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CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2016; 20(01): 013-017
DOI: 10.1055/s-0035-1564721
Original Research
Thieme Publicações Ltda Rio de Janeiro, Brazil

Effectiveness of Chin-tuck Maneuver to Facilitate Swallowing in Neurologic Dysphagia

Mariana Saconato
1   Department of Phonoaudiology, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
,
Brasilia Maria Chiari
1   Department of Phonoaudiology, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
,
Henrique Manoel Lederman
2   Image Diagnostics, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
,
Maria Inês Rebelo Gonçalves
1   Department of Phonoaudiology, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
› Author Affiliations
Further Information

Publication History

04 January 2015

26 June 2015

Publication Date:
20 October 2015 (online)

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Abstract

Introduction The chin-tuck maneuver is the most frequently employed postural maneuver in the treatment of neurogenic oropharyngeal dysphagia caused by encephalic vascular strokes and degenerative diseases.

Objective The purpose of this study was to investigate the effectiveness of this maneuver in patients with neurogenic dysphagia and factors that could interfere in it.

Methods In this retrospective cohort, we analyzed the medical files and videofluoroscopy exams of 35 patients (19 male – 54% and 16 female – 46%; age range between 20 and 89 years old; mean = 69 years).

Results The results suggest that the effectiveness of chin-tuck maneuver is related to the overall degree of dysphagia: the more severe the dysphagia, the less effective the maneuver.

Conclusion Chin-tuck maneuver should benefit dysphagic patients with delay in the swallowing trigger, reduced laryngeal elevation, and difficulties to swallow liquids, but is not the best compensatory strategy for patients with severe dysphagia.

Keywords

deglutition - fluoroscopy - deglutition disorders - dysphagia
 

  • References

  • 1 Ayuse T, Ayuse T, Ishitobi S. , et al. Effect of reclining and chin-tuck position on the coordination between respiration and swallowing. J Oral Rehabil 2006; 33 (06) 402-408
    CrossrefPubMedSearch in Google Scholar
  • 2 Cook IJ. Investigative techniques in the assessment of oral-pharyngeal dysphagia. Dig Dis 1998; 16 (03) 125-133
    CrossrefPubMedSearch in Google Scholar
  • 3 Ding R, Larson CR, Logemann JA, Rademaker AW. Surface electromyographic and electroglottographic studies in normal subjects under two swallow conditions: normal and during the Mendelsohn maneuver. Dysphagia 2002; 17 (01) 1-12
    CrossrefPubMedSearch in Google Scholar
  • 4 Ertekin C, Keskin A, Kiylioglu N. , et al. The effect of head and neck positions on oropharyngeal swallowing: a clinical and electrophysiological study. Arch Phys Med Rehabil 2001; 82 (09) 1255-1260
    CrossrefPubMedSearch in Google Scholar
  • 5 Hori K, Tamine K, Barbezat C. , et al. Influence of chin-down posture on tongue pressure during dry swallow and bolus swallows in healthy subjects. Dysphagia 2011; 26 (03) 238-245
    CrossrefPubMedSearch in Google Scholar
  • 6 McCabe D, Ashford J, Wheeler-Hegland K. , et al. Evidence-based systematic review: Oropharyngeal dysphagia behavioral treatments. Part IV—impact of dysphagia treatment on individuals' postcancer treatments. J Rehabil Res Dev 2009; 46 (02) 205-214
    CrossrefPubMedSearch in Google Scholar
  • 7 Ashford J, McCabe D, Wheeler-Hegland K. , et al. Evidence-based systematic review: Oropharyngeal dysphagia behavioral treatments. Part III—impact of dysphagia treatments on populations with neurological disorders. J Rehabil Res Dev 2009; 46 (02) 195-204
    CrossrefPubMedSearch in Google Scholar
  • 8 Terré R, Mearin F. Effectiveness of chin-down posture to prevent tracheal aspiration in dysphagia secondary to acquired brain injury. A videofluoroscopy study. Neurogastroenterol Motil 2012; 24 (05) 414-419 , e206
    CrossrefPubMedSearch in Google Scholar
  • 9 Crary MA, Carnaby Mann GD, Groher ME, Helseth E. Functional benefits of dysphagia therapy using adjunctive sEMG biofeedback. Dysphagia 2004; 19 (03) 160-164
    PubMedSearch in Google Scholar
  • 10 Welch MV, Logemann JA, Rademaker AW, Kahrilas PJ. Changes in pharyngeal dimensions effected by chin tuck. Arch Phys Med Rehabil 1993; 74 (02) 178-181
    PubMedSearch in Google Scholar
  • 11 Logemann JA. Treatment of oral and pharyngeal dysphagia. Phys Med Rehabil Clin N Am 2008; 19 (04) 803-816 , ix
    CrossrefPubMedSearch in Google Scholar
  • 12 Macrae P, Anderson C, Humbert I. Mechanisms of airway protection during chin-down swallowing. J Speech Lang Hear Res 2014; 57 (04) 1251-1258
    CrossrefPubMedSearch in Google Scholar
  • 13 Solazzo A, Monaco L, Del Vecchio L. , et al. Investigation of compensatory postures with videofluoromanometry in dysphagia patients. World J Gastroenterol 2012; 18 (23) 2973-2978
    CrossrefPubMedSearch in Google Scholar
  • 14 Shanahan TK, Logemann JA, Rademaker AW, Pauloski BR, Kahrilas PJ. Chin-down posture effect on aspiration in dysphagic patients. Arch Phys Med Rehabil 1993; 74 (07) 736-739
    CrossrefPubMedSearch in Google Scholar
  • 15 O'Neil KH, Purdy M, Falk J, Gallo L. The Dysphagia Outcome and Severity Scale. Dysphagia 1999; 14 (03) 139-145
    CrossrefPubMedSearch in Google Scholar
  • 16 Chen MYM, Ott DJ, Peele VN, Gelfand DW. Oropharynx in patients with cerebrovascular disease: evaluation with videofluoroscopy. Radiology 1990; 176 (03) 641-643
    CrossrefPubMedSearch in Google Scholar
  • 17 Horner J, Buoyer FG, Alberts MJ, Helms MJ. Dysphagia following brain-stem stroke. Clinical correlates and outcome. Arch Neurol 1991; 48 (11) 1170-1173
    CrossrefPubMedSearch in Google Scholar
  • 18 Nagaya M, Kachi T, Yamada T, Sumi Y. Videofluorographic observations on swallowing in patients with dysphagia due to neurodegenerative diseases. Nagoya J Med Sci 2004; 67 (1–2): 17-23
    PubMedSearch in Google Scholar
  • 19 Leigh JH, Oh BM, Seo HG. , et al. Influence of the chin-down and chin-tuck maneuver on the swallowing kinematics of healthy adults. Dysphagia 2015; 30 (01) 89-98
    CrossrefPubMedSearch in Google Scholar
  • 20 Veis SL, Logemann JA. Swallowing disorders in persons with cerebrovascular accident. Arch Phys Med Rehabil 1985; 66 (06) 372-375
    PubMedSearch in Google Scholar