HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal My Folders Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Logemann, J. A. Articles by Miller Gardner, P. J. Search for Related Content PubMed PubMed Citation Articles by Logemann, J. A. Articles by Miller Gardner, P. J. Social Bookmarking                         What's this?

A Randomized Study of Three Interventions for Aspiration of Thin Liquids in Patients With Dementia or Parkinson's Disease

Gary Gensler
The EMMES Corporation, Rockville, MD

JoAnne Robbins
University of Wisconsin, Madison, WI

Anne S. Lindblad
Diane Brandt
The EMMES Corporation, Rockville, MD

Jacqueline A. Hind
William S. Middleton VA Medical Center, Madison, WI

Steven Kosek
Minneapolis VA Medical Center, Minneapolis, MN

Karen Dikeman
Marta Kazandjian
New York Hospital Medical Center – Queens, Flushing, NY

Gary D. Gramigna
VA Boston Healthcare System, Roxbury, MA

Donna Lundy
University of Miami Medical Center, Miami, FL

Susan McGarvey-Toler
Richard L. Roudebush VA Medical Center, Indianapolis, IN

Patricia J. Miller Gardner
Communication Sciences and Disorders Clinical Trials Research Group, American Speech-Language-Hearing Association, Rockville, MD

Contact author: Jeri A. Logemann, Department of Communication Sciences and Disorders, Northwestern University, 2240 Campus Drive, #3-358, Evanston, IL 60208. E-mail: j-logemann{at}northwestern.edu.

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.

KEY WORDS: dementia, Parkinson's disease, aspiration, thickened liquids, posture

CiteULike    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				D. M. Ney, J. M. Weiss, A. J. H. Kind, and J. Robbins Senescent Swallowing: Impact, Strategies, and Interventions Nutr Clin Pract, June 1, 2009; 24(3): 395 - 413. [Abstract] [Full Text] [PDF]

				J. Robbins and J. Hind Overview of Results From the Largest Clinical Trial for Dysphagia Treatment Efficacy Swallowing and Swallowing Disorders (Dysphagia) , June 1, 2008; 17(2): 59 - 66. [Abstract] [Full Text] [PDF]

				J. Robbins, G. Gensler, J. Hind, J. A. Logemann, A. S. Lindblad, D. Brandt, H. Baum, D. Lilienfeld, S. Kosek, D. Lundy, et al. Comparison of 2 Interventions for Liquid Aspiration on Pneumonia Incidence: A Randomized Trial Ann Intern Med, April 1, 2008; 148(7): 509 - 518. [Abstract] [Full Text] [PDF]

				J. Robbins, S. G. Butler, S. K. Daniels, R. Diez Gross, S. Langmore, C. L. Lazarus, B. Martin-Harris, D. McCabe, N. Musson, and J. Rosenbek Swallowing and Dysphagia Rehabilitation: Translating Principles of Neural Plasticity Into Clinically Oriented Evidence J Speech Lang Hear Res, February 1, 2008; 51(1): S276 - S300. [Abstract] [Full Text] [PDF]