Platos de base proteica con textura segura para personas con parálisis cerebral: diseño, elaboración y vida útil

Abstract

Strategies to manage oropharyngeal dysphagia (OD) associated with cerebral palsy (CP) include feeding based on texture-modified dishes (TMD). Although several studies have been conducted on specific foods, little is known about the characteristics of TMDs from an analytical and technological point of view. Therefore, the objectives of the present tesis were (1) to establish the textural characteristics of TMDs intended for DO, (2) to develop a method to elaborate DOoriented TMDs associated with CP, and (3) to define the sensory characteristics and acceptability of CP-oriented TMDs. Finally, it was considered opportune (4) to carry out a literatura review of the instrumental and sensory methods frequently used in the textural analysis of foods intended for OD in order to identify the most suitable ones for the clinical and technological fields. For the instrumental characterization of TMDs suitable for OD, it resorted to viscometer and texturometer analysis at different speeds. For the design of CP-associated OD-oriented TMDs, a method of cooking, grinding and mixing with food additives was developed to make them thermostable and with a longer shelf life. Five dishes commonly found in the diet of people with CP were texturized and analyzed instrumentally with a texturometer (5 mm/s) and by descriptive sensory analysis with expert OD speech therapists. Acceptance by people affected with OD and CP and the general and particular characterization of each TMD were also evaluated using nonexpert judges, consumers, by means of the Check-all-that-apply (CATA) method. As for the systematic review, the PRISMA method was applied. A classification of viscosity and texture into three levels of TMD was established. Five TMDs were generated and classified as suitable by the expert in OD speech therapists, their main characteristics being: low levels of firmness, adhesiveness and residue, medium values of cohesiveness and high values of fluidity and suitable texture score. In addition, they were accepted by people with OD and CP. Attributes were identified to define in a general or particular way the different dishes. Finally, methods and their parameters were proposed for different types of dysphagia foods, solid, semisolid or liquid. It is necessary to continue researching and generating new TMDs with nutritional and organoleptic characteristics appropriate to the requirements of people with CP-associated OD. This will require the development of standardized characterization methods, in a consensual and multidisciplinary way, in order to facilitate the work in the OD food industry and in the clinical and research fields.