Subjective and objective evaluation of swallowing in lateral decubitus positions examined in healthy volunteers.
Dysphagia
Healthy volunteer
Lateral decubitus position
Swallowing sound
Visual analogue scale
Journal
European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
ISSN: 1434-4726
Titre abrégé: Eur Arch Otorhinolaryngol
Pays: Germany
ID NLM: 9002937
Informations de publication
Date de publication:
Feb 2022
Feb 2022
Historique:
received:
17
05
2021
accepted:
14
07
2021
pubmed:
28
7
2021
medline:
1
2
2022
entrez:
27
7
2021
Statut:
ppublish
Résumé
Dysphagia can result from shock, trauma, aging, head and neck neoplasms, and some cerebrovascular diseases or neuromotor degenerative disorders. Swallowing rehabilitation therapy combined with postural control of the neck, head, and body can be effective for patients with dysphagia. Though the lateral decubitus posture has been a favorable option for swallowing rehabilitation therapy, available clinical data pertaining to it are scarce. Twenty-seven healthy volunteers were enrolled in this study. The subjects underwent a repetitive saliva swallowing test, food swallowing test, and water swallowing test. The trials were performed in four different positions: upright sitting position, lateral decubitus position with the head raised to 60°, lateral decubitus position with the head raised to 30°, and complete lateral decubitus position. After each trial, the subjects were asked to declare the swallowing difficulty utilizing a visual analogue scale. Swallowing time and swallowing sound level were recorded simultaneously, as objective evaluation in each trial. We analyzed the visual analogue scale scores, swallowing time, and swallowing sound levels for all the four positions. The results of the visual analogue scale of the water swallowing test in the sitting position were significantly lower than those of the complete lateral decubitus position (p < 0.01). However, statistical significance was not detected in swallowing time or the swallowing sound level among the four different positions. Although subjective discomfort in swallowing was identified, difficulty of swallowing was not objectively evident in the trials, irrespective of the position. A complete lateral decubitus position can be an effective and safe position in swallowing.
Sections du résumé
BACKGROUND
BACKGROUND
Dysphagia can result from shock, trauma, aging, head and neck neoplasms, and some cerebrovascular diseases or neuromotor degenerative disorders. Swallowing rehabilitation therapy combined with postural control of the neck, head, and body can be effective for patients with dysphagia. Though the lateral decubitus posture has been a favorable option for swallowing rehabilitation therapy, available clinical data pertaining to it are scarce.
METHODS
METHODS
Twenty-seven healthy volunteers were enrolled in this study. The subjects underwent a repetitive saliva swallowing test, food swallowing test, and water swallowing test. The trials were performed in four different positions: upright sitting position, lateral decubitus position with the head raised to 60°, lateral decubitus position with the head raised to 30°, and complete lateral decubitus position. After each trial, the subjects were asked to declare the swallowing difficulty utilizing a visual analogue scale. Swallowing time and swallowing sound level were recorded simultaneously, as objective evaluation in each trial. We analyzed the visual analogue scale scores, swallowing time, and swallowing sound levels for all the four positions.
RESULTS
RESULTS
The results of the visual analogue scale of the water swallowing test in the sitting position were significantly lower than those of the complete lateral decubitus position (p < 0.01). However, statistical significance was not detected in swallowing time or the swallowing sound level among the four different positions. Although subjective discomfort in swallowing was identified, difficulty of swallowing was not objectively evident in the trials, irrespective of the position.
CONCLUSIONS
CONCLUSIONS
A complete lateral decubitus position can be an effective and safe position in swallowing.
Identifiants
pubmed: 34313834
doi: 10.1007/s00405-021-07001-2
pii: 10.1007/s00405-021-07001-2
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1071-1080Subventions
Organisme : Japan Society for the Promotion of Science
ID : JP 20K19260
Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Sura L, Madhavan A, Carnaby G, Crary MA (2012) Dysphagia in the elderly: management and nutritional considerations. Clin Interv Aging 7:287–298. https://doi.org/10.2147/CIA.S23404
doi: 10.2147/CIA.S23404
pubmed: 22956864
pmcid: 3426263
Leslie P, Carding PN, Wilson JA (2003) Investigation and management of chronic dysphagia. BMJ 326:433–436. https://doi.org/10.1136/bmj.326.7386.433
doi: 10.1136/bmj.326.7386.433
pubmed: 12595385
pmcid: 1125316
Tibbling L, Gustafsson B (1991) Dysphagia and its consequences in the elderly. Dysphagia 6:200–202. https://doi.org/10.1007/BF02493526
doi: 10.1007/BF02493526
pubmed: 1778095
Langmore SE, Terpenning MS, Schork A, Chen Y, Murray JT, Lopatin D, Loesche WJ (1998) Predictors of aspiration pneumonia: how important is dysphagia? Dysphagia 13:69–81. https://doi.org/10.1007/PL00009559
doi: 10.1007/PL00009559
pubmed: 9513300
Sekizawa K, Matsui T, Nakagawa T, Nakayama K, Sasaki H (1998) ACE inhibitors and pneumonia. Lancet 352:1069. https://doi.org/10.1016/S0140-6736(05)60114-6
doi: 10.1016/S0140-6736(05)60114-6
pubmed: 9759784
Ebihara T, Takahashi H, Ebihara S, Okazaki T, Sasaki T, Watando A, Nemoto M, Sasaki H (2005) Capsaicin troche for swallowing dysfunction in older people. J Am Geriatr Soc 53:824–828. https://doi.org/10.1111/j.1532-5415.2005.53261.x
doi: 10.1111/j.1532-5415.2005.53261.x
pubmed: 15877558
Ohrui T (2005) Preventive strategies for aspiration pneumonia in elderly disabled persons. Tohoku J Exp Med 207:3–12. https://doi.org/10.1620/tjem.207.3
doi: 10.1620/tjem.207.3
pubmed: 16082150
Solazzo A, Monaco L, Del Vecchio L, Tamburrini S, Iacobellis F, Berritto D, Pizza NL, Reginelli A, Di Martino N, Grassi R (2012) Investigation of compensatory postures with videofluoromanometry in dysphagia patients. World J Gastroenterol 18:2973–2978. https://doi.org/10.3748/wjg.v18.i23.2973
doi: 10.3748/wjg.v18.i23.2973
pubmed: 22736921
pmcid: 3380325
Tsukada T, Taniguchi H, Ootaki S, Yamada Y, Inoue M (2009) Effects of food texture and head posture on oropharyngeal swallowing. J Appl Physiol 106:1848–1857. https://doi.org/10.1152/japplphysiol.91295.2008
doi: 10.1152/japplphysiol.91295.2008
pubmed: 19325027
Park BH, Seo JH, Ko MH, Park SH (2013) Effect of 45 degrees reclining sitting posture on swallowing in patients with dysphagia. Yonsei Med J 54:1137–1142. https://doi.org/10.3349/ymj.2013.54.5.1137
doi: 10.3349/ymj.2013.54.5.1137
pubmed: 23918562
pmcid: 3743196
Oh BM, Lee JH, Seo HG, Lee WH, Han TR, Jeong SU, Jeong HJ, Sim YJ (2018) Changes in hyolaryngeal movement during swallowing in the lateral decubitus posture. Ann Rehabil Med 42:416–424. https://doi.org/10.5535/arm.2018.42.3.416
doi: 10.5535/arm.2018.42.3.416
pubmed: 29961739
pmcid: 6058586
Honda T, Baba T, Fujimoto K, Goto T, Nagao K, Harada M, Honda E, Ichikawa T (2016) Characterization of swallowing sound: preliminary investigation of normal subjects. PLoS ONE 11:e0168187. https://doi.org/10.1371/journal.pone.0168187
doi: 10.1371/journal.pone.0168187
pubmed: 27959902
pmcid: 5154546
Persson E, Wårdh I, Östberg P (2019) Repetitive saliva swallowing test: norms, clinical relevance and the impact of saliva secretion. Dysphagia 34:271–278. https://doi.org/10.1007/s00455-018-9937-0
doi: 10.1007/s00455-018-9937-0
pubmed: 30132122
Oguchi K, Saitoh E, Mizuno M, Baba M, Okui M, Suzuki M (2000) The Repetitive Saliva Swallowing Test (RSST) as a screening test of functional dysphagia (1) normal values of RSST. Jpn J Rehabil Med 37:375–382 (In Japanese Abstract in English)
doi: 10.2490/jjrm1963.37.375
Oguchi K, Saitoh E, Baba M, Kusudo S, Tanaka T, Onogi K (2000) The Repetitive Saliva Swallowing Test (RSST) as a screening test of functional dysphagia (2) validity of RSST. Jpn J Rehabil Med 37:383–388 (In Japanese Abstract in English)
doi: 10.2490/jjrm1963.37.383
Tohara H, Saitoh E, Mays KA, Kuhlemeier K, Palmer JB (2003) Three tests for predicting aspiration without videofluorography. Dysphagia 18:126–134. https://doi.org/10.1007/s00455-002-0095-y
doi: 10.1007/s00455-002-0095-y
pubmed: 12825906
Taniwaki M, Gao Z, Nishinari K, Kohyama K (2013) Acoustic analysis of the swallowing sounds of food with different physical properties using the cervical auscultation method. J Texture Stud 44:169–175. https://doi.org/10.1111/jtxs.12009
doi: 10.1111/jtxs.12009
Nakauma M, Ishihara S, Funami T, Nishinari K (2011) Swallowing profiles of food polysaccharide solutions with different flow behaviors. Food Hydrocoll 25:1165–1173. https://doi.org/10.1016/j.foodhyd.2010.11.003
doi: 10.1016/j.foodhyd.2010.11.003
Shinjo Y, Okitsu A, Ukeda I, Miyagi A, Domen K, Koyama T (2013) Effects of posture on subjective swallowing difficulty during screening tests for dysphagia. Int J Phys Med Rehabil 1:133. https://doi.org/10.4172/2329-9096.1000133
doi: 10.4172/2329-9096.1000133
Morinière S, Boiron M, Alison D, Makris P, Beutter P (2008) Origin of the sound components during pharyngeal swallowing in normal subjects. Dysphagia 23:267–273. https://doi.org/10.1007/s00455-007-9134-z
doi: 10.1007/s00455-007-9134-z
pubmed: 18071792
Morinière S, Beutter P, Boiron M (2006) Sound component duration of healthy human pharyngoesophageal swallowing: a gender comparison study. Dysphagia 21:175–182. https://doi.org/10.1007/s00455-006-9023-x
doi: 10.1007/s00455-006-9023-x
pubmed: 16897324