24, 25 There is reduction in all the measured distances in the pharynx with flexion of head and neck. 22, 23 It also decreases pharyngeal contraction to decrease dysphagia limit. 20, 21 This position should be avoided while training patients with various swallowing disorders.Ĭhin tuck position makes the vallecular space wide and airway entrance narrow to prevent aspiration. During neck extension, there is mechanical widening of laryngeal vestibule and narrowing of valleculae, leading to decrease in upper esophageal sphincter relaxation and difficulty in its closure. 18, 19 Similarly, our results also show that subjects reported maximum difficulty in swallowing while sitting with head and neck in extension. It has been shown that while swallowing different volumes of water, healthy adults didn't experience piecemeal deglutition or aspiration however while swallowing with head in extension physiologic dysphagia was seen. Various changes occur in mechanism of swallowing with aging, including slowing of oral stage and trigger of pharyngeal swallow. 15, 16 that can help patients with various dysfunctions. However, different head and neck positions can facilitate the process of swallowing to eliminate aspiration etc. There are individual differences in swallowing and dysphagia limit depending on individual condition, preferences and habits. Statistically significant differences were found between sitting upright, sitting with head/neck flexed, head/neck extended and lying supine. It was found to be least when subjects were asked to swallow in upright sitting position. We saw the effect of different body postures on the self-perceived difficulty while swallowing in normal healthy subjects. In this study, we decided to see the effect of different body postures while sitting and lying on swallowing in normal healthy subjects. 14 Modification of body position can help to improve rehabilitation of such patients. Head flexion and extension has been shown to decrease the opening of airways and esophagus. Although there are studies that report head/neck movements during mastication, there are fewer studies that show the effect of head/neck position on difficulty while swallowing. 11, 12 These movements facilitate effective chewing of the bolus, 13 in preparation for swallowing. 9, 10 Chewing induces head extension due to co-contraction of sternocleidomastoid and trapezius muscles along with jaw muscles. Mandibular movements during mastication have been shown to cause head movements. 6, 7 Various techniques have been proposed to improve the swallowing function that can improve patient's quality of life. 5 Clinical presentation may vary from patient to patient and that needs to be taken into consideration while planning rehabilitation. 3, 4 It can further lead to aspiration pneumonia, dehydration, malnutrition and other serious complications. 2 Approximately, 33 to 73% of patients are reported to suffer dysphagia following stroke, motor neuron disease, Parkinson's disease, cerebral palsy, etc. 1 Any structural, physiological or neurological disturbance in this process may cause dysphagia. Swallowing involves a predictable and systematic process.
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