Journal article
Effect of Body Position on Pharyngeal Swallowing Pressures Using High-Resolution Manometry
Dysphagia, Vol.33(3), pp.389-398
06/01/2018
DOI: 10.1007/s00455-017-9866-3
PMID: 29218488
Abstract
The effect of body position and gravitational pull on the complex pressure-driven process of pharyngeal swallowing remains unknown. Using high-resolution manometry (HRM), this study aims to identify positional adaptations of pharyngeal physiology by evaluating swallowing pressure patterns in a series of inverted body positions. Ten healthy adults each underwent swallowing tasks with pharyngeal HRM at six body positions using an inversion table (0°[upright], 45°, 90°[supine], 110°, 135°, and 180°[fully inverted]). Repeated measures ANOVA was used to assess impact of position on pressure parameters, and pharyngeal-UES pressure gradients translate. Velopharyngeal pressures varied by position (P < 0.001), with significantly higher pressures generated with inversion ≥90°, compared with upright and 45°. Change in position did not significantly affect common mesopharyngeal pressures or swallowing pressure durations. UES valving mechanisms were preserved during inversion, with subtle variations observed in integral pressures (P = 0.011). Pharyngeal-UES pressure gradients changed with position (P < 0.01), increasing with inversion > 90° compared to upright and 45°. Mechanisms of deglutition may differ with position and relative direction of gravity, particularly when at > 45° inclination. Increased palatal pressure is generated in the upside-down position to achieve nasopharyngeal closure and prevent regurgitation. While other classically measured pressures may not consistently differ with positioning, many individuals exhibit adaptations in pressure gradients when inverted, likely due to a combination of changes in pharyngeal driving force and UES opening mechanisms. Identification of these changes, relative to position, further builds on our understanding of the adaptability of the pharyngeal swallowing system.
Details
- Title: Subtitle
- Effect of Body Position on Pharyngeal Swallowing Pressures Using High-Resolution Manometry
- Creators
- Sarah P Rosen - University of Wisconsin–MadisonSuzan M Abdelhalim - University of Wisconsin–MadisonCorinne A Jones - University of Wisconsin–MadisonTimothy M McCulloch - University of Wisconsin–Madison
- Resource Type
- Journal article
- Publication Details
- Dysphagia, Vol.33(3), pp.389-398
- DOI
- 10.1007/s00455-017-9866-3
- PMID
- 29218488
- NLM abbreviation
- Dysphagia
- ISSN
- 0179-051X
- eISSN
- 1432-0460
- Grant note
- DC011130 / NIH HHS T32 GM007507 / NIH HHS R21 DC011130 / NIDCD NIH HHS T32 GM007507 / NIGMS NIH HHS R33 DC011130 / NIDCD NIH HHS T32 DC009401 / NIH HHS T32 DC009401 / NIDCD NIH HHS
- Language
- English
- Date published
- 06/01/2018
- Academic Unit
- Communication Sciences and Disorders
- Record Identifier
- 9985217033502771
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