We conducted sensory evaluation and physical property measurements to determine the usefulness of commercially available “Universal Design Food” (UDF). We also analyzed general foods (handmade foods) as a control. The test foods were okayu (rice porridge) and bread, which are frequently consumed food items. The sensory evaluation was performed on 46 healthy adult volunteers who were involved in the development of food items and nursing care food items. They evaluated six items each in two categories: ease of eating and taste. The physical property measurements included investigation of the hardness, cohesiveness, and adhesiveness.

　The rice porridge was tested as follows: the sensory evaluation was performed twice 60 min after preparation, and the physical property measurements were conducted by measuring the longitudinal changes that took place at 20℃ and 45℃. The results of the sensory evaluation showed that the UDF received higher evaluations for ease of eating than the food items prepared in saucepans or general food items. They also showed that in terms of taste, the handmade food items (rice cooker and saucepan) were evaluated higher than the UDF. Examination of the longitudinal changes of the handmade food items showed that there were problems at the time the foods were provided for consumption, but that the UDF underwent fewer longitudinal changes than the general food items, which indicates that the users were less worried about consuming UDF.

　The types of bread tested were sliced bread, milk bread, and paste/mousse consistency bread. Each of these forms of the UDF and the general items were compared. The results of the sensory evaluation showed that the UDF was evaluated higher than the general items in terms of ease of eating, but that the general items tended to be rated higher for taste. The fact that the food forms that the user based on their personal dietary experiences were rated as tasting better indicates the importance of improving ease of eating while simultaneously maintaining the taste and appearance/image of the food item.

　In the case of the UDF, we also found that factors such as the stickiness and effect on longitudinal changes were adjusted in addition to hardness. This can be interpreted as indicating the importance of increasing the precision of the sensory evaluation in addition to the physical property measurements.

　Background and aims:　We enrolled elderly patients to perform head flexion exercises and investigated their effects on swallowing ability.

　Methods:　Subjects were assigned alternately to the intervention group and the control group in the order of hospitalization. The intervention group performed repeated head flexion exercises in the supine position for 2 weeks. The control group was limited to normal rehabilitation, with no intervention for swallowing ability or function. The primary outcome was repeated swallowing of saliva three times, and the secondary outcomes were tongue pressure, jaw-opening force, and oral quality of life. The change in the outcome index before and after the intervention was examined by analysis of variance by repeated measurement of two factors and the paired t-test.

　Results:　Only the intervention group showed a significantly reduced outcome index for repeated swallowing of saliva three times and significantly increased tongue pressure and jaw-opening force. Oral quality of life did not significantly differ between the groups. Head flexion exercises are an effective method for improving swallowing ability.

　Conclusion:　Head flexion exercises were shown to be an effective exercise method for improving swallowing ability.

　Purpose:　Dealing with dysphagia in elderly people requiring support and care who use daytime rehabilitation services is important in terms of supporting them to continue a stable life at home, and appropriate swallowing assessment is required for this purpose. The aim of this study was to identify the factors that influence the risk of dysphagia among users of daytime rehabilitation services and to clarify the relationship between such factors and the combination of screening that appropriately assesses individual ability, in addition to understanding the risk of dysphagia among the users.

　Methods:　The results of three types of swallowing assessments, basic information, and related factors were examined in subjects aged 65 years and older who used a facility between January 2016 and April 2021.

　Results:　There were 81 subjects with a mean age of 82.3 years. The results of the swallowing assessments showed that 29.6% of the subjects had a risk of dysphagia on both the Seirei questionnaire and MMASA, and 42.0% on the RSST. The Seirei questionnaire had the highest percentage of respondents with severe symptoms of nutritional status, and the MMASA had the lowest percentage of gag reflex scores. In addition, the judgments of the three types of swallowing assessments did not always agree, and the fact that there were seven different combinations of patients judged to have a risk of dysphagia suggests that each may have characteristics based on the assessment method.

　Discussion:　Although a relatively large number of users were in a state of low nutrition, many of them tended not to have symptoms severe enough to cause aspiration or aspiration pneumonia. Regarding the combination of assessment methods, the Seirei questionnaire and RSST were used more frequently in patients without dementia, so these two methods were used preferentially for such patients. On the other hand, for users with dementia, it was thought to be highly necessary to include MMASA in the judgment, thereby facilitating a broader understanding of the risk of dysphagia. In the future, it is necessary to include the results of the videofluoroscopic swallowing study in patients who were at risk, so that more appropriate assessments can be made.

　Introduction:　Recently, electrical stimulation treatment has been reported to be an effective treatment for patients with dysphagia. However, the specific effects of interferential electrical stimulation (IFCS) on swallowing function are still unclear. In this study, we investigated the effects of IFCS on masticatory and swallowing function in healthy adults.

　Materials and Methods:　Eighteen healthy young volunteers were enrolled in this study. Spontaneous swallowing frequency (SSF) was measured as the number of swallowing times counted over 10 min and calculated as swallowing times per minute. Voluntary swallowing frequency (VSF) was obtained using the Repetitive Saliva Swallowing Test. Salivary secretion volume (SSV) was measured using the Saxon test. Glucose elution volume (GEV) was measured using the masticatory efficiency of gummy jelly chewing. All measurement scales were collected under the condition of both IFCS on the bilateral neck skin and Sham stimulation (without stimulation; Sham). The intensity of IFCS was set at a level lower than each subject's sensory threshold. Measurements were collected on two different days, IFCS or Sham randomly selected on day 1, and measures were collected before and during stimulation. One week later, the same measurements were collected with a different stimulation from day 1. Statistical analysis was performed using the t-test for each measurement point before and during IFCS and Sham stimulation.

　Results:　Regarding IFCS, the results of each measurement before and during stimulation were SSF: 1.21 and 1.52, VSF: 8.0 and 8.4, SSV: 5.35 g and 5.51 g, and GEV: 168.7 mg/dL and 203.2 mg/dL. SSF and GEV during stimulation were significantly higher than before stimulation (SSF: p＝0.001 and GEV: p＝0.017). Regarding Sham, the results of each measurement before and during stimulation were SSF: 1.28 and 1.38, respectively, VSF: 8.0 and 7.8, respectively, SSV: 5.52 g and 6.04 g, respectively, and GEV: 169.4 mg/dL and 181.1 mg/dL, respectively. There was no significant difference between measurements points.

　Conclusion:　The results of this study indicated that IFCS significantly increased SSF and GEV. The findings suggested that IFCS on the superior laryngeal nerve, which is a swallowing-related nerve, might affect masticatory function in addition to swallowing function.

　In the Japanese Dysphagia Diet defined based on 2021 guidelines, the “syringe method” was newly introduced as a simple and low-cost method for measuring viscosity. To our knowledge, viscosity assessments using the syringe test to evaluate the thickening of liquid nutrition products have not been described in prior research or in any medical guidelines to date. We evaluated four kinds of liquid nutrition products and six kinds of thickeners. Thickeners were dissolved in liquid nutrition products. Changes in viscosity were determined based on the dissolution amount and stationary time evaluated via the syringe test and were compared with viscometer measurements and organoleptic evaluations. Liquid viscosity was scored and categorized into five levels based on the residual amount of liquid via the syringe test, as was objectively measured viscosity (i.e., measured via a viscometer) and the results of organoleptic evaluations. We verified the consistency of these scores across evaluation methods. When liquid nutrition products were thickened with thickeners, viscosities evaluated via the syringe test were lower than objectively measured viscosity values. The differences between syringe and viscometer assessments were especially large for high-viscosity liquids. However, the viscosity scores assessed via organoleptic evaluation tended to be similar to scores obtained via simple tests and the syringe tests. It is preferable to understand these properties when measuring the thickness of liquid nutrition products using the syringe test or other methodologies.

　Introduction:　We report a case in which high-resolution manometry (HRM) was used to comprehend the pathophysiology of dysphagia and to objectively evaluate the improvement process, which enabled us to select more effective swallowing exercises.

　Case:　A male in his forties developed a left medullary infarction after coil embolization for a dissecting aneurysm of the left vertebral artery. After 2 days, we performed a videoendoscopic examination and found that he could not perform the swallowing reflex. After 11 days, we performed a videofluoroscopic examination (VF) and HRM and found decreased pharyngeal pressure and reduced upper esophageal sphincter (UES) relaxation time. After 23 days, VF and HRM were performed again, and these showed that his pharyngeal pressure and UES relaxation time had slightly improved. On the same day, the effects of tongue-held swallow, effortful swallow, and the Mendelsohn maneuver were evaluated using HRM. The pharyngeal contractile integrals were higher for tongue-hold swallow, effortful swallow, and the Mendelssohn maneuver than for normal swallow. The UES relaxation time was longer with the Mendelssohn maneuver than with normal swallow. After we explained these findings to him, he practiced these swallowing exercises. After 39 days, his pharyngeal contractile integrals improved further.

　Discussion:　In this case, we were able to comprehend the detailed pathological condition of pharyngeal pressure and UES using HRM. Furthermore, we were able to confirm more effective swallowing exercises using HRM. It is suggested that HRM can contribute to the selection of appropriate exercises for dysphagia rehabilitation.