A randomized study of three interventions for aspiration of thin liquids in patients with dementia or Parkinson's disease.
Logemann Jeri A, Gensler Gary, Robbins Joanne, Lindblad Anne S, Brandt Diane, Hind Jacqueline A, Kosek Steven, Dikeman Karen, Kazandjian Marta, Gramigna Gary D, Lundy Donna, McGarvey-Toler Susan, Miller Gardner Patricia J
Journal of speech, language, and hearing research : JSLHR · 2008 · PMID 18230864 · 인용 418
PURPOSE: This study was designed to identify which of 3 treatments for aspiration on thin liquids-chin-down posture, nectar-thickened liquids, or honey-thickened liquids-results in the most successful immediate elimination of aspiration on thin liquids during the videofluorographic swallow study in patients with dementia and/or Parkinson's disease.
METHOD: This randomized clinical trial included 711 patients ages 50 to 95 years who aspirated on thin liquids as assessed videofluorographically. All patients received all 3 interventions in a randomly assigned order during the videofluorographic swallow study.
RESULTS: Immediate elimination of aspiration on thin liquids occurred most often with honey-thickened liquids for patients in each diagnostic category, followed by nectar-thickened liquids and chin-down posture. Patients with most severe dementia exhibited least effectiveness on all interventions. Patient preference was best for chin-down posture followed closely by nectar-thickened liquids.
CONCLUSION: To identify best short-term intervention to prevent aspiration of thin liquid in patients with dementia and/or Parkinson's disease, a videofluorographic swallow assessment is needed. Evidence-based practice requires taking patient preference into account when designing a dysphagic patient's management plan. The longer-term impact of short-term prevention of aspiration requires further study.