Abstract
Bolus manipulation is a primary treatment strategy in the management of oral-pharyngeal dysphagia. The use of thickening agents to alter bolus rheology is particularly commonplace; however, the precise effects of these alterations on swallowing remain uncertain. The purpose of our study, a prospective, double-blind clinical trial (Level 1b), was to investigate the effects of viscosity on aspiration. One hundred patients with dysphagia were prospectively evaluated with fluoroscopic swallow studies performed across three standardized and randomized conditions: thin liquid barium (THIN), liquid barium thickened with a starch-based agent (STARCH), and liquid barium thickened with a gum-based agent (GUM). Outcome measures included the prevalence of aspiration and score on the Penetration-Aspiration Scale. A total of 23 out of 100 patients exhibited 56 episodes of aspiration. Twenty patients aspirated on THIN, 15 on STARCH, and 11 on GUM bolus conditions (P<0.05, thin vs gum). There were 28 instances of aspiration on THIN, 16 on STARCH, and 12 on GUM. Mean Penetration-Aspiration Scale score±standard deviation was 2.11±2.22 for THIN, 1.76±1.88 for STARCH, and 1.42±1.47 for GUM conditions, respectively (P<0.001, THIN vs GUM). A clinically significant reduction in the incidence of penetration and aspiration was observed for gum-thickened barium compared with thin liquid barium.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 590-594 |
| Number of pages | 5 |
| Journal | Journal of the Academy of Nutrition and Dietetics |
| Volume | 114 |
| Issue number | 4 |
| DOIs | |
| State | Published - 2014 |
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Keywords
- Aspiration
- Penetration
- Starch
- Thickening agent
- Xanthan gum
ASJC Scopus subject areas
- Food Science
- Nutrition and Dietetics
Cite this
Effects of bolus rheology on aspiration in patients with dysphagia. / Leonard, Rebecca J; White, Cheryl; McKenzie, Susan; Belafsky, Peter C.
In: Journal of the Academy of Nutrition and Dietetics, Vol. 114, No. 4, 2014, p. 590-594.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Effects of bolus rheology on aspiration in patients with dysphagia
AU - Leonard, Rebecca J
AU - White, Cheryl
AU - McKenzie, Susan
AU - Belafsky, Peter C
PY - 2014
Y1 - 2014
N2 - Bolus manipulation is a primary treatment strategy in the management of oral-pharyngeal dysphagia. The use of thickening agents to alter bolus rheology is particularly commonplace; however, the precise effects of these alterations on swallowing remain uncertain. The purpose of our study, a prospective, double-blind clinical trial (Level 1b), was to investigate the effects of viscosity on aspiration. One hundred patients with dysphagia were prospectively evaluated with fluoroscopic swallow studies performed across three standardized and randomized conditions: thin liquid barium (THIN), liquid barium thickened with a starch-based agent (STARCH), and liquid barium thickened with a gum-based agent (GUM). Outcome measures included the prevalence of aspiration and score on the Penetration-Aspiration Scale. A total of 23 out of 100 patients exhibited 56 episodes of aspiration. Twenty patients aspirated on THIN, 15 on STARCH, and 11 on GUM bolus conditions (P<0.05, thin vs gum). There were 28 instances of aspiration on THIN, 16 on STARCH, and 12 on GUM. Mean Penetration-Aspiration Scale score±standard deviation was 2.11±2.22 for THIN, 1.76±1.88 for STARCH, and 1.42±1.47 for GUM conditions, respectively (P<0.001, THIN vs GUM). A clinically significant reduction in the incidence of penetration and aspiration was observed for gum-thickened barium compared with thin liquid barium.
AB - Bolus manipulation is a primary treatment strategy in the management of oral-pharyngeal dysphagia. The use of thickening agents to alter bolus rheology is particularly commonplace; however, the precise effects of these alterations on swallowing remain uncertain. The purpose of our study, a prospective, double-blind clinical trial (Level 1b), was to investigate the effects of viscosity on aspiration. One hundred patients with dysphagia were prospectively evaluated with fluoroscopic swallow studies performed across three standardized and randomized conditions: thin liquid barium (THIN), liquid barium thickened with a starch-based agent (STARCH), and liquid barium thickened with a gum-based agent (GUM). Outcome measures included the prevalence of aspiration and score on the Penetration-Aspiration Scale. A total of 23 out of 100 patients exhibited 56 episodes of aspiration. Twenty patients aspirated on THIN, 15 on STARCH, and 11 on GUM bolus conditions (P<0.05, thin vs gum). There were 28 instances of aspiration on THIN, 16 on STARCH, and 12 on GUM. Mean Penetration-Aspiration Scale score±standard deviation was 2.11±2.22 for THIN, 1.76±1.88 for STARCH, and 1.42±1.47 for GUM conditions, respectively (P<0.001, THIN vs GUM). A clinically significant reduction in the incidence of penetration and aspiration was observed for gum-thickened barium compared with thin liquid barium.
KW - Aspiration
KW - Penetration
KW - Starch
KW - Thickening agent
KW - Xanthan gum
UR - http://www.scopus.com/inward/record.url?scp=84896319393&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84896319393&partnerID=8YFLogxK
U2 - 10.1016/j.jand.2013.07.037
DO - 10.1016/j.jand.2013.07.037
M3 - Article
C2 - 24161369
AN - SCOPUS:84896319393
VL - 114
SP - 590
EP - 594
JO - Journal of the Academy of Nutrition and Dietetics
JF - Journal of the Academy of Nutrition and Dietetics
SN - 2212-2672
IS - 4
ER -