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VARIABILITY OF STARCH‐BASED THICKENED DRINKS FOR PATIENTS WITH DYSPHAGIA IN THE HOSPITAL SETTING
Author(s) -
PAYNE CLARE,
METHVEN LISA,
FAIRFIELD CAROL,
GOSNEY MARGOT,
BELL ALAN E.
Publication year - 2012
Publication title -
journal of texture studies
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.593
H-Index - 54
eISSN - 1745-4603
pISSN - 0022-4901
DOI - 10.1111/j.1745-4603.2011.00319.x
Subject(s) - dysphagia , thickening agent , rheology , starch , medicine , rheometer , thickening , viscosity , oropharyngeal dysphagia , materials science , food science , surgery , composite material , polymer science , chemistry
Starch‐based thickening agents may be prescribed for patients with dysphagia. Thickened fluids alter variables of the swallow reflex, allowing more time for bolus manipulation without compromising airway closure. This investigation explored the variation in viscosity and physical characteristics of thickened drinks prepared in different media under laboratory conditions and compared the results with those of thickened drinks presented to dysphagic patients in one hospital. The rheological characteristics were tested on a simple plastometer and a Bohlin CVOR rheometer (Malvern Instruments, Worcestershire, UK). Samples prepared to “syrup” consistency both in the laboratory and in the hospital were significantly different from each other ( P < 0.0001). This was also the case for samples prepared to “custard” consistency. Differences existed not only in viscosity, but drinks prepared in different media produced different rheological matrices. This signifies different viscoelastic behaviors that may effect manipulation in the mouth. From this study, preparation of thickened drinks using starch‐based instant thickening powders appears to be a highly variable practice. PRACTICAL APPLICATIONS The research has highlighted differences in the preparation of thickened drinks for patients with dysphagia among guidelines, descriptors, manufacturers' instruction and actual preparation in the hospital setting. The differences in the final thickness and rheology produced when preparing drinks of different types and temperatures were significant and may have clinical consequences. The results can be used to provide advice and recommendations when preparing drinks in practice.