aim measure dose-response of barium materials used for dysphagia diagnosis and treatment planning

This article and any supplementary material should be cited as follows: Hind J, Divyak E, Zielinski J, Taylor A, Hartman M, Gangnon R, Robbins J. Comparison of standardized bariums with varying rheological parameters on swallowing kinematics in males. J Rehabil Res Dev. 2012;49(9):1399–1404. http://dx.doi.org/10.1682/JRRD.2011.09.0180

Slideshow ProjectDOI:10.1682.JRRD.2011.09.0180JSP

Comparison of standardized bariums with varying rheological

parameters on swallowing kinematics in males

Jacqueline Hind, MS, CCC-SLP, BRS-S; Elizabeth Divyak, MS, CCC-SLP; Jill Zielinski, MS, CCC-SLP; Andrew Taylor, MD; Michael Hartman, MD;

Ronald Gangnon, PhD; JoAnne Robbins, PhD, CCC-SLP, BRS-S



• Aim– Measure dose-response of barium materials used for

dysphagia diagnosis and treatment planning.– Help radiologists, speech-language pathologists, and

other medical professionals make informed decisions regarding safest barium materials to use during videofluoroscopic swallow studies (VFSSs).

• Relevance– While modifying textures is common to prevent

aspiration of food and liquids, debate surrounds unified terminology and standardized rheological properties.



Method• 16 adult males representing various medical

diagnoses qualified to complete VFSSs.– Tested with liquid barium of three viscosities:

• Nectar: 300 cP.• Thin honey: 1,500 cP.• Thick honey: 3,000 cP.

• Outcome measures included:– Airway invasion (Penetration-Aspiration Scale).– Postswallow residue.– Patient preference.



Results• Penetration-Aspiration and residue:

– No significant difference observed between thin and thick honey.

– Significantly more severe airway invasion with nectar than with thin or thick honey.

– Significantly more residue in oral cavity and valleculae with thin and thick honey than with nectar.

• Patient preference:– 67% rated thin honey as “easy” or “average” to drink

(vs 54% for thick honey).



Mean Penetration/Aspiration Scale (Pen/Asp) scores for liquid bariums of different viscosities. Higher scores represent more severe airway invasion.



Conclusion

• This study supports use of thin honey barium over thick honey barium during VFSSs.– The 2 honey bariums were comparable in airway

protection and postswallow residue in oropharynx.

• Thin honey was preferred by patients.

aim measure dose-response of barium materials used for dysphagia diagnosis and treatment planning

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