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Thickened Liquids for Dysphagia Management: a Current Review of the Measurement of Liquid Flow


Purpose of Review

The use of thickened liquids has become one of the most common management strategies for individuals with dysphagia. The purpose of this paper is to review methods that can be used to measure the flow characteristics of liquids used in dysphagia management. We describe the measurement of apparent viscosity, measures of extensional flow, slump tests (specifically the line-spread test and Bostwick consistometry), gravity flow tests, and subjective methods.

Recent Findings

We discuss the relationship between different approaches to measuring flow, the 2002 American National Dysphagia Diet and the 2017 International Dysphagia Diet Standardisation Initiative (IDDSI) framework. A comparison of test results across four methods is provided.


A consistent approach is needed for the measurement of flow for thickened liquids used in dysphagia management. This review highlights differences that can be expected across different flow testing methodologies. Adherence to a common method and measurement definitions will promote patient safety and facilitate future research regarding the effectiveness of texture modification as an intervention for dysphagia.

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The authors would like to thank Steve Pong for his assistance with line-spread testing.

Author information

Correspondence to Carly E. A. Barbon.

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Conflict of Interest

Carly E. A. Barbon declares no conflicts of interest.Catriona M. Steele serves as a board member for the International Dysphagia Diet Standardisation Initiative and has received speaker fees/travel expense support from International Dysphagia Diet Standardisation Initiative.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Swallowing Disorders

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Barbon, C.E.A., Steele, C.M. Thickened Liquids for Dysphagia Management: a Current Review of the Measurement of Liquid Flow. Curr Phys Med Rehabil Rep 6, 220–226 (2018).

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  • Deglutition
  • Deglutition disorders
  • Dysphagia
  • Viscosity
  • Thickened liquids
  • Texture modification