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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.

      • KCI등재

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

        Allison Trent, 박태옥(Taeok Park),Elizabeth Oommen, 김영선(Youngsun Kim) 한국언어청각임상학회 2014 Communication Sciences and Disorders Vol.19 No.2

        배경 및 목적: 진한 액체나 퓨레 음식은 병원이나 요양원의 삼킴장애 환자에게 가장 많이 쓰이는 보상치료방법이다. 본 연구의 목적은 흡인을 보이는 뇌졸중 환자가 다양한 음식점도(묽은 액체, 진한 액체, 퓨레)를 삼켰을때 삼킴안전에 변화를 보이는지와 다양한 음식 사이에는 삼킴안전에 차이를 보이는지 알아보는 것이다. 방법: 뇌졸중 환자 24명 중 묽은 액체에서 흡인을 보인 환자 12명의 비디오투시조영검사 자료에서 각 환자의 5 mL의 묽은 액체, 진한 액체, 퓨레의 삼킴을 분석하였다. 본 연구에서 삼킴의 안전을 측정하기 위해 사용한 침습-흡인 척도는 1에서 8점 척도이다. 자료분석을 위해 일원분산분석(one way ANOVA)을 실시하였고, 유의수준은 .05로 설정하였다. 결과: 흡인을 보이는 뇌졸중 환자의 경우 음식점도에 따라 침습-흡인 척도에서 유의미한 차이를 보였다(p<.01). 흡인을 보이는 뇌졸중 환자의 묽은 액체와 진한 액체, 묽은 액체와 퓨레에서 침습-흡인 척도의 감소가 나타났고(p<.01), 진한 액체와 퓨레 사이는 유의한 차이를 보이지 않았다(p=.55). 논의 및 결론: 본 연구를 통해서 다음의 두 가지 임상적 의의를 생각해 볼 수 있다. 첫째, 묽은 액체에 흡인을 보이는 환자라 할지라도 진한 액체나 퓨레로 대체하여 액체나 음식을 안전하게 삼킬 수 있다. 둘째, 환자에게 묽은 액체를 대체할 것을 선택 시 진한 액체와 퓨레는 삼킴안전에 차이가 없다는 것이다. 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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