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        The Effects of Bolus Consistencies on the Swallowing Safety in Poststroke Patients

        Allison Trent,박태옥,Elizbeth Oommen,김영선 한국언어청각임상학회 2014 Communication Sciences and Disorders Vol.19 No.2

        Objectives: Thickened liquids or pureed foods are one of the most frequently used compensatory strategies in hospitals and long-term care facilities for patients with dysphagia. The purpose of this study was to determine whether different bolus consistencies (thin liquid, nectar thick liquid, and puree) would improve the safety of swallowing and whether there would be a difference within these consistencies on swallowing safety in poststroke patients. Methods: Videofluoroscopic swallowing examinations (VFSEs) were obtained from 24 poststroke patients. Among them, 12 poststroke patients showed aspiration in thin liquid. VFSEs of these patients were advanced to swallowing nectar thick liquid and puree. To determine the safety of swallow in changes of bolus consistency, penetration-aspiration scale (P-A scale) was used to rate the swallow on a scale of 1 to 8. Statistical comparisons were made by one-way analysis of variance (ANOVA), and the significance level was set at p<.05. Results: For poststroke patients with aspiration, change in bolus consistency had a significant effect on the P-A acale rating (p<.01). The poststroke patients with aspiration exhibited significant decreases in P-A scale between thin liquid and nectar thick liquid and between thin liquid and puree (p<.01), but not between nectar thick liquid and puree (p=.55). Conclusion: The findings have two clinical implications. First, thickened liquid or puree provided an alternative way to obtain liquid or food safely to poststroke patients who aspirated thin liquids. Second, there is no difference on swallowing safety between nectar thick liquids and puree in poststroke patients with aspiration.

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