Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Dec;6(4):220-226.
doi: 10.1007/s40141-018-0197-6. Epub 2018 Aug 25.

Thickened Liquids for Dysphagia Management: a Current Review of the Measurement of Liquid Flow

Carly E A Barbon  1   2 , Catriona M Steele  1   2
Affiliations

Thickened Liquids for Dysphagia Management: a Current Review of the Measurement of Liquid Flow

Carly E A Barbon et al. Curr Phys Med Rehabil Rep. 2018 Dec.

Abstract

Purpose of review: The use of thickened liquids has become one of the most common management strategies for individuals with dysphagia. The purpose of this paper is to review methods that can be used to measure the flow characteristics of liquids used in dysphagia management. We describe the measurement of apparent viscosity, measures of extensional flow, slump tests (specifically the line-spread test and Bostwick consistometry), gravity flow tests, and subjective methods.

Recent findings: We discuss the relationship between different approaches to measuring flow, the 2002 American National Dysphagia Diet and the 2017 International Dysphagia Diet Standardisation Initiative (IDDSI) framework. A comparison of test results across four methods is provided.

Summary: A consistent approach is needed for the measurement of flow for thickened liquids used in dysphagia management. This review highlights differences that can be expected across different flow testing methodologies. Adherence to a common method and measurement definitions will promote patient safety and facilitate future research regarding the effectiveness of texture modification as an intervention for dysphagia.

Keywords: Deglutition; Deglutition disorders; Dysphagia; Texture modification; Thickened liquids; Viscosity.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Carly E. A. Barbon declares no conflicts of interest.Catriona M. Steele serves as a board member for the International Dysphagia Diet Standardisation Initiative and has received speaker fees/travel expense support from International Dysphagia Diet Standardisation Initiative.

Figures

Fig. 1
Fig. 1
Comparison of average flow results for the line-spread test, Bostwick, and IDDSI flow test
See this image and copyright information in PMC

References

    1. Cichero JAY, Steele CM, Duivestein J, Clave P, Chen J, Kayashita J, et al. The need for international terminology and definitions for texture modified foods and thickened liquids used in dysphagia management: foundations of a global initiative. Curr Phys Med Rehabil Rep. 2013;1(4):280–91. 10.1007/s40141-013-0024-z. http://link.springer.com/article/10.1007%2Fs40141-013-0024-z

      Paper describing variation in terminology around the world used to describe categories of food texture and liquid consistency for use in dysphagia management, illustrating the need for standard terms and measurement.

    1. Garcia JM, Chambers E, Molander M. Thickened liquids: practice patterns of speech-language pathologists. Am J Speech Lang Pathol. 2005;14(1):4–13. - PubMed

    1. Logemann JA, Gensler G, Robbins J, Lindblad AS, Brandt D, Hind JA, et al. A randomized study of three interventions for aspiration of thin liquids in patients with dementia or Parkinson’s disease. J Speech Lang Hear Res. 2008;51(1):173–83.

      Largest known randomized trial of the effect of liquid consistency on aspiration rates in people with dysphagia (dementia or Parkinson’s Disease), compared directly within a videofluoroscopy exam. Efficacy of thickened liquids for eliminating aspiration in this population was determined.

    1. Steele CM, Alsanei WA, Ayanikalath S, Barbon CE, Chen J, Cichero JA, et al. The influence of food texture and liquid consistency modification on swallowing physiology and function: a systematic review. Dysphagia. 2015;30(1):2–26. 10.1007/s00455-014-9578-x. http://bit.ly/1wvZydp

      Systematic review of > 10,000 references from the medical and engineering scientific literature regarding the influence of liquid consistency and food texture on swallowing function and physiology. Findings include evidence that thicker liquids do help to decrease aspiration. However, evidence was also found that residue begins to accumulate when liquids are too thick.

    1. American Dietetic Association National Dysphagia Diet Task Force. National Dysphagia Diet: standardization for optimal care. Chicago: Faulhaber, D; 2002.

LinkOut - more resources