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The effectiveness of the head-turn-plus-chin-down maneuver for eliminating vallecular residue
Nagy, Ahmed; Peladeau-Pigeon, Melanie; Valenzano, Teresa Josephine; Namasivayam, Ashwini Marini; Steele, Catriona Margaret.
  • Nagy, Ahmed; University Health Network. Toronto Rehabilitation Institute. Toronto. CA
  • Peladeau-Pigeon, Melanie; University Health Network. Toronto Rehabilitation Institute. Toronto. CA
  • Valenzano, Teresa Josephine; University Health Network. Toronto Rehabilitation Institute. Toronto. CA
  • Namasivayam, Ashwini Marini; University Health Network. Toronto Rehabilitation Institute. Toronto. CA
  • Steele, Catriona Margaret; University Health Network. Toronto Rehabilitation Institute. Toronto. CA
CoDAS ; 28(2): 113-117, mar.-abr. 2016. tab, graf
Artículo en Inglés | 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.
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Texto completo: Disponible Índice: LILACS (Américas) Asunto principal: Postura / Trastornos de Deglución / Epiglotis Tipo de estudio: Ensayo Clínico Controlado / Estudio de etiología / Estudios de evaluación Límite: Adulto / Anciano / Aged80 / Femenino / Humanos / Masculino Idioma: Inglés Revista: CoDAS Asunto de la revista: Audiología / Patología del Habla y Lenguaje Año: 2016 Tipo del documento: Artículo País de afiliación: Canadá Institución/País de afiliación: University Health Network/CA

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Texto completo: Disponible Índice: LILACS (Américas) Asunto principal: Postura / Trastornos de Deglución / Epiglotis Tipo de estudio: Ensayo Clínico Controlado / Estudio de etiología / Estudios de evaluación Límite: Adulto / Anciano / Aged80 / Femenino / Humanos / Masculino Idioma: Inglés Revista: CoDAS Asunto de la revista: Audiología / Patología del Habla y Lenguaje Año: 2016 Tipo del documento: Artículo País de afiliación: Canadá Institución/País de afiliación: University Health Network/CA