Limits...
Variations in tongue-palate swallowing pressures when swallowing xanthan gum-thickened liquids.

Steele CM, Molfenter SM, Péladeau-Pigeon M, Polacco RC, Yee C - Dysphagia (2014)

Bottom Line: The viscosity differences between these nectar- and honey-thick stimuli were confirmed to exceed sensory perceptual discrimination thresholds.Data were collected from 78 healthy adults in two sex-balanced age-groups (young; mature) and compared to reference values obtained during water swallowing.Age-related reductions were seen in tongue strength but not in swallowing pressures, which fell below 40 % of maximum isometric pressure values.

View Article: PubMed Central - PubMed

Affiliation: Toronto Rehabilitation Institute - University Health Network, 550 University Avenue, #12-101, Toronto, ON, M5G 2A2, Canada, catriona.steele@uhn.ca.

ABSTRACT
Thickened liquids are frequently recommended to reduce the risk of aspiration in patients with oropharyngeal dysphagia. Although it has previously been reported that tongue-palate pressures increase when swallowing spoon-thick and semi-solid consistencies compared to thin liquids, relatively little is known about how swallowing behaviors differ when swallowing liquids of nectar- or honey-thick consistency. Furthermore, previous studies have primarily used starch-based thickeners, and little is known about swallowing behaviors with xanthan gum-thickened liquids, which have recently been introduced for dysphagia management. In this study, we measured variations in tongue-palate pressures during the swallowing of liquids thickened to apparent viscosities of 190, 250, and 380 mPa s at 50/s using increasing concentrations of xanthan gum (0.5, 0.63 and 0.87 w/w%). The viscosity differences between these nectar- and honey-thick stimuli were confirmed to exceed sensory perceptual discrimination thresholds. Data were collected from 78 healthy adults in two sex-balanced age-groups (young; mature) and compared to reference values obtained during water swallowing. The results confirm that increased amplitudes of tongue-palate pressure were used when swallowing the thickened liquid stimuli, compared to swallows of water, and for the honey-thick liquid compared to the two nectar-thick liquids. Age-related reductions were seen in tongue strength but not in swallowing pressures, which fell below 40 % of maximum isometric pressure values. Thus, the use of xanthan gum-thickened liquids is unlikely to tax the swallowing system in terms of tongue pressure generation requirements, even in seniors with reduced maximum isometric tongue pressure measures.

No MeSH data available.


Related in: MedlinePlus

Stimulus differences in tongue-palate pressure decay for thickened liquids. A pattern of more rapid pressure decay for thicker liquids was seen, with significantly faster pressure decay (p < 0.05) for the 380 mPa s stimulus compared to the 190 mPa s liquid
© Copyright Policy - OpenAccess
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4247849&req=5

Fig4: Stimulus differences in tongue-palate pressure decay for thickened liquids. A pattern of more rapid pressure decay for thicker liquids was seen, with significantly faster pressure decay (p < 0.05) for the 380 mPa s stimulus compared to the 190 mPa s liquid

Mentions: The rate-of-pressure-increase for swallows of the three-thickened liquids showed no significant difference across stimuli, averaging 117 % of the values seen for water swallows (95 % CI 105–129 %). This contrasted with a significant main effect of stimulus for the rate-of-pressure-decay, [F(2, 807.1) = 3.2, p = 0.041, d = 0.19, i.e., small effect size], in which lower values of pressure decay (i.e., more gradual) were seen for the 190 mPa s liquid compared to the 380 mPa s liquid (see Fig. 4). Rates-of-pressure-decay increased gradually with increasing viscosity, with the combined 95 % CIs spanning 107–146 % of the values seen during water swallows.Fig. 4


Variations in tongue-palate swallowing pressures when swallowing xanthan gum-thickened liquids.

Steele CM, Molfenter SM, Péladeau-Pigeon M, Polacco RC, Yee C - Dysphagia (2014)

Stimulus differences in tongue-palate pressure decay for thickened liquids. A pattern of more rapid pressure decay for thicker liquids was seen, with significantly faster pressure decay (p < 0.05) for the 380 mPa s stimulus compared to the 190 mPa s liquid
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4247849&req=5

Fig4: Stimulus differences in tongue-palate pressure decay for thickened liquids. A pattern of more rapid pressure decay for thicker liquids was seen, with significantly faster pressure decay (p < 0.05) for the 380 mPa s stimulus compared to the 190 mPa s liquid
Mentions: The rate-of-pressure-increase for swallows of the three-thickened liquids showed no significant difference across stimuli, averaging 117 % of the values seen for water swallows (95 % CI 105–129 %). This contrasted with a significant main effect of stimulus for the rate-of-pressure-decay, [F(2, 807.1) = 3.2, p = 0.041, d = 0.19, i.e., small effect size], in which lower values of pressure decay (i.e., more gradual) were seen for the 190 mPa s liquid compared to the 380 mPa s liquid (see Fig. 4). Rates-of-pressure-decay increased gradually with increasing viscosity, with the combined 95 % CIs spanning 107–146 % of the values seen during water swallows.Fig. 4

Bottom Line: The viscosity differences between these nectar- and honey-thick stimuli were confirmed to exceed sensory perceptual discrimination thresholds.Data were collected from 78 healthy adults in two sex-balanced age-groups (young; mature) and compared to reference values obtained during water swallowing.Age-related reductions were seen in tongue strength but not in swallowing pressures, which fell below 40 % of maximum isometric pressure values.

View Article: PubMed Central - PubMed

Affiliation: Toronto Rehabilitation Institute - University Health Network, 550 University Avenue, #12-101, Toronto, ON, M5G 2A2, Canada, catriona.steele@uhn.ca.

ABSTRACT
Thickened liquids are frequently recommended to reduce the risk of aspiration in patients with oropharyngeal dysphagia. Although it has previously been reported that tongue-palate pressures increase when swallowing spoon-thick and semi-solid consistencies compared to thin liquids, relatively little is known about how swallowing behaviors differ when swallowing liquids of nectar- or honey-thick consistency. Furthermore, previous studies have primarily used starch-based thickeners, and little is known about swallowing behaviors with xanthan gum-thickened liquids, which have recently been introduced for dysphagia management. In this study, we measured variations in tongue-palate pressures during the swallowing of liquids thickened to apparent viscosities of 190, 250, and 380 mPa s at 50/s using increasing concentrations of xanthan gum (0.5, 0.63 and 0.87 w/w%). The viscosity differences between these nectar- and honey-thick stimuli were confirmed to exceed sensory perceptual discrimination thresholds. Data were collected from 78 healthy adults in two sex-balanced age-groups (young; mature) and compared to reference values obtained during water swallowing. The results confirm that increased amplitudes of tongue-palate pressure were used when swallowing the thickened liquid stimuli, compared to swallows of water, and for the honey-thick liquid compared to the two nectar-thick liquids. Age-related reductions were seen in tongue strength but not in swallowing pressures, which fell below 40 % of maximum isometric pressure values. Thus, the use of xanthan gum-thickened liquids is unlikely to tax the swallowing system in terms of tongue pressure generation requirements, even in seniors with reduced maximum isometric tongue pressure measures.

No MeSH data available.


Related in: MedlinePlus