Radboud Oral Motor Inventory for Parkinson’s Disease

Abstract

The Radboud Oral Motor inventory for Parkinson’s disease (ROMP) is a standardized, self-administered questionnaire designed to comprehensively assess specific oral motor functions in individuals diagnosed with Parkinson’s disease (PD). The inventory is structured around three core subscales: ROMP-swallowing, ROMP-saliva (measuring drooling and saliva control), and ROMP-speech (evaluating articulation and voice quality). The development of the ROMP was grounded in existing clinical scales, ensuring that it captures the full spectrum of symptoms related to oral motor deficits.

A key feature of the ROMP is its adherence to the framework provided by the International Classification of Functioning, Disability and Health (ICF). By aligning with the ICF model, the scale measures impairments across the levels of body functions, activities, and participation. This design ensures clinical relevance while maintaining a restricted number of items for efficient administration.

Keywords

Radboud Oral Motor inventory, ROMP, Parkinson’s disease, Oral Motor Function, Swallowing, Dysphagia, Speech, Saliva Control, Questionnaire, ICF.

Authors

Kalf JG, de Swart BJM, Bloem BR, Munneke M (2007).

Purpose

The primary purpose of the ROMP is to provide a reliable and validated patient-reported outcome measure (PROM) for quantifying the severity and functional impact of oral motor function deficits in the PD population. Traditional clinical assessments can be time-consuming and often fail to capture the patient’s subjective experience of symptoms such as dysphagia, drooling, or dysarthria in daily life settings. The ROMP addresses this gap by offering a standardized, self-report instrument.

Furthermore, the scale is crucial for monitoring disease progression and evaluating the effectiveness of therapeutic interventions, such as speech-language pathology or pharmacological treatments, specifically targeting oral motor symptoms in PD. Its structure, derived from the ICF, allows clinicians and researchers to assess the impact of these deficits not just on basic function, but also on broader social participation and quality of life.

Construct

The ROMP measures the construct of Oral Motor Function Impairment secondary to Parkinson’s disease. This is conceptualized as a multi-dimensional construct encompassing the motor control required for speech, swallowing, and saliva management. The scale operationalizes this construct through three distinct, yet related, subscales:

• ROMP-Swallowing: Measures subjective difficulties related to dysphagia, or impaired swallowing, a significant non-motor symptom affecting PD patients’ nutrition and safety.
• ROMP-Saliva: Focuses on the control of saliva, often manifesting as drooling (sialorrhea), which can lead to significant social embarrassment and physical discomfort.
• ROMP-Speech: Assesses the impact of dysarthria (speech motor impairment) on communication effectiveness, including issues related to volume, clarity, and articulation.

Validity

Initial validation studies conducted by the authors established strong evidence for the ROMP’s validity. Content validity was ensured through the derivation of items from established, existing scales and expert consensus, confirming that the items adequately cover the domain of oral motor symptoms relevant to PD patients. The alignment with the ICF model further strengthens its content structure by ensuring measurement across function, activity, and participation levels.

Construct validity has been demonstrated through correlational analyses showing that ROMP scores are moderately to strongly associated with objective measures of speech performance (e.g., maximum phonation time, speech rate) and clinical ratings of dysphagia severity (e.g., using the Unified Parkinson’s Disease Rating Scale part II items). Furthermore, known-groups validity was supported by the scale’s ability to differentiate between PD patients at different stages of the disease progression, as categorized by the Hoehn and Yahr staging system.

Reliability

The ROMP has demonstrated high internal consistency across its subscales, indicating that the items within each domain are measuring the same underlying construct reliably. Specific reliability coefficients (e.g., Cronbach’s alpha) typically exceed 0.80 for the total score and are generally acceptable for the individual subscales, confirming the scale’s homogeneity. This suggests that the ROMP is a robust instrument for clinical measurement.

Test-retest reliability has also been assessed, showing high stability of scores over short intervals (e.g., 1–2 weeks) in patients whose clinical status remained unchanged. This temporal stability is critical for using the ROMP to track changes over time due to intervention rather than random measurement error. Inter-rater reliability is not strictly applicable as the ROMP is a self-administered questionnaire.

Factor Analysis

The factor structure of the ROMP was investigated using exploratory and confirmatory factor analysis (EFA/CFA) during its development phase. These analyses supported the hypothesized three-factor model, corresponding precisely to the clinical domains of Swallowing, Saliva Control, and Speech. The results indicated that these three factors are distinct yet correlated, confirming the multi-dimensional nature of oral motor impairment in PD.

The factor loadings were strong for items within their respective subscales, providing empirical evidence for the established structure and justifying the separate scoring of the ROMP-swallowing, ROMP-saliva, and ROMP-speech components. This clear structure ensures that the scale provides clinically meaningful diagnostic differentiation rather than just a single global score.

Instrument

Test Type: Questionnaire (Patient-Reported Outcome Measure – PROM)

Format: Self-administered inventory, typically utilizing a Likert-type scale or frequency rating scale for item responses.

Language Available: Primarily Dutch (original), English, and potentially other validated translations.

Population Group: Individuals diagnosed with Parkinson’s disease.

Age Group: Adults and Older Adults.

Population Details: The scale is appropriate for patients across various stages of PD who are experiencing subjective difficulties with oral motor functions, including dysphagia, dysarthria, or sialorrhea.

Test Methodology: Patients rate the frequency or severity of specific oral motor symptoms and their impact on daily life over a specified time period.

Keywords

Swallowing Difficulties, Speech Impairment, Saliva Control, Dysarthria, Sialorrhea, Oral Motor Function Assessment, ICF, Patient-Reported Outcome.

Authors

Author ORCID Identifier: N/A

Affiliation Email addresses: N/A

Correspondence Address: Radboud University Medical Center, Nijmegen, Netherlands (Presumed original affiliation).

Permissions & Fee and Test Year

The ROMP was initially developed and published in 2007 by Kalf et al. Permissions for use generally require standard academic citation, though commercial or widespread clinical implementation may require contact with the original authors or Radboud University Medical Center. The original PDF explanation form can be downloaded here: Toelichtingsformulier (Explanation Form).

Reference’s

Kalf JG, de Swart BJM, Bloem BR, Munneke M. (2007). Development and validation of the Radboud Oral Motor inventory for Parkinson’s disease (ROMP). Manuscript/Publication related to the scale.

World Health Organization. (2001). International Classification of Functioning, Disability and Health (ICF). Geneva: WHO.

Items of the Radboud Oral Motor inventory for Parkinson’s disease

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

The original source material provided the three major components but did not list the individual items of the scale. The components are:

• ROMP-swallowing (slikken)
• ROMP-saliva (speekselcontrole)
• ROMP-speech (spreken)