Validation of a clinician-developed, bulbar function protocol in motor neuron disease.

Comprehensive bulbar assessment methods for use within ALS clinics are limited. The C-BAS standardizes ALS clinical bulbar function, identifying the broader goal of providing reliable data collection for clinical and research application. The C-BAS compilation of measures is designed to identify and track progression of bulbar function over time, by quantifying speech and swallowing features, maintaining sensitivity to longitudinal change, and characterizing functional impacts. This data is projected to identify early impairments, facilitating timely clinical interventions.

The C-BAS represents a collection of objective and subjective clinical bulbar measures, designed to assess speech and swallowing impairments while tracking progression in ALS. Participant results were measured in speech and swallowing profiles, UMN and LMN features, and patient reported effort, fatigue, and communication-swallowing effectiveness.

Preliminary data analysis includes:

1. Content validation of C-BAS items (CVR < 0.99).
2. Ongoing data collection, with analyses of (n=39) participants to date. C-BAS scores range from 8-93 (M=38.56, SD 24.1); a trend in C-BAS scores is noted (i.e., bulbar higher (M=56.2, SD=24.8); spinal lower (M=36.0, SD = 23.8)).
3. Significant correlations were identified with existing bulbar scales (e.g., ALSFRS, CNS-BFS) with ALSFRS (r=-.71, p<0.001), CNS-BFS (r=.84, p<0.001).
4. Significant correlations were identified with existing communication (CFCS) and eating (EDAC) classifications to the C-BAS (r=.68 & r=.86, respectively; both p<0.001)

The C-BAS incorporates systematic data collection, targeting the assessment of ALS bulbar dysfunction within a clinical setting. The design is based on the WHO ICF (e.g., body structure & function, activity, participation). Preliminary evidence suggests a valid, reliable scale for objectively assessing bulbar motor function in patients with ALS.