Effect of Body Position on Pharyngeal Swallowing Pressures Using High-Resolution Manometry.
Sarah P Rosen, Suzan M Abdelhalim, Corinne A Jones and 1 others
PMID 29218488WHAT IT FOUND
Swallowing water while lying flat or inverted raised velopharyngeal pressures compared with upright. 45° pressure was lower than 110°, 135°, and 180°.
UES pressure events mostly stayed similar. Expect position-related pressure changes in non-upright swallowing assessments.
Key findings
01Velopharyngeal maximum pressure and pressure integral were lower upright than at 90°, 110°, 135°, and 180°, and lower at 45° than at 110°, 135°, and 180°.
02Pharyngeal-UES pressure gradient was greater at 90°, 110°, 135°, and 180° than upright and 45°, and the integral gradient was largest at 180°.
03UES pre-opening maximum, post-opening maximum, and baseline pressures did not differ across positions, but minimum pressure was higher at 45° and 90° than upright and 180°.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study included only healthy adults with no swallowing, respiratory, or neurological deficits, so it cannot describe people with dysphagia. The sample was small, and the study did not evaluate differences by gender. Swallowing trials were run in a fixed order, so practice or adaptation effects cannot be ruled out. No imaging was done at the same time as manometry, so the pressure findings cannot be linked directly to anatomy or bolus flow. The catheter did not reach the distal esophagus, so distal pressure changes were not assessed. Only water boluses of one volume were tested, so bolus type and volume effects are unknown. Pairwise comparisons were not adjusted for the number of comparisons.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read these pressure changes as proof that lying flat or inverted improves swallowing safety. The study measured healthy adults only and did not test aspiration, residue, or patients with dysphagia.