| Co-Investigator(Kenkyū-buntansha) |
BABA Mikoto Fujita Health University, School of Health Sciences, Professor (40298542)
SAITOH Eiichi Fujita Health University, School of Medicine, Department of rehabilitation medicine, professor (50162186)
MURAOKA Yoshihiro Fujita Health University, School of Health Sciences, associate professor (10338254)
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| Budget Amount *help |
¥2,910,000 (Direct Cost: ¥2,700,000、Indirect Cost: ¥210,000)
Fiscal Year 2007: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2006: ¥2,000,000 (Direct Cost: ¥2,000,000)
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| Research Abstract |
Purpose: We studied about the Chin down maneuver which is a postural technique used widely for treatment of individuals with dysphagia. Chin down posture is, in terms of functional anatomy, a head and neck (capital and cervical) posture in the anterior-posterior direction. Therefore, there could be various combinations of head and neck positions. So we classified chin down postures functional anatomically into three postures: 1) head flexion on the neck (HF), 2) neck flexion (NF), 3) combination of head and neck flexion (HFNF), and investigated the differences of the effects of each posture.
Methods: ten normal, healthy adults, eight dysphagia patients with water aspiration and/or pharyngeal residue ware recruited. Using Videofluorography, we compared the structural changes (distances between tongue base and posterior-pharyngeal wall, width of valleculae, laryngeal inlet) under the each head and neck position and swallowing movement (ex: onset time of swallowing reflex, distances of hyo
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id movement, and so on). Besides that, oropharyngeal structural differences were examined by the Videoendoscopy.
Results : Results of normal, healthy adults showed below
1. Distances between tongue base and posterior pharyngeal wall, width of valleculae, and width of laryngeal inlet were shortened under HF. NF and HFNF made no significant differences.
2. The duration time of contacting tongue base and posterior pharyngeal wall were prolonged under HF. Other components of swallowing movement were not influenced by postural changes.
3. The results of Patients data were similar to that of normal adults, but differences of oropharingeal structure and swallowing movements were not significant, because of individual variability : some had metatypical cervical spine, some had atrophy of pharynx and so on.
4. We can not find only one chin down posture which was effective for dysphagic patients, patients with different problems need different types of chin down, so we should recognize differences of some kinds of chin down postures and
Discussion: we revealed that chin down posture as a swallowing maneuver has some variations and each posture have different effects on orophalyngeal structure. We think we should separate 3 kinds of chin down postures differently depending on patients's specific characteristics
It is necessary more investigation about effects for patients by collecting more data. Less
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