![]() ![]() We found that the head angle increased not only in HF, but also in NF and HFNF positions. ![]() The purpose of this study was to evaluate the effects of head, neck, and combined head-and-neck flexion postures separately. 10ĭifferent definitions could result in inconsistency in the reported effects of the chin-down posture. In Japan, however, more than half of speech-language-hearing therapists consider the chin-down posture to be head flexion alone. 9 A questionnaire survey showed that most speech-language pathologists in the United States recognize the chin-down posture to be a combination of head and neck flexion. Anatomically, head flexion arises from flexion of the atlanto-occipital and C1–C2 joints, whereas neck flexion refers to flexion in the lower cervical spine. 3Īlthough the chin-down posture involves tucking the chin to the neck, presumably via flexion of the head and/or neck, the posture is not clearly defined. ![]() However, other researchers have claimed that the chin-down posture narrows the vallecular space and does not affect the airway entrance. In many patients, this posture pushes the tongue base and epiglottis closer to the posterior pharyngeal wall, narrows the airway entrance, and widens the vallecular space. 1– 8 Logemann 4 suggested that the chin-down posture is helpful in patients with delayed triggering of the pharyngeal swallow, reduced tongue base retraction, and/or reduced airway entrance closure. The “chin-down” posture is one of the most frequently used in dysphagia rehabilitation, with many researchers commenting on its effects. Many compensatory postures have been advocated to treat dysphagia. The tongue base was in contact with the posterior pharyngeal wall longer in the HF position than in the N position.Ĭonclusion: Because HF, NF and HFNF positions have different effects, we recommend the use of these terms instead of “chin-down position.”ĭysphagia hinders oral intake. The distance between the tongue base and the posterior pharyngeal wall, the vallecular space and the airway entrance were smaller in the HF position than in the N position. Neck angles were significantly greater in the NF position than in the N position. Results: Head angles in HF, NF and HFNF positions were significantly greater than in the N position. Statistical analysis was performed with a paired t-test with Bonferroni correction. Head and neck angles at rest, distances in the pharynx and larynx at rest, and duration of swallowing were measured. Participants were instructed to swallow 4 ml of thick barium liquid in an upright sitting position. The head and neck were set in neutral (N), head flexion (HF), neck flexion (NF) or combined head-and-neck flexion (HFNF) positions. Methods: Ten healthy volunteers participated in the study. The purpose of this study was to evaluate the effects of head, neck and combined head-and-neck flexion postures separately. However, clinicians and researchers have their own forms of the chin-down posture: some consider it to be head and neck flexion, whereas others consider it to be head flexion alone. Objective: The “chin-down” posture involves tucking the chin to the neck. ![]()
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