velopharyngeal function. Traditional phonation-based tasks can pose challenges for individuals with compromised phonatory subsystems. Identifying alternative, reliable tasks for visualizing velum movement is important for clinical assessment and intervention planning. The objective of the study was to determine whether a forced expiration task (FET) elicits greater velum movement compared to a phonation task (PT) during oral motor examination, using direct oral visualization.

The study included 100 participants (50 males, 50 females) aged 18-70 years, excluding individuals with craniofacial anomalies, neurologic disorders, or conditions affecting velar function. Participants performed two tasks: phonation ("ah" repeated five times) and a FET (inhalation through the nose and forced exhalation through the mouth). Audio-video recordings were evaluated by three experienced speech-language pathologists using a 5-point scale for velum movement effectiveness. A Wilcoxon signed-rank test was used to compare scores between the two tasks. The Mann-Whitney U test was used to assess gender differences. Inter-rater reliability was evaluated using the intraclass correlation coefficient (ICC).

Velum movement was significantly greater during the FET compared to the PT (Z = -7.051, p < 0.001), with a large effect size (r = 0.705). No significant gender differences were found for either task. Inter-rater reliability was moderate to good (ICC = 0.703).

The FET was more effective than the PT in producing visible velum movement during oral motor examination. This task may serve as a practical alternative in assessing patients with limited phonatory ability and may enhance clinical assessment protocols for velopharyngeal function.