The effectiveness of the head-turn-plus-chin-down maneuver for eliminating vallecular residue
CoDAS
;
28(2): 113-117, mar.-abr. 2016. tab, graf
Article
in English
| LILACS
| ID: lil-782139
ABSTRACT
ABSTRACT Purpose When swallowing efficiency is impaired, residue accumulates in the pharynx. Cued or spontaneous swallows in the head neutral position do not always successfully clear residue. We investigated the impact of a novel maneuver on residue clearance by combining a head turn with the chin down posture. Methods Data were collected from 26 participants who demonstrated persistent vallecular residue after an initial head neutral clearance swallow in videofluoroscopy. Participants were cued to perform a head-turn-plus-chin-down swallow, with the direction of head turn randomized. Pixel-based measures of residue in the vallecular space before and after the maneuver were made on still frame lateral images using ImageJ software. Measures of % full and the Normalized Residue Ratio Scale (NRRS) were extracted. Univariate analyses of variance were used to detect significant reductions in residue. Results On average, pre-maneuver measures showed residue filling 56-73% of the valleculae, depending on stimulus consistency (NRRS scores 0.2-0.4). More than 80% of pre-swallow measures displayed NRRS ratios > 0.06, a threshold previously linked to increased risk of post-swallow aspiration. Conclusion The head-turn-plus-chin-down maneuver achieved significant reductions in residue for thin and nectar-thick fluids, suggesting that this maneuver can be effective in reducing persistent vallecular residue with these consistencies.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Posture
/
Deglutition Disorders
/
Epiglottis
Type of study:
Controlled clinical trial
/
Etiology study
/
Evaluation studies
Limits:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
Language:
English
Journal:
CoDAS
Journal subject:
Audiology
/
Speech-Language Pathology
Year:
2016
Type:
Article
Affiliation country:
Canada
Institution/Affiliation country:
University Health Network/CA
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