Purpose: Practice pattern studies suggest that liquid modification is currently a primary strategy used by speech-language pathologists to manage dysphagia; however, the breadth of negative consequences associated with their use is not well understood. The purpose of this review was to summarize the evidence on adverse events and effects of thickened liquid (TL) use in adults. Method: Six databases were searched in February 2022: EMBASE, MEDLINE (PubMed), Speechbite, AMED, AgeLine, and CINAHL. Articles were included if they compared adults receiving different TL viscosities and discussed at least one adverse event or effect of consuming TLs. Articles were excluded if they were review articles, rehabilitation studies, rheological analyses, not in English, or not peer reviewed. Screening and data extraction were completed by two independent reviewers. Risk of bias was assessed using Cochrane tools. Results: Thirty-three studies ( N = 4,990 participants across all studies) were eligible for inclusion (2,405 unique records screened). Reported adverse events included dehydration ( n = 5), pneumonia ( n = 4), death ( n = 2), urinary tract infection ( n = 1), and hospitalization ( n = 1); adverse effects included reduced quality of life ( n = 18), aspiration ( n = 12), reduced intake ( n = 8), increased residue ( n = 4), and reduced medication bioavailability ( n = 2). Results were mapped on to codes and domains of the International Classification of Functioning, Disability and Health. Conclusions: A range of adverse outcomes associated with TL use were identified. Adverse outcomes should be monitored and reported in dysphagia research. Given current research evidence, it is vital for clinicians to weigh the risks and benefits of TL use to mitigate potential adverse outcomes.
Purpose: Objective measures of lingual strength are used in both clinical practice and research to provide information regarding the ability of the tongue to contribute to safe and efficient swallowing. The Iowa Oral Performance Instrument (IOPI) is the most frequently used tongue pressure manometer and is considered to be the gold standard. The Tongueometer device was developed to circumvent IOPI shortcomings including bulb slippage, cost, and patient utility. As such, the aims of this pilot study were to examine the validity of the Tongueometer and to obtain comparative adult reference values. Method: Using the Tongueometer, participants completed three trials of anterior and posterior maximum isometric lingual pressure and regular effort saliva swallow tasks. Moreover, 41% of participants also completed all trials using the IOPI. Independent-samples t tests compared maximum means between the IOPI and Tongueometer. Concurrent validity was assessed using Lin's concordance correlations. Associations were evaluated using independent-samples t tests (sex) and Pearson correlation coefficient (age). Results: Seventy-six healthy participants (48 women, 28 men) with no history of swallowing difficulty were included in the study ( M age = 50 ± 21). Across all lingual pressure task measures, mean maximum Tongueometer measures strongly correlated with corresponding IOPI measures (anterior: concordance correlation coefficient [CCC] = 0.74, p < .000; posterior: CCC = 0.81, p < .000; swallow: CCC = 0.62, p < .000). Tongueometer and IOPI mean anterior maximum isometric lingual pressures were not statistically different, whereas posterior lingual pressures and pressures elicited during swallowing were statistically different ( p < .01). A significant negative correlation was found between age and maximum anterior tongue pressure ( r = −.43, p < .01). No significant association of sex on maximum tongue pressure was observed. Conclusion: Overall, this pilot research suggests that the Tongueometer is a valid tool for clinical use in measuring lingual strength and swallowing function.
Purpose Dysphagia is a common symptom of the rare genetic disease oculopharyngeal muscular dystrophy (OPMD). There are, however, limited resources and recommendations for speech-language pathologists who treat individuals with this condition. This review provides a consolidation of the literature to understand how the components and outcomes of intervention for dysphagia rehabilitation are described and studied in adults with OPMD. Method A rapid scoping review was completed to identify studies related to dysphagia interventions for adults with OPMD. Data were extracted and analyzed through the lens of the Rehabilitation Treatment Specification System and the International Classification of Functioning, Disability and Health frameworks. Results A total of eight studies met the review criteria. Six of the studies described rehabilitative interventions, and three focused on outcomes of intervention. Rehabilitation interventions were not described in detail, and a wide variety of outcome measures were used. Conclusions There is limited research to guide clinical decision-making and intervention for dysphagia rehabilitation in OPMD at this time. Neurodegenerative disorder research may be beneficial in guiding clinical practice. Further research is required to determine the most effective interventions for individuals with OPMD.
Purpose: Hydration is essential for health; however, long-term care (LTC) residents consume less fluid than is recommended, which may contribute to dehydration. Residents who drink thickened liquids likely consume even less than peers. Therefore, the aims of this study were to (a) determine if LTC residents who drink thickened liquids consume less fluid compared to those consuming thin liquids and (b) determine factors associated with fluid intake of residents who drink thickened liquids. Method: Participants who drank thickened liquids ( n = 68) were compared with participants who drank thin liquids ( n = 68). Fluid intake, cognition, diet prescription, and mealtime challenges were compared between groups. A stepwise multiple regression model assessed variables associated with fluid intake of residents who consumed thickened fluids. Results: All participants consumed less than recommended fluid volumes. No statistically significant difference was found in fluid intake between groups; however, the group consuming thickened liquids drank less than those consuming thin liquids. The thickened liquid group was also more likely to eat a modified diet, had higher levels of cognitive impairment, and had more mealtime challenges requiring more assistance. As age increased, thickened liquid intake decreased across study participants. Conclusion: These results highlight the need for interventions in LTC to support fluid intake in this vulnerable population.
The purpose of this study was to collate and summarize the content covered in published literature describing speech-language pathology management of adult patients with COVID-19 in the acute hospital setting as of February 2022. This review serves as an updated review of the initial recommendations to guide speech-language pathology management for adults with COVID-19 in the acute hospital setting previously provided by Namasivayam-MacDonald and Riquelme in July of 2020. This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review Extension protocol. We searched for relevant peer-reviewed articles in the following electronic databases: MEDLINE, EMBASE, and CINAHL. The article review process was conducted using Covidence. Our searches yielded a combined total of 3019 unique citations, of which 54 were accepted for full-text review. Thirty-seven of the 54 studies were review articles, recommendations, or opinion pieces. This translates to mostly low levels of evidence (i.e., Levels VI and VII) and a grade of ‘D’ when applying the American Society of Plastic Surgeons grade recommendation scale for evidence-based clinical practice guidelines, meaning there is little or no systematic empirical evidence available. The remaining 17 provided empirical data, which translates to higher levels of evidence and a grade of ‘B’. The empirical data shared in this scoping review provide support for the ongoing role of the SLP in the acute care setting and the impact COVID-19 and its variants have on the underlying systems for communication and swallowing. This document serves as further proof of the need for ongoing research into the clinical presentations of patients with speech-language, cognitive and/or swallowing deficits resulting from COVID-19, as well as into systems of care that will provide the best outcomes in their rehabilitation.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.