[Purpose] The purpose of this study was to develop a new paste food suitable for the dysphagia characteristics of dysphagic patients with severe motor and intellectual disabilities.
[Subjects] Of the dysphagic patients with severe motor and intellectual disabilities who came to our hospital as an outpatient with a chief complaint of dysphagia, a total of 20 who were confirmed as having clinical aspiration symptoms while eating conventional paste food were enrolled in the study.
[Method]
1. The findings of a total of 14 patients who were confirmed as showing aspiration of solid examination diet (jelly, gel, conventional paste) by videofluoroscopic swallow study were examined to analyze the dysphagia.
2. A new paste food, “Fluffy paste food”, the physical properties of which were designed to compensate for the shortcomings of each examination diet confirmed with aspiration by videofluoroscopic swallow study, was developed.
3. A clinical assessment of eating scenes was conducted by continuously using the cervical auscultation method and monitoring the percutaneous arterial blood oxygen saturation (SpO2).
4. The physical properties of each examination diet, traditional paste food, and the new paste food were measured.
5. A hearing survey on the clinical condition and outcome at one year later was conducted for the 20 patients.
[Results]
1. The following findings were observed as a result of analyzing the aspiration patterns of solid examination diet. The whole or a portion of a separated bolus of food ran into the trachea. A portion of the bolus of food was broken into pieces during swallowing and ran into the trachea. The bolus of food remaining at the pharynx got mixed with saliva and induced aspiration.
2. The new paste food, the physical properties of which were designed to compensate for the shortcomings of each examination diet confirmed with aspiration by videofluoroscopic swallow study, was developed with two kinds of thickeners and water mixed into the foodstuff.
3. A clinical assessment using the cervical auscultation method and SpO2 monitoring revealed that aspiration symptoms while eating the new paste food were reduced in all cases and thus the food was judged to be safer than the previous paste food.
4. As a result of physical property measurements, the new paste food showed a hardness of 3,500-8,500
N/m2, stickiness of 500-1,500 J/m3, cohesiveness of 0.55-0.6, and higher hardness and stickiness than
the previous paste food.
5. The outcome at one year later proved to be effective in terms of either fever frequency or absorption frequency based on the fact that 16 patients were able to continue oral eating.
[Conclusion] A new paste food, “Fluffy paste food”, which was developed by analyzing the findings of a videofluoroscopic swallow study of patients with severe motor and intellectual disabilities, was found by clinical evaluation to be safer for dysphagic patients with severe motor and intellectual disabilities.
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