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Chin-down posture effect on aspiration in dysphagic patients
T K Shanahan1, J A Logemann, A W Rademaker
1Department of Communication Sciences and Disorders, Northwestern University Medical School, Evanston, IL.
Archives of Physical Medicine and Rehabilitation
|July 1, 1993
Summary
The chin-down posture may not benefit all dysphagic patients with swallowing difficulties. Younger patients who aspirated from the pyriform sinus despite the posture showed a greater epiglottic angle increase.
Area of Science:
- Neurology
- Swallowing Disorders
- Biomechanics
Background:
- The chin-down posture is a common intervention for dysphagia.
- Its effectiveness in reducing aspiration varies among patients.
- Understanding the physiological changes associated with this posture is crucial.
Purpose of the Study:
- To investigate the impact of the chin-down posture on pharyngeal dimensions in neurologically impaired patients with swallowing difficulties.
- To identify factors differentiating patients who benefit from the posture versus those who do not.
Main Methods:
- Measurement of four pharyngeal dimensions in 30 neurologically impaired patients.
- Comparison of patients who aspirated before the swallow (delayed pharyngeal swallow trigger) with and without the chin-down posture.
- Analysis of patient demographics and aspiration location (pyriform sinus vs. valleculae).
Main Results:
- Patients who did not benefit from the chin-down posture were younger.
- These patients aspirated material from the pyriform sinus.
- A significantly greater increase in the epiglottic angle was observed in patients who continued to aspirate despite the posture.
Conclusions:
- The chin-down posture's efficacy in reducing aspiration is patient-specific.
- Younger patients with pyriform sinus aspiration may not benefit from this intervention.
- The increased epiglottic angle in non-responders suggests altered pharyngeal mechanics.