In this article, the author presents a model that demonstrates that viscosity is an important variable in all aspects of the dysphagia evaluation and management. Data are presented that show that clinicians do not provide close control of this important variable. As a consequence, clinicians are at risk for producing diagnostic and management errors. The author summarizes the “dilution curve” method for creating viscosity-accurate test materials and reviews the status of research for developing viscosity standards for thickened liquids.
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References
1.
MillerBF: Encyclopedia and Dictionary of Medicine. Nursing and Allied Health. WB Saunders Company, Philadelphia, 1972.
2.
SchrammG: Introduction to Practical Viscometry. Gebruder HAAKE GmbH, West Germany, 1981.
3.
LiMGrasseurJGKernMK: Viscosity measurements of barium sulfate mixtures for use in motility studies of the pharynx and esophagus. Dysphagia7:17–30, 1992.
4.
CurranJGroherM: Development and dissemination of an aspiration risk reduction diet. Dysphagia5:6–12, 1990.
5.
GroherM: Management: General principles and guidelines. Dysphagia6:67–70, 1991.
6.
LogemannJ.Evaluation and Treatment of Swallowing Disorders. Pro-Ed, Austin, TX, 1983.
7.
MartinAW: Dietary management of swallowing disorders. Dysphagia6:129–134, 1991.
8.
StanekKHensleyCVan RiperC: Factors affecting use of food and commercial agents to thicken liquids for individuals with swallowing disorders. J Am Diet Assoc92:488–490, 1992.
9.
GroherM: Dysphagia Diagnosis and Management. Butterworths Publishers, Stoneham, MA, 1984.
10.
O'GaraJA: Dietary adjustments and nutritional therapy during treatment for oral-pharyngeal dysphagia. Dysphagia4:209–212, 1990.
11.
FinestoneHMGreene-FinestoneLSWilsonES: Malnutrition in stroke patients on the rehabilitation service and at follow-up: Prevalence and predictors. Arch Phys Med Rehabil76:310–316, 1995.
12.
PardoeEM: Development of a multistage diet for dysphagia. J Am Diet Assoc93:568–571, 1993.
13.
MillsRHDaubertCRStewmanDY: Control of viscosity in modified barium swallow examinations. Dysphagia: In press.
14.
BrownAMillsRHDaubertCR: Establishing labels and standards for thickened liquids in the dysphagia diet. Consult Diet23(2):1–5, 1998.
15.
FeltPMillsRHAndersonC: The national dysphagia diet project: The science behind the practice. Seminar at the American Speech-Language and Hearing Association Convention. San Antonio, TX, November 1998.