Abstract
Chin tuck has been has been widely used to prevent aspiration in the patients with dysphagia. This study was performed to investigate the effectiveness and the degree of optimal neck flexion of chin tuck. Ninety-seven patients who showed aspiration in the videofluoroscopic swallow study (VFSS). Participants were grouped into the effective (patients who showed effect with chin tuck) and ineffective group (those who did not show effect with chin tuck). VFSS was performed in neutral and chin tuck position and findings were compared between the groups. Severity of aspiration was assessed by the point penetration-aspiration scale. Duration of dysphagic symptoms, history of tracheostomy, and other possible contributing factors were also compared. Neck flexion angle was measured to find appropriate posture in which aspiration was prevented with chin tuck. Aspiration was reduced or eliminated in only 19 patients (19.6 %) with chin tuck. Oral transit time, pharyngeal delayed time and pharyngeal transit time were significantly shortened in both groups (p < 0.05), but the difference between the groups was not significant. Female sex and absence of residue in pyriform sinus favored the effect of chin tuck (p < 0.05). At least 17.5° of neck flexion was required to achieve an effect with chin tuck. The effectiveness of chin tuck was less than anticipated. Patients without residue in pyriform sinus were more likely to benefit from chin tuck. Sufficient neck flexion was important in chin tuck to prevent aspiration.
Similar content being viewed by others
References
Ashford J, McCabe D, Wheeler-Hegland K, Frymark T, Mullen R, Musson N, Schooling T, Hammond CS. Evidence-based systematic review: oropharyngeal dysphagia behavioral treatments. Part III? Impact of dysphagia treatments on populations with neurological disorders. J Rehabil Res Dev. 2009;46(2):195–204.
Buckley JE, Addicks CL, Maniglia J Feeding patients with dysphagia. In: Nursing forum, 1976. Wiley Online Library, pp 69–85.
Gaffney TW, Campbell RP. Feeding Techinques for Dysphagic Patients. Am J Nurs. 1974;74(12):2194–5.
Larsen GL. Conservative management for incomplete dysphagia paralytica. Arch Phys Med Rehabil. 1973;54(4):180.
Welch MV, Logemann JA, Rademaker AW, Kahrilas PJ. Changes in pharyngeal dimensions effected by chin tuck. Arch Phys Med Rehabil. 1993;74(2):178.
Logemann JA, Gensler G, Robbins J, Lindblad AS, Brandt D, Hind JA, Kosek S, Dikeman K, Kazandjian M, Gramigna GD. A randomized study of three interventions for aspiration of thin liquids in patients with dementia or Parkinson’s disease. J Speech, Lang Hear Res. 2008;51(1):173.
Bulow M, Olsson R, Ekberg O. Videomanometric analysis of supraglottic swallow, effortful swallow, and chin tuck in healthy volunteers. Dysphagia. 1999;14(2):67–72.
Hung D, Sejdić E, Steele CM, Chau T. Extraction of average neck flexion angle during swallowing in neutral and chin-tuck positions. BioMed Eng OnLine. 2009;8(1):25.
Logemann JA. Evaluation and Treatment of Swallowing Disorders. 2nd ed. Texas: Pro-ed; 1998.
Coyle JL, Wood JL. A penetration-aspiration scale. Dysphagia. 1996;11(2):93–8.
Harrison DE, Harrison DD, Cailliet R, Troyanovich SJ, Janik TJ, Holland B. Cobb method or Harrison posterior tangent method: which to choose for lateral cervical radiographic analysis. Spine. 2000;25(16):2072–8.
Shanahan TK, Logemann JA, Rademaker AW, Pauloski BR, Kahrilas PJ. Chin-down posture effect on aspiration in dysphagic patients. Arch Phys Med Rehabil. 1993;74(7):736–9.
Nagaya M, Kachi T, Yamada T, Sumi Y. Videofluorographic observations on swallowing in patients with dysphagia due to neurodegenerative diseases. Nagoya J Med Sci. 2004;67(1–2):17–23.
Robbins J, Gensler G, Hind J, Logemann JA, Lindblad AS, Brandt D, Baum H, Lilienfeld D, Kosek S, Lundy D. Comparison of 2 Interventions for Liquid Aspiration on Pneumonia IncidenceA Randomized Trial. Ann Intern Med. 2008;148(7):509–18.
Acknowledgment
The present research was conducted by the research fund of Dankook University in 2013.
Conflict of interest
The authors declare that there is no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Ra, J.Y., Hyun, J.K., Ko, K.R. et al. Chin Tuck for Prevention of Aspiration: Effectiveness and Appropriate Posture. Dysphagia 29, 603–609 (2014). https://doi.org/10.1007/s00455-014-9551-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00455-014-9551-8