Bolus Consistency and Swallowing in Children and Adults

Ruark, Jacki L.; McCullough, Gary H.; Peters, Rebecca L.; Moore, Christopher A.

doi:10.1007/s00455-001-0098-0

Cited by 51 publications

(48 citation statements)

References 24 publications

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“…Reasons for referral included choking, coughing, gagging and/or vomiting during or after mealtime, gastroesophageal reflux, chest congestion, upper respiratory infections, or combinations of these concerns. VFSS Procedure Participants 7,8,9,11,12,13 and 15 were seated upright in a Multiple Application Multiple Articulation (MAMA) chair appropriate for infants, toddlers, and children up to 75 lb and 5 ft tall. The MAMA chair fits into standardized fluoroscopy units to allow for feeding and view of the swallow in the lateral projection.…”

Section: Methodsmentioning

confidence: 99%

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Preliminary Temporal Measurement Analysis of Normal Oropharyngeal Swallowing in Infants and Young Children

2010

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Temporal measures of normal pediatric oropharyngeal deglutition have not been studied. Knowledge of range and variation of normative temporal measures could define abnormal deglutition and assist in design of appropriate compensatory and rehabilitative treatment techniques. The purpose of this retrospective study was to determine temporal measurements for oral filling, oral transit, onset of laryngeal closure, time of bolus arrival at the valleculae, pharyngeal delay, pharyngeal transit, and UES opening. Videofluoroscopic swallow studies of 15 normally swallowing pediatric subjects were divided into three age groups and method of liquid delivery. Mean, standard deviation, percentages, and extension of the median were utilized to determine relationships of temporal measures. Mean temporal duration increased with age for oral filling, oral transit time, time of laryngeal closure, UES opening, and pharyngeal delay time. However, no significant differences were found between age groups indicating a deglutitive biomechanical adaptation to growth of the oral and pharyngeal cavity. Feeding method for bottle versus cup mean duration increased for oral transit time, laryngeal closure time, UES opening, and pharyngeal delay time. Bolus head location relative to onset of laryngeal vestibule closure changed with increased age and method of feeding. Temporal measures were not significantly different for age groups or feeding methods. Bolus location was at or fully contained in the valleculae at the onset of laryngeal closure and appeared to be a normal finding in functional pediatric swallows and is not indicative of a delay or disorder.

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Section: Methodsmentioning

confidence: 99%

“…Group II included six children with mean age of 10.80 ± 2.16 months. Ruark et al [11] found that by 5 years of age children have similar swallowing strategies for managing bolus consistency compared to adults. The four children in Group III had deciduous teeth and mean age of 36.00 ± 10.95 months.…”

Section: Operational Definitionsmentioning

confidence: 99%

Preliminary Temporal Measurement Analysis of Normal Oropharyngeal Swallowing in Infants and Young Children

2010

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“…From 10147 search results, 488 articles described a measurement of swallowing using more than one consistency of food or liquid but only 36 met quality criteria and relevance. Thicker liquids were reported to increase the duration of swallowing events in accelerometry [29], electromagnetic articulography [30], ultrasound [31] and surface electromyography signals [32], [33], [34], and also on videofluoroscopy for pharyngeal transit time measures [35], [36], although more recently a study found no effect of thickening on bolus velocity [37]. Regarding dysphagia, several videofluoroscopic studies provided evidence of texture modification having a measurable effect on swallowing efficacy [38], [39], [40], [41], e.g.…”

Section: Clinical Evidence Relating To Texture Modification and Swallmentioning

confidence: 99%

A review of diet standardization and bolus rheology in the management of dysphagia

Hanson

2016

Current Opinion in Otolaryngology & Head and Neck Surgery

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Purpose: Texture modification is a widespread practice as a strategy for the management of dysphagia and can be very effective in individual cases. However, it is often performed in a qualitative, subjective manner and practices vary internationally according to multiple sets of national guidelines. This paper aims to identify best practice by reviewing the theory and practice of texture modification, focussing on recent advances. Recent findings:Instrumental assessment of texture modification in-vivo is challenging, but studies including rheology and perception have indicated that fluid viscosity is only one of many factors affecting texture modification in practice. Systematic reviews have identified a historical lack of high-quality clinical evidence, but recent controlled studies are beginning to identify positive and negative aspects of thickened fluids. Research and practice to date have been limited by the lack of control and standardisation of foods and drinks. However in 2015 a notfor-profit organisation, the International Dysphagia Diet Standardisation Initiative, has published a framework for texture modification from thin liquids to solid foods based on all the existing documentation and guidance, and the -limited-available clinical evidence. Summary:Rheology exists in the lab, however normal practice is often subjective or lacking control and standardisation. In the near future, cohesion of practice and the availability of practical standardisation tools may increase awareness and use of rheology. KeywordsDysphagia, Swallowing, Rheology, Viscosity, Texture modification Key points •The relationships between rheology and swallowing are beginning to be characterised using oral pressure sensing and videofluoroscopy, together with careful control of bolus rheology.• It is becoming clearer that viscosity alone is not sufficient to categorise texture modification.• Literature to date shows a trend for reduced aspiration with increased thickness of liquids, and increased residue with some thicker consistencies, however evidence is scarce.• An inconsistent approach to definition of texture modification techniques has been limiting the collation of a coherent evidence base.• A new international standard (IDDSI) has been created, drawing on available evidence and including practical objective measures.

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“…It has been established that children use a similar swallowing method to adults from the age of five, and it has also been suggested that children under six years old find it harder to swallow tablets and capsules 12, 13. Despite this, it has been shown that preschool children can swallow tablets at the age of three, with training 14, and our study also found that preschool children could often swallow tablets and capsules before the use of the in situ coating.…”

Section: Discussionmentioning

confidence: 99%

In situ coating makes it easier for children to swallow and tolerate tablets and capsules

2015

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AimGetting children to swallow tablets and capsules is a challenge, and factors that influence their ability to swallow include taste, smell and texture. The aim of this study was to explore how well paediatric patients tolerated and accepted the MedCoat® in situ coating for tablets and capsules.MethodsA nonrandomised intervention study was performed at the Astrid Lindgren Children′s Hospital, Karolinska University Hospital, Sweden. We identified 78 paediatric patients, 43 females and 35 males, who had problems swallowing tablets and capsules and evaluated their abilities with questionnaires. The median age of the patients was nine years old, and the range was two to 17 years old.ResultsSwallowing ability and palatability was improved by in situ coating. The results showed that 66 of 77 paediatric patients (86%, 95% confidence interval: 76–93%) were able to take the drugs they had been prescribed after in situ coating. Swallowing improved in 87% of cases, and palatability improved in 85% of cases.ConclusionA study of 77 paediatric patients with a median age of nine years, and a range of two to 17 years, found that 86% were able to take the tablets and capsules they had been prescribed after they were coated with the MedCoat.

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Bolus Consistency and Swallowing in Children and Adults

Cited by 51 publications

References 24 publications

Preliminary Temporal Measurement Analysis of Normal Oropharyngeal Swallowing in Infants and Young Children

Preliminary Temporal Measurement Analysis of Normal Oropharyngeal Swallowing in Infants and Young Children

A review of diet standardization and bolus rheology in the management of dysphagia

In situ coating makes it easier for children to swallow and tolerate tablets and capsules

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