Dysphagia or swallowing difficulty is a common morbidity experienced by those who have suffered a stroke or those undergone such treatments as head and neck surgeries. Dysphagic patients require special foods that are easier to swallow. Various technologies, including high‐pressure processing, high‐hydrodynamic pressure processing, pulsed electric field treatment, plasma processing, ultrasound‐assisted processing, and irradiation have been applied to modify food texture to make it more suitable for such patients. This review surveys the applications of these technologies for food texture modification of products made of meat, rice, starch, and carbohydrates, as well as fruits and vegetables. The review also attempts to categorize, via the use of such key characteristics as hardness and viscosity, texture‐modified foods into various dysphagia diet levels. Current and future trends of dysphagia food production, including the use of three‐dimensional food printing to reduce the design and fabrication time, to enhance the sensory characteristics, as well as to create visually attractive foods, are also mentioned.

Context:Various methods are available for the evaluation of skin color. A skin color scale chart is a convenient and inexpensive tool. However, the correlation between a skin color scale chart and objective measurement has not been evaluated.Aims:To assess the correlation between skin color evaluation done by a skin color scale chart (Felix von Luschan skin color chart) and a narrowband reflectance spectrophotometer (Mexameter MX18).Materials and Methods:The participants were evaluated for skin color by using the Felix von Luschan skin color chart (range 1-36) and a narrowband reflectance spectrophotometer (Mexameter MX18) in which the results of the measurements were expressed as Erythema (E) and Melanin (M) indices. Skin color was measured on four different anatomical skin sites from each participant on the medial aspect of the volar and the dorsal regions of both forearms. Results: A total of 208 records from 52 participants were established. The majority of participants (19.2%) were rated with the skin color scale at the number 16 (range 14-33). The mean M plus E, M, and E indices were 498.9 ± 143.9, 230.4 ± 74.4, and 268.5 ± 73.2, respectively. The correlation coefficient between the number on the skin color scale and each index: M plus E, M, and E indices were 0.90, 0.90, and 0.86, respectively, with a statistical significance of P < 0.001.Conclusions:Skin color evaluation using a skin color scale chart has shown a high correlation with skin color evaluation done by the narrowband reflectance spectrophotometer.

The present study examined the effect of bolus viscosity on the onset of laryngeal closure (relative to hyoid elevation), the duration of laryngeal closure, and other key events of swallowing in ten healthy volunteers. All volunteers underwent 320-row area detector computed tomography swallow studies while swallowing 10 ml of honey-thick barium (5 % v/w) and thin barium (5 % v/w) in a 45° reclining position. Three-dimensional images of both consistencies were created in 29 phases at an interval of 0.10 s (100 ms) over a 2.90-s duration. The timing of the motions of the hyoid bone, soft palate, and epiglottis; the opening and closing of the laryngeal vestibule, true vocal cords (TVC), and pharyngoesophageal segment; and the bolus movement were measured and compared between the two consistencies. The result showed differing patterns of bolus movement for thin and thick liquids. With thin liquids, the bolus reached the hypopharynx earlier and stayed in the hypopharynx longer than with thick liquids. Among events of laryngeal closure, only the timing of TVC closure differed significantly between the two consistencies. With thin liquids, TVC closure started earlier and lasted longer than with thick liquids. This TVC movement could reflect a response to the faster flow of thin liquids. The results suggest that bolus viscosity alters the temporal characteristics of swallowing, especially closure of the TVC.

Although oropharyngeal and laryngeal structures are essential for swallowing, the three-dimensional (3D) anatomy is not well understood, due in part to limitations of available measuring techniques. This study uses 3D images acquired by 320-row area detector computed tomography ('320-ADCT'), to measure the pharynx and larynx and to investigate the effects of age, gender and height. Fifty-four healthy volunteers (30 male, 24 female, 23-77 years) underwent one single-phase volume scan (0.35 s) with 320-ADCT during resting tidal breathing. Six measurements of the pharynx and two of larynx were performed. Bivariate statistical methods were used to analyse the effects of gender, age and height on these measurements. Length and volume were significantly larger for men than for women for every measurement (P < 0.05) and increased with height (P < 0.05). Multiple regression analysis was performed to understand the interactions of gender, height and age. Gender, height and age each had significant effects on certain values. The volume of the larynx and hypopharynx was significantly affected by height and age. The length of pharynx was associated with gender and age. Length of the vocal folds and distance from the valleculae to the vocal folds were significantly affected by gender (P < 0.05). These results suggest that age, gender and height have independent and interacting effects on the morphology of the pharynx and larynx. Three-dimensional imaging and morphometrics using 320-ADCT are powerful tools for efficiently and reliably observing and measuring the pharynx and larynx.

Study design: A 6-month prospective design. Objective: To investigate the relationship between ability of obstacle crossing and falls in independent ambulatory participants with spinal cord injury (SCI). Setting: A tertiary rehabilitation center. Methods: Ninety-four participants were evaluated for their SCI characteristics, ability of walking over small obstacles and functional ability relating to dynamic balance control, lower-extremity motor strength (LEMS) and walking ability. Their fall data were then prospectively monitored every month for 6 months. Results: Twenty-four participants failed in obstacle crossing. However, only eight of the thirty-three participants who fell during the follow-up period were unable to clear the obstacle while walking. The LEMS and functional ability of the participants who failed were significantly poorer than those of individuals who passed an obstacle-crossing test (P ⩽ 0.001). For the falls, significant differences between the groups were found only in age and tactile scores. The findings further indicated that failures on obstacle crossing were not significantly associated with falls (P40.05). Conclusion: Ability of obstacle crossing in a closed/controlled environment clearly correlated with intrinsic causes, whereas a fall in an open environment may be associated with not only intrinsic but also extrinsic causes. Therefore, apart from functional ability, rehabilitation professionals may need to consider extrinsic factors around falls in order to manage risk of injury to the patients.