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What Is the Chin-down Posture? A Questionnaire Survey of Speech Language Pathologists in Japan and the United States

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Abstract

The “chin-down” or “chin-tuck” maneuver is a postural technique widely used in dysphagia treatment. The posture, however, does not have a precise anatomical definition. We studied the current practice of 42 speech-language pathologists (SLPs) in Japan and the U.S. with a questionnaire survey regarding the chin-down posture. The main findings were that (1) three of five of the pictures were selected by respondents both in Japan and in the U.S. as depicting the chin-down posture; (2) 23% of Japanese and 58% of the U.S. SLPs made a distinction between chin down and chin tuck; and (3) the use of anatomical terminology by SLPs differed between the two countries. This study showed that there is poor agreement among SLPs about the meaning of the chin-down and chin-tuck postures. Developing a precise definition is important because various postures may have differing physiologic effects.

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References

  1. Logemann JA: Evaluation and treatment of swallowing disorders. Austin, TX: Pro-Ed, 1998

    Google Scholar 

  2. White AA, Panjabi MM: Clinical Biomechanics of the Spine. Philadelphia: J.B. Lippincott, 1978

    Google Scholar 

  3. DeLisa JA, Gans BM: Rehabilitation Medicine Principles and Practice. Philadelphia: Lippincott-Raven, 1998

    Google Scholar 

  4. Hislop HJ, Montgomery J: Daniels and Worthingham’s muscle testing : techniques of manual examination. Philadelphia: W.B. Saunders, 2002

    Google Scholar 

  5. Shanahan TK, Logemann JA, Rademaker AW, Pauloski BR, Kahrilas PJ: Chin-down posture effect on aspiration in dysphagic patients. Arch Phys Med Rehabil 74:736–739, 1993

    Article  PubMed  CAS  Google Scholar 

  6. Ekberg O: Posture of the head and pharyngeal swallowing. Acta Radiol Diagn (Stockh) 27:691–696, 1986

    CAS  Google Scholar 

  7. Welch MV, Logemann JA, Rademaker AW, Kahrilas PJ: Changes in pharyngeal dimensions effected by chin tuck. Arch Phys Med Rehabil 74:178–181, 1993

    PubMed  CAS  Google Scholar 

  8. Ertekin C, Keskin A, Kiylioglu N, Kirazli Y, On AY, Tarlaci S, Aydogdu I: The effect of head and neck positions on oropharyngeal swallowing: a clinical and electrophysiologic study. Arch Phys Med Rehabil 82:1255–1260, 2001

    Article  PubMed  CAS  Google Scholar 

  9. Lewin JS, Hebert TM, Putnam JB Jr, DuBrow RA: Experience with the chin tuck maneuver in postesophagectomy aspirators. Dysphagia 16:216–219, 2001

    Article  PubMed  CAS  Google Scholar 

  10. Okada S, Saitoh E, Yokoyama M, Baba M, Fujii W, Shigeta R, Terao S: The influence of the head and neck positions on the oropharyngeal structure and swallowing movement. Dyaphagia Res Soc 201, 2004

  11. Logemann JA: Evaluation and treatment of swallowing disorders. Austin, TX: Pro-Ed, 1983

    Google Scholar 

  12. Groher ME: Dysphagia : diagnosis and management. Boston, MA: Butterworth-Heinemann, 1997

    Google Scholar 

  13. Bülow M, Olsson R, Ekberg O: Videomanometric analysis of supraglottic swallow, effortful swallow, and chin tuck in healthy volunteers. Dysphagia 14:67–72, 1999

    Article  PubMed  Google Scholar 

  14. Bülow M, Olsson R, Ekberg O: Supraglottic swallow, effortful swallow, and chin tuck did not alter hypopharyngeal intrabolus pressure in patients with pharyngeal dysfunction. Dysphagia 17:197–201, 2002

    Article  PubMed  Google Scholar 

  15. Huckabee ML, Pelletier CA: Management of adult neurogenic dysphagia. San Diego, CA: Singular Publishing Group, 1999

    Google Scholar 

  16. Karaho T: The chin down effect in normal swallowing. J Jpn Bronchoesophagol 50:396–409, 1999

    Google Scholar 

  17. Okada S, Saitoh E, Iizumi T, Shigeta R, Kunori Y, Baba M, Matsuo K, Yokoyama M, Palmer JB: What is the Chin down posture? An analysis of questionnaire to the speech therapists in Japan. Jpn J Dysphagia Rehabil 9:148–158, 2005 [in Japanese]

    Google Scholar 

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Acknowledgment

This research was partially supported by 2004 Grant-in-Aid for Scientific Research of the Health, Labor and Welfare Ministry (H14-Longevity-019).

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Authors and Affiliations

  1. Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan

    Sumiko Okada SLP, MS & Mikoto Baba MD

  2. Department of Rehabilitation Medicine, Fujita Health University, Toyoake, Aichi, Japan

    Eiichi Saitoh MD & Michio Yokoyama MD

  3. Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, Maryland, USA

    Jeffrey B. Palmer MD & Koichiro Matsuo DDS, PhD

  4. Department of Otolaryngology-Head and Neck Surgery, and Center for Functional Anatomy and Evolution, Johns Hopkins University, Baltimore, Maryland, USA

    Jeffrey B. Palmer MD

  5. Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Aichi, Japan

    Ritsuko Shigeta SLP

  6. School of Health Sciences, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan

    Sumiko Okada SLP, MS

Authors
  1. Sumiko Okada SLP, MS
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  2. Eiichi Saitoh MD
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  3. Jeffrey B. Palmer MD
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  4. Koichiro Matsuo DDS, PhD
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  5. Michio Yokoyama MD
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  6. Ritsuko Shigeta SLP
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  7. Mikoto Baba MD
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Corresponding author

Correspondence to Sumiko Okada SLP, MS.

Appendix 1

Appendix 1

  1. Q1:

    Do you think chin-down position is the same as chin-tuck position? Please check your choice

    • Yes ( ) No ( )

  2. Q2:

    Please choose a figure of chin-down position you are instructing to your patients from A to E on a Figure sheet and check the box below. If you use more than one posture as chin down, fill the number 1 (the most frequent)-3 (the least) in box. If you think chin tuck is different from chin down, please indicate your chin tuck as letters of “C-T” in box

    • A. B. C. D. E.

  3. Q3:

    Please, give us your career as a SLP

    • A. ( ) 1–2 years, B. ( ) 3–5 years, C. ( ) more than 5 years.

  4. Q4:

    How many dysphagic patients do you treat per month? Please fill number in box.

    • About ( ) patients

  5. Q5:

    If you have any clinical idea about the chin-down position, please tell it.

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Okada, S., Saitoh, E., Palmer, J.B. et al. What Is the Chin-down Posture? A Questionnaire Survey of Speech Language Pathologists in Japan and the United States. Dysphagia 22, 204–209 (2007). https://doi.org/10.1007/s00455-006-9073-0

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  • DOI: https://doi.org/10.1007/s00455-006-9073-0

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