Different types of dysphagia alleviated by the chin-down position

Miyamoto, Takumi; Kumai, Yoshihiko; Matsubara, Keigo; Kodama, Narihiro; Satoh, Chise; Orita, Yorihisa

doi:10.1016/j.anl.2021.02.008

Cited by 6 publications

(15 citation statements)

References 14 publications

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“…We did not evaluate pharyngeal residue because this could not be calculated from the two‐dimensional VF image. However, one article insisted that the neck flexion posture did not affect vallecular residue but reduced the residue of the pyriform sinus using VF 23 . Because the residue volume in the pharynx can be accurately assessed using computed tomography (CT), 24 the effects of the head flexion posture on pharyngeal residuals should be evaluated via CT analysis.…”

Section: Discussionmentioning

confidence: 99%

“…However, one article insisted that the neck flexion posture did not affect vallecular residue but reduced the residue of the pyriform sinus using VF. 23 Because the residue volume in the pharynx can be accurately assessed using computed tomography (CT), 24 the effects of the head flexion posture on pharyngeal residuals should be evaluated via CT analysis. The thickness and amount of the contrast material used in this study were not same.…”

Section: Discussionmentioning

confidence: 99%

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Effects of head flexion posture in patients with dysphagia

Nagura

Kagaya

Inamoto

et al. 2022

J of Oral Rehabilitation

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Background The chin‐down posture is often used as a compensatory manoeuvre for patients with dysphagia. This posture presumably involves flexion of the head and/or neck, but this is not clearly defined. Objective This study aimed to assess the effects of head flexion posture in a retrospective study of videofluoroscopic examination of swallowing (VF). Methods A total of 73 patients who underwent VF both with and without head flexion posture in the lateral projection were included in the analysis. The head and neck angles at the initiation of the swallowing reflex, penetration–aspiration scale (PAS), nasopharyngeal closure time, stage transition duration, duration of laryngeal closure, time from swallowing reflex to laryngeal closure and to the opening of upper oesophageal sphincter (UES), duration of UES opening, location of the bolus leading edge at swallowing reflex, and bolus transition time were evaluated. Results The head flexion angle increased (p < 0.001), but the neck flexion angle did not change in the head flexion posture. Moreover, PAS improved (p < 0.001), aspiration was reduced (p < 0.001), the time between the swallowing reflex and the onset of laryngeal closure was shortened (p = 0.006), and the leading edge of the bolus at swallowing reflex became shallower (p = 0.004) in the head flexion posture. Other parameters did not significantly change. Conclusion The head flexion posture resulted in earlier laryngeal closure and a shallower position of the leading bolus edge at swallowing reflex, resulting in PAS improvement and decreased aspiration.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effects of head flexion posture in patients with dysphagia

Nagura

Kagaya

Inamoto

et al. 2022

J of Oral Rehabilitation

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“…studies. 6,8,9,[20][21][22][23][24][25][26][27][28][29] Four studies were published in Korea, four studies were published in the United States of America and the rest in Japan. Included studies were published between 1993 and 2022.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Eight of the included studies used penetration-aspiration scale to evaluate the risk of aspiration of patients 8,9,20,21,23,26,28,29 ; a total of 405 subjects were included. Three studies did not have specific figure, 8,21,23 so only five of studies were included for data analysis. 9,20,26,28,29 The pooled data revealed moderate heterogeneity among studies (I 2 = 71%，p = .009), so we used random-effects model.…”

Section: Effects On Aspirationmentioning

confidence: 99%

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The effectiveness of chin‐down manoeuvre in patients with dysphagia: A systematic review and meta‐analysis

Li,

Huang,

Ding

et al. 2023

J of Oral Rehabilitation

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AimThe chin‐down posture is a widely used compensatory manoeuvre for patients with dysphagia. The aim of this study was designed to systematically measure the effectiveness of chin‐down manoeuvre application.MethodologyWe retrieved the PubMed, Web of Science, Embase, Cochrane Library, EBSCO, Medline, CNKI, WANFANG, VIP and SinoMed databases from inception to 30 August 2022. Raters independently screened literature according to inclusion and exclusion criteria. The quality of the included literature was evaluated, and data were extracted. The software Review Manager software 5.3 was used for statistical analysis.ResultsFourteen studies with a total of 571 patients were included in this meta‐analysis. The meta‐analysis indicated that chin‐down manoeuvre could significantly reduce the risk of aspiration (MD = −1.35, 95% CI [−2.25, −0.44], Z = 2.92, p < .01), decrease the chin angle (MD = −12.20, 95% CI [−14.61, −9.79], Z = 9.91, p < .001), shorten oral transit time (MD = −0.81, 95% CI [−1.20, −0.43], Z = 4.17, p < .001), reduce the maximum swallowing pressure at upper oesophageal sphincter (MD = −82.07, 95% CI [−112.77, −51.37], Z = 5.24, p < .001) and decrease pharyngeal residue.ConclusionsExisting evidence indicated that chin‐down manoeuvre could reduce the risk of aspiration and pharyngeal residue, decrease the maximum swallowing pressure at UES. More large‐sample, high‐quality clinical trials are still needed in the future to further ascertain the results of this research.

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Clinical validation of the nursing outcome “Swallowing status: pharyngeal phase” in patients with laryngeal cancer

Duan,

Ding,

Tian

et al. 2024

Int J of Nursing Knowl

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Aims and objectivesThis study aimed to clinically validate the nursing outcome “Swallowing status: pharyngeal phase” (1013).MethodsA two‐stage study was designed: (1) Chinese translation and cultural adaptation and (2) clinical validation. Internal consistency and interrater reliability tests were performed on 285 patients with laryngeal cancer, and an additional 130 patients were randomly selected from the 285 patients as an independent sample. Criterion‐related validity tests were performed using the standardized swallowing assessment (SSA). Nursing outcome sensitivity was detected by scoring two time points.ResultsThe Cronbach's alpha coefficients were 0.951 for the nursing outcome and 0.942–0.965 for each indicator. The interclass correlation coefficient (ICC) values for each indicator ranged from 0.73 to 0.929. The scores of the nursing outcome were negatively correlated with the SSA scores (r = −0.555, p < 0.01). With the exception of two indicators, there was a significant difference (p < 0.05) between the total scores of the scale and its 11 indicator scores for the two time points. The results indicated that the nursing outcome “Swallowing status: pharyngeal phase” (1013) exhibited satisfactory psychometric properties and high sensitivity to change.ConclusionsThe nursing outcome “Swallowing status: pharyngeal phase” (1013) demonstrated good reliability, validity, and sensitivity in patients with laryngeal cancer.Implications for nursing practiceThe nursing outcome “Swallowing status: pharyngeal phase” (1013) can be used to assess swallowing function in patients with laryngeal cancer and provide guidance for the development of rehabilitation intervention plans and nursing care.

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Different types of dysphagia alleviated by the chin-down position

Cited by 6 publications

References 14 publications

Effects of head flexion posture in patients with dysphagia

Effects of head flexion posture in patients with dysphagia

The effectiveness of chin‐down manoeuvre in patients with dysphagia: A systematic review and meta‐analysis

Clinical validation of the nursing outcome “Swallowing status: pharyngeal phase” in patients with laryngeal cancer

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