Department of Communication Sciences and Disorders, Howard University, Washington, DC.
Department of Communication Sciences and Disorders, The University of Iowa, Iowa City.
Am J Speech Lang Pathol. 2021 May 18;30(3):1049-1060. doi: 10.1044/2021_AJSLP-19-00223. Epub 2021 May 4.
Purpose The chin-down position is a commonly prescribed posture by health care professionals to alleviate the symptoms of dysphagia. Yet, how the technique influences swallowing physiology lacks clarity. Our goal was to examine the impact of the postural technique on patients with various medical conditions and swallowing impairments. Method Temporal and functional measures were examined with videofluoroscopy in the chin-down and neutral head position on 15 patients. Also, timing differences between head positions were examined to determine the presence of improvement during the chin-down posture. Results The primary finding was chin-down posture swallows prolonged the elapsed time between when the prematurely spilled bolus entered the pharynx relative to swallow onset compared to the neutral head position ( = .006). Also, no improvement in airway protection was found when performing the postural technique. Conclusions The chin-down posture may benefit patients with specific swallowing impairments. However, the general use of the technique for all patients who experience swallowing difficulty might be negligent and could potentially have adverse or no effect on patient outcomes. Future studies examining patients with the same pathophysiology are needed to understand the benefit of the chin-down posture based on swallowing impairment.
目的 低头姿势是医疗保健专业人员常规定位以缓解吞咽困难症状的姿势。然而，该技术如何影响吞咽生理仍不清楚。我们的目标是研究该姿势技术对患有各种疾病和吞咽障碍的患者的影响。 方法 使用视频透视法在 15 名患者的低头和中立头位下检查时间和功能测量值。此外，还检查了头位之间的时间差，以确定在低头姿势下是否有改善。 结果 主要发现是，与中立头位相比，低头位吞咽使过早溢出的食团进入咽部的时间相对于吞咽起始时间延长（=.006）。此外，在进行姿势技术时，并未发现气道保护得到改善。 结论 低头姿势可能对具有特定吞咽障碍的患者有益。然而，对于所有吞咽困难的患者普遍使用该技术可能是疏忽的，并且可能对患者的结果没有影响或产生不利影响。需要对具有相同病理生理学的患者进行未来的研究，以根据吞咽障碍了解低头姿势的益处。
