The Effectiveness of the Chin-Down Posture in the Improvement of Dysphagia in Stroke Patients

Tai, Shiu-Hao

Introduction

This study investigates the effectiveness of the Chin-down swallowing technique in the improvement of dysphagia in stroke patients.

Methods

This study was a quasi-experimental design conducted in January 2013 to December 2013 .Subjects were selected by purposive sampling from in stroke patients with dysphagia the rehabilitation and neurologic department of a medical center. Patients with brainstem stroke, brain trauma, or past cervical vertebra damage were excluded; patients with unstable vital signs, those who could not follow instructions, and those who could not perform the maneuver were also excluded. Those patients who met the inclusion criteria were alternately assigned to the experimental group and the control group, for 30 patients in each group and a total of 60 subjects. The experimental group applied the Chin-down swallowing technique at least 3 times a day, 3-5 minutes at a time, for a period of 4 weeks. Nurse completed “The Dysphasia Assessment Scale “and “The Swallow Self-assessment “as the evaluation of the experiment outcome at the beginning and after 4 weeks of training.

Results and Conclusion

The results of this research showed 68.3% with cerebral infarction, 66.7% on oral feeding, 78.3% first-time stroke. The chi-square and paired t-test were used to compare the effect of Chin-down swallowing training. There were significant differences(p< .05)in the dysphasia assessment scale between the difference of pretest and post-test among 2 groups in the questions:(1)the need of careful swallowing,(2)inability to maintain food in your mouth,(3) awake up choking with saliva,(4)having swallowing difficulty,(5)having ENT problems. Comparing the differences between pretest and post-test in swallow self-assessment showed significant differences (p< .05) between experimental group and control group in (1) difficulty with swallow causes weight loss, (2) swallow causes pain, (3) cough during eating, (4) pressure in the throat swallowing. This study confirmed the effectiveness of the Chin-down swallowing technique to improve dysphagia among the stroke patients.