The Sequence of Swallowing Events During the Chin-Down Posture Purpose This study investigated the effect of the chin-down posture on the sequence of swallowing events in healthy adults. Method Sixteen healthy participants performed 45 5-ml thin liquid swallows during videofluoroscopy: 5 neutral head position, 30 chin-down posture, and then 10 neutral head position. Eight swallowing events were ... Research Article
Research Article  |   November 01, 2015
The Sequence of Swallowing Events During the Chin-Down Posture
 
Author Affiliations & Notes
  • Jennifer L. Young
    Towson University, MD
  • Phoebe Macrae
    Johns Hopkins School of Medicine, Baltimore, MD
  • Cheryl Anderson
    Johns Hopkins School of Medicine, Baltimore, MD
  • Isha Taylor-Kamara
    Johns Hopkins School of Medicine, Baltimore, MD
  • Ianessa A. Humbert
    Johns Hopkins School of Medicine, Baltimore, MD
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication. ×
  • Correspondence to Ianessa A. Humbert, who is now with the University of Florida: ihumbert@ufl.edu
  • Editor: Krista Wilkinson
    Editor: Krista Wilkinson×
  • Associate Editor: Julie Barkmeier-Kraemer
    Associate Editor: Julie Barkmeier-Kraemer×
Article Information
Swallowing, Dysphagia & Feeding Disorders / Research Articles
Research Article   |   November 01, 2015
The Sequence of Swallowing Events During the Chin-Down Posture
American Journal of Speech-Language Pathology, November 2015, Vol. 24, 659-670. doi:10.1044/2015_AJSLP-15-0004
History: Received January 19, 2015 , Revised April 30, 2015 , Accepted July 2, 2015
 
American Journal of Speech-Language Pathology, November 2015, Vol. 24, 659-670. doi:10.1044/2015_AJSLP-15-0004
History: Received January 19, 2015; Revised April 30, 2015; Accepted July 2, 2015
Web of Science® Times Cited: 3

Purpose This study investigated the effect of the chin-down posture on the sequence of swallowing events in healthy adults.

Method Sixteen healthy participants performed 45 5-ml thin liquid swallows during videofluoroscopy: 5 neutral head position, 30 chin-down posture, and then 10 neutral head position. Eight swallowing events were measured: the time of hyoid burst, bolus head in the pharynx, bolus tail in the pharynx, laryngeal vestibule closure (LVC), upper esophageal sphincter (UES) opening, bolus head in the UES, bolus tail exiting the pharynx, and laryngeal vestibule opening (LVO).

Results Our key finding is that LVC was one of the first 3 swallowing events in 69% of neutral swallows and in 78% of chin-down swallows (p = .006). Also, LVO occurred last in 14% of chin-down swallows but never occurred last in the preceding neutral swallows (p ≤ .001). Thus, in chin-down swallows, LVC occurred earlier and LVO occurred later.

Conclusions The chin-down posture may be beneficial for individuals with delayed onset of LVC and reduced duration of the LVC. Future studies are needed to examine this effect in individuals with dysphagia.

Acknowledgments
Funding for this investigation was provided by the National Institute on Deafness and Other Communication Disorders and the National Center for Medical Rehabilitation Research (5K23DC010776-05, 1R01DC01428501A1), as well as the American Heart Association (14BGIA20380348). All listed funding was awarded to Ianessa A. Humbert (Principal Investigator).
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