Influence of the syringe model on the results of the International Dysphagia Diet Standardisation initiative flow test

Dantas, Roberto Oliveira; Oliveira, Luciana Pissolato de

doi:10.1590/1982-021620182031818

Cited by 7 publications

(10 citation statements)

References 14 publications

(15 reference statements)

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“…Moreover, hardly any outflow was measured in the 10 s test-time for concentrations of PEO above 4% w/w. The 2% w/w PEO solution, the 1% w/w cereal extract solution and the TUC solution (1.19 % w/w) were classified as IDDSI Level 2, the latter in agreement with the level indicated on the package and with the results of other studies 15,16 . Finally, the 0.3% w/w cereal extract was characterized as IDDSI Level 1.…”

Section: Resultssupporting

confidence: 82%

“…Under the IDDSI framework, thickened beverages are classified via a simple gravity discharge test 13 . This flow test has already been considered by several authors [14][15][16][17] , but a relationship between the liquid rheology and the IDDSI scale has not yet been comprehensively investigated. While there is general agreement that texture modified liquids reduce aspiration, but the mechanistic reasons why this occurs are still debated.…”

mentioning

confidence: 99%

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The role of extensional rheology in the oral phase of swallowing: an in vitro study

Marconati

Ramaioli

2020

Food Funct.

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Swallowing disorders deteriorate significantly the quality of life and can be lifethreatening. Texture modification using shear thinning food thickeners have proven effective in the management of dysphagia. Some studies have recently considered the positive role of cohesiveness, but there is still an insufficient understanding of the effect of the rheological properties of the liquid bolus on the dynamics of bolus transport, particularly when elasticity and extensional properties are combined with a shear thinning behaviour. This study combines steady shear, SAOS and capillary breakage extensional rheometry with an in vitro method to characterize the oral transport of elastic liquids. Bolus velocity and bolus length were measured from in vitro experiments using image analysis and related to the shear and extensional properties. A theory describing the bolus dynamics shows that the elastic and extensional properties do not influence significantly the oral transit dynamics. Conversely, in vitro results suggest that the extensional properties can affect the transition from the oral to the pharyngeal phase of swallowing, where thin, viscoelastic liquids lead to a fast transit, lower oral post-swallow residues and more compact bolus with a smoother surface, which may suggest a lower risk of fragmentation. This mechanistic explanation suggests that the benefit of the extensional properties of thin viscoelastic liquids in the management of dysphagia should be further evaluated in clinical trials.

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Section: Resultssupporting

confidence: 82%

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confidence: 99%

The role of extensional rheology in the oral phase of swallowing: an in vitro study

Marconati

Ramaioli

2020

Food Funct.

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“…The IDDSI technical requirements further specify use of a syringe with a barrel length of 61.5 mm (distance from 0 to 10‐ml marking) and a Luer slip tip (central or eccentric syringe nozzle) (Cichero et al, ). Although 10‐ml syringes are commonly available, it is acknowledged that variations in syringe dimensions (such as barrel length) can impact the accuracy of measurement readings in relation to IDDSI guidelines (Alves, Alves, & Dantas, ; Cichero et al, ; Dantas & Oliveira, ). A recent report by Dantas and Oliveira () found higher flow rates (less viscous samples) with an IDDSI correct syringe in comparison to a 10‐ml syringe with a barrel length of 50 mm.…”

Section: Introductionmentioning

confidence: 99%

“…Although 10‐ml syringes are commonly available, it is acknowledged that variations in syringe dimensions (such as barrel length) can impact the accuracy of measurement readings in relation to IDDSI guidelines (Alves, Alves, & Dantas, ; Cichero et al, ; Dantas & Oliveira, ). A recent report by Dantas and Oliveira () found higher flow rates (less viscous samples) with an IDDSI correct syringe in comparison to a 10‐ml syringe with a barrel length of 50 mm. Their study included findings for water and barium samples prepared with a gum thickening agent.…”

Section: Introductionmentioning

confidence: 99%

“…Mildly thick (nectar‐like) consistency also is the most frequently prescribed level of texture modification (Garcia & Chambers, ; Garcia, Chambers, & Molander, ). In contrast to Dantas and Oliveira (), the current project included both starch and gum thickening products given concern about the type of thickening agent (starch vs. gum) and its possible influence on flow characteristics (Kim et al, ). The thickening agent is of additional importance due to reported differences in post swallow residue with starch versus gum thickened liquids (Vilardell, Rofes, Arreola, Speyer, & Clave', ).…”

Section: Introductionmentioning

confidence: 99%

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Gravity flow test comparisons for mildly thick consistency

Garcia

Chambers

Noll

2019

Journal of Texture Studies

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Simple measurement tools that provide objective information about the consistency of thickened liquids have received increasing attention given possible application to clinical practice for dysphagia. The International Dysphagia Diet Standardization Initiative (IDDSI) advocates the use of the IDDSI Flow Test for measuring thickness and verifying a prescribed level of consistency. This study compares gravity flow test measurements taken with two 10‐ml syringes of starch and gum‐thickened samples prepared to a mildly thick consistency using product label information. One of the 10‐ml syringes met IDDSI specification and the other 10‐ml syringe did not. Thickened samples also were measured using the line spread apparatus. The results showed that two syringes yielded significantly different gravity flow test measurements, often resulting in changes to the classification level of thickness. There was no effect of thickening agent. Line spread measurements did not vary from one another. Study findings indicate the importance of continued testing with the IDDSI Flow Test and education/awareness about the use of the IDDSI reference syringe. An essential aspect about the use of thickened liquids in dysphagia management is that beverage preparations represent their prescribed level of modification. The findings of this study indicate the importance of following syringe specifications when conducting gravity flow testing using the IDDSI methodology. The implication is that the wrong 10‐ml syringe could result in errant clinical decisions in determining the accuracy of texture modifications, resulting in care providers who are more likely to over or under thicken modifications to achieve a targeted level of thickness.

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Food Structure Development for Specific Population Groups

Alsanei

Chen

2019

Handbook of Food Structure Development

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The world's population is ageing, and elderly people have become one of the most important target groups for the food industry due to their specific diet requirements. Reduced eating capability and even dysphagia are very common among elderly populations, and therefore appropriate texture design and modification of food and beverages are key for this category of consumers. However, to ensure safe swallowing through the selection of a controlled daily diet with correct consistency and texture is not always an easy task due to the lack of guidance. For this reason, various texture standards have been proposed in different countries in order to protect the health and well-being of these vulnerable populations. Such texture standards include the ones published in the United States, the UK, Australia, and Japan. While these standards serve well in their own countries and cultures, the global inconsistency of food texture becomes a big problem not only to the food industry but also to health care givers. The recently published International Dysphagia Diet Standardisation Initiative (IDDSI) serves as a very practical global standard and has been implemented by professional bodies in many different countries. The last part of the chapter highlights some prominent approaches to texture modification for specific population groups, with special focus on the use of functional ingredients and innovative techniques.

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Influence of the syringe model on the results of the International Dysphagia Diet Standardisation initiative flow test

Cited by 7 publications

References 14 publications

The role of extensional rheology in the oral phase of swallowing: an in vitro study

The role of extensional rheology in the oral phase of swallowing: an in vitro study

Gravity flow test comparisons for mildly thick consistency

Food Structure Development for Specific Population Groups

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