ORCID Profile
0000-0002-9330-0402
Current Organisation
Royal Brisbane and Women's Hospital
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Publisher: Wiley
Date: 07-02-2019
Abstract: The need for effective compensatory strategies in neurogenic dysphagia management has led to the exploration of sensory enhancement strategies (SES), such as carbonated liquids. Despite some positive findings, evidence related to the efficacy of carbonation as an SES is limited. To determine if carbonated thin liquids reduced dysphagia symptoms and to explore clinical factors associated with response to carbonation. Participants (n = 29) with neurogenic dysphagia demonstrating deep penetration or aspiration on thin liquids during videofluoroscopic swallow studies (VFSS) completed a set protocol: discrete sips of non-carbonated thin fluids (DS-NC) followed by discrete sips of carbonated thin fluids (DS-C) and then consecutive sips of carbonated fluids (CS-C). The impact of carbonation was identified through changes to swallow physiology (videofluoroscopy dysphagia scale-VDS) and depth of airway compromise (penetration-aspiration scale-PAS). Demographic variables including genetic taste type, cranial nerve function and key results from the VDS were examined for association with carbonation response using both in idual parameter analysis and exploratory cluster analysis. Significant (p < 0.05) improvements in PAS scores were noted in DS-C and CS-C conditions compared with DS-NC. Total VDS score was also significantly (p < 0.05) reduced (i.e., improved function) in the DS-NC condition. In idual variability in response to carbonation was noted and no clear clinical factors associated with carbonation response in the current set of parameters were identified. Findings support that carbonated thin fluids sometimes result in neurogenic dysphagia symptom reduction. However, identifying the clinical characteristics of patients who may benefit from trials of carbonation needs further investigation.
Publisher: Springer Science and Business Media LLC
Date: 10-2020
DOI: 10.1007/S00455-016-9747-1
Abstract: Whilst some research evidence supports the potential benefits of sensory enhancement strategies (SES) in dysphagia management, there is limited understanding of how SES are used in clinical services and the influencing drivers involved in selection during instrumental assessment. SES include modification of temperature, flavour, texture, chemesthetic qualities and bolus size of food/fluid. This study aimed to explore the use of SES within Australian Videofluoroscopic Swallow Study (VFSS) clinics providing adult services, via a qualitative methodology. Maximum variation s ling was used to select a cross section of speech-language pathologists (SLPs) with a range of experience working within 16 VFSS clinics across metropolitan and regional settings to participate in semi-structured, focus group or in idual teleconference interviews. Content analysis of interview transcripts was conducted, with four themes emerging as influencing drivers of SES use, including: Patient factors influence SES use Clinician factors influence SES use Trials of SES require planning and organisation, and Organisational barriers impact on SES use. These four themes were all connected through a single integrative theme: Extensive variations of SES procedures exist across clinical settings. Findings indicate that achieving alignment of clinical purpose and implementation of practices amongst VFSS clinicians will be complex given current ersity in SES use. Organisational issues and clinician training need to be addressed, and more research is needed to provide a stronger evidence base to inform clinical practice in this emerging area of dysphagia management.
Publisher: American Speech Language Hearing Association
Date: 09-08-2019
DOI: 10.1044/2019_AJSLP-19-0045
Abstract: Existing studies examining the effect of carbonated fluids on swallow physiology under videofluoroscopy (videofluoroscopic swallowing studies [VFSSs]) have significant variability across the fluids tested and limited consideration of the stability of the carbonation or fluid palatability. This study compared the effervescence behavior, carbonation intensity (sour, bite, bubble), palatability, and sip volumes of carbonated liquids as used in VFSSs and control s les. Forty-two healthy women (20 supertasters, 22 nontasters 20–61 years old) took sips of 4 different liquids (water, carbonated water, barium sulfate with sodium bicarbonate granules, and barium sulfate with carbonated water) across 2 time conditions (on preparation and 5 min postpreparation). The 8 conditions were presented in 100-ml amounts, in randomized order. At presentation of each fluid, participants immediately rated effervescence via visual inspection. Then after sips of each fluid, participants rated perceived intensity of sour, “bubbles” and “bite,” and palatability. Sip size was derived from residual volumes. Participant perceptions of fluids were also collected. The effervescence of barium sulfate with sodium bicarbonate granules, as used in the majority of published studies, was most impacted by time ( p .05), rated poorly for palatability, and had the largest impact on sip size ( p .05). Participant comments regarding the VFSS fluids were grouped in 4 themes: (a) adverse/other reactions, (b) awareness of sensory properties, (c) physiological reactions, and (d) swallow changes. The significant differences between liquids regarding effervescence behavior, impact of preparation time, palatability, impact on naturalistic sipping, and patient perceptions warrant consideration when testing carbonated fluids during videofluoroscopy.
No related grants have been discovered for Leisa Turkington.