| 저자 |
Dasom Yoon1*, Hyun Hwa Bae1, You Min Lee2, Seung A Jeong2, Hoon Tae Kwon2, Si Hyun Kang1, Jaewon Beom1, Kyung-Mook Seo1, Don-Kyu Kim1† |
Objective This study is to evaluate the suitability of the liquid test foods which were developed for different levels according to the International Swallowing Disorder Standardization (IDDSI) framework. Our hypothesis was that test foods of different levels would show different swallowing parameters that can be grouped accordingly.
Methods The samples of 0-4 levels (total 5 levels) were produced and those samples underwent viscosity measurement and IDDSI flow test to determine whether the sample was properly made according to the level of IDDSI framework. The subjects including 30 young adults and 30 elderly were participated. All subjects were evaluated for dentition status as well as age, sex salivary flow rate and tongue pressure measurement etc. The questionnaire of mastication and swallowing function and the questionnaire of a four-step mastication stages flow chart of UDF were conducted with all the participants. Subjects assessed for aroma, flavor, overall acceptance on a 6-point scale of sensory evaluation. Five kinds of flavor (apple, grape, yogurt, orange, red ginseng, no added) were added to the samples and tested. The samples in each level (0-4) were provided twice to each subject during VFSS test. Bolus transit times such as post‐faucial aggregation time (PFAT), vallecular aggregation time (VAT) and first subsequence duration were used for VFSS analysis.
Results
The results of the viscosity and the IDDSI flow test of the final sample are shown in Table 1. It presented that these samples of each level were suitable for the liquid level (0-4) of IDDSI framework. The age of young adult and elderly group was 25.90±3.32 years and 76.20±5.18 years respectively. All the subject had more than 20 teeth. In response of questionnaire of mastication and swallowing function, there were 8 elderly subjects who expressed functional decline in the mastication, but none in the young adult group. In the sensory evaluation, the samples with apple flavor added were obtained the highest score in both young adult (3.13±1.11) and the elderly group (3.83±1.21), and conventional samples with no added flavor sample showed the lowest preference (1.18±1.21). Among the developed samples of 0-4 IDDSI level, the samples of 0, 3, and 4 level showed significant(p<0.05) difference in VFSS parameters such as first subsequence duration and total duration but there were no significant differences between 0,1,2 level. All developed samples have improved adhesiveness compared to commonly used as test diets in hospitals such as yogurt with mixed barium.
Conclusion We have developed barium mixed test diet in accordance with IDDSI framework. Among the developed test diets, level of 0, 3 and 4 are expected to be key samples of the VFSS test because these test sample showed significant differences in the swallowing parameters and our results may be helpful for making optimal test diet protocols and providing more accurate results of VFSS. |
