The Relationship Between Posture and Swallowing: Difference between revisions
No edit summary |
No edit summary |
||
| Line 10: | Line 10: | ||
== Deglutition and Posture == | == Deglutition and Posture == | ||
Deglutition has a direct impact on the postural system.<ref name=":1">Banfi M. Deglutition Course. Physioplus, 2021.</ref><ref>Bordoni B, Morabito B, Mitrano R, Simonelli M, Toccafondi A. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6390887/ The anatomical relationships of the tongue with the body system]. Cureus. 2018;10(12):e3695. </ref> | Deglutition has a direct impact on the postural system.<ref name=":1">Banfi M. Deglutition Course. Physioplus, 2021.</ref><ref name=":2">Bordoni B, Morabito B, Mitrano R, Simonelli M, Toccafondi A. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6390887/ The anatomical relationships of the tongue with the body system]. Cureus. 2018;10(12):e3695. </ref> | ||
* Alghadir and colleagues found that when the tongue is positioned against the upper incisors, postural stability is enhanced in young adults when they are standing on unstable surfaces or are without visual cues<ref>Alghadir AH, Zafar H, Iqbal ZA. Effect of tongue position on postural stability during quiet standing in healthy young males. Somatosens Mot Res. 2015;32(3):183-6.</ref> | * Alghadir and colleagues found that when the tongue is positioned against the upper incisors, postural stability is enhanced in young adults when they are standing on unstable surfaces or are without visual cues<ref>Alghadir AH, Zafar H, Iqbal ZA. Effect of tongue position on postural stability during quiet standing in healthy young males. Somatosens Mot Res. 2015;32(3):183-6.</ref> | ||
| Line 22: | Line 22: | ||
The deglutition cycle is repeated thousands of times each day in all positions (standing, sitting, sleeping etc). Every time an individual swallows (starting in utero), increased force is applied to his / her teeth and cranial system.<ref name=":1" /> The forces applied during childhood, particularly those generated by the masticatory muscles, are believed to be associated with an adult’s facial features.<ref>Inoue M, Ono T, Kameo, Y, Sasaki F, Ono T, Adachi T et al. [https://www.nature.com/articles/s41598-019-40463-3 Forceful mastication activates osteocytes and builds a stout jawbone]. Sci Rep 9, 4404 (2019).</ref> | The deglutition cycle is repeated thousands of times each day in all positions (standing, sitting, sleeping etc). Every time an individual swallows (starting in utero), increased force is applied to his / her teeth and cranial system.<ref name=":1" /> The forces applied during childhood, particularly those generated by the masticatory muscles, are believed to be associated with an adult’s facial features.<ref>Inoue M, Ono T, Kameo, Y, Sasaki F, Ono T, Adachi T et al. [https://www.nature.com/articles/s41598-019-40463-3 Forceful mastication activates osteocytes and builds a stout jawbone]. Sci Rep 9, 4404 (2019).</ref> | ||
== Palatine Spot == | |||
The palatine spot is on the roof of the mouth (i.e. palate. It corresponds with the palatine bone, between the interdental papillam(i.e. gum tissue between the teeth) of the top front teeth and the first fold of the palate.<ref>di Vico R, Ardigò LP, Salernitano G, Chamari K, Padulo J. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3940506/ The acute effect of the tongue position in the mouth on knee isokinetic test performance: a highly surprising pilot study]. Muscles Ligaments Tendons J. 2014;3(4):318-23.</ref> This spot has a large number of trigeminal nerve endings and exteroceptors.<ref name=":2" /> | |||
Correct stimulation of the palatine spot helps to inform postural control centres about relevant anatomical structures (e.g. the teeth, arches of the teeth, head position etc).<ref name=":1" /> | |||
== Red Flags == | |||
Whenever assessing swallowing, it is essential to screen for red flags, including neurological and degenerative pathologies (e.g. multiple sclerosis, amyotrophic lateral sclerosis (ALS), myasthenia gravis etc). In cases where there is a loss of strength related to a central deficit, it is important to aim for active motor coordination and allow for necessary postural compensations. The goal is not to achieve the optimal normal position, but to maintain residual function.<ref name=":1" /> | |||
== Posture == | |||
The assessment of posture is discussed [[Postural Principles Useful in Speech Therapy|here]]. These same tests can be repurposed to see how the system changes in response to deglutition.<ref name=":1" /> | |||
* Look for any compensation during swallowing - is the head in the correct position? Is there a forward head position?<ref name=":1" /> | |||
* When posture is corrected, observe if deglutition is: <ref name=":1" /> | |||
** Possible | |||
** Possible, but only with difficulty | |||
** Impossible | |||
== References == | == References == | ||
Revision as of 02:23, 9 July 2021
Top Contributors - Jess Bell, Kim Jackson, Tarina van der Stockt, Lucinda hampton and Kirenga Bamurange Liliane
Introduction[edit | edit source]
Deglutition (i.e. swallowing) enables food to move from the mouth to the stomach, via the pharynx and oesophagus.[1]
There is evidence to suggest that swallowing begins to develop in utero from 15 weeks gestation.[1] Swallowing actions (such as sucking, swallowing and the breathing sequence) continue to evolve after birth as babies are introduced to new food and start to exercise conscious control over their swallowing.[1] Our ability to swallow continues to change as we age, eventually leading to swallowing disorders in some adults.[2]
Deglutition and Posture[edit | edit source]
Deglutition has a direct impact on the postural system.[3][4]
- Alghadir and colleagues found that when the tongue is positioned against the upper incisors, postural stability is enhanced in young adults when they are standing on unstable surfaces or are without visual cues[5]
- Wildenberg and colleagues found that electrical stimulation of the tongue had a positive effect on balance, gait, and posture in patients who had with postural dysfunction[6]
The tongue is the first structure to influence postural chains. The input from the feet becomes more important when a child is able to maintain an upright position and begin walking.[3]
The pattern of the deglutition changes from childhood to adulthood:[3]
- Children apply forces of up to 300g when chewing whereas adults can apply 3kg of force
The deglutition cycle is repeated thousands of times each day in all positions (standing, sitting, sleeping etc). Every time an individual swallows (starting in utero), increased force is applied to his / her teeth and cranial system.[3] The forces applied during childhood, particularly those generated by the masticatory muscles, are believed to be associated with an adult’s facial features.[7]
Palatine Spot[edit | edit source]
The palatine spot is on the roof of the mouth (i.e. palate. It corresponds with the palatine bone, between the interdental papillam(i.e. gum tissue between the teeth) of the top front teeth and the first fold of the palate.[8] This spot has a large number of trigeminal nerve endings and exteroceptors.[4]
Correct stimulation of the palatine spot helps to inform postural control centres about relevant anatomical structures (e.g. the teeth, arches of the teeth, head position etc).[3]
Red Flags[edit | edit source]
Whenever assessing swallowing, it is essential to screen for red flags, including neurological and degenerative pathologies (e.g. multiple sclerosis, amyotrophic lateral sclerosis (ALS), myasthenia gravis etc). In cases where there is a loss of strength related to a central deficit, it is important to aim for active motor coordination and allow for necessary postural compensations. The goal is not to achieve the optimal normal position, but to maintain residual function.[3]
Posture[edit | edit source]
The assessment of posture is discussed here. These same tests can be repurposed to see how the system changes in response to deglutition.[3]
- Look for any compensation during swallowing - is the head in the correct position? Is there a forward head position?[3]
- When posture is corrected, observe if deglutition is: [3]
- Possible
- Possible, but only with difficulty
- Impossible
References[edit | edit source]
- ↑ 1.0 1.1 1.2 Panara K, Ramezanpour Ahangar E, Padalia D. Physiology, Swallowing. [Updated 2020 Aug 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK541071/
- ↑ Kletzien H, Cullins MJ, Connor NP. Age-related alterations in swallowing biomechanics. Exp Gerontol. 2019;118:45-50.
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 Banfi M. Deglutition Course. Physioplus, 2021.
- ↑ 4.0 4.1 Bordoni B, Morabito B, Mitrano R, Simonelli M, Toccafondi A. The anatomical relationships of the tongue with the body system. Cureus. 2018;10(12):e3695.
- ↑ Alghadir AH, Zafar H, Iqbal ZA. Effect of tongue position on postural stability during quiet standing in healthy young males. Somatosens Mot Res. 2015;32(3):183-6.
- ↑ Wildenberg JC, Tyler ME, Danilov YP, Kaczmarek KA, Meyerand ME. Sustained cortical and subcortical neuromodulation induced by electrical tongue stimulation. Brain Imaging Behav. 2010;4(3-4):199-211.
- ↑ Inoue M, Ono T, Kameo, Y, Sasaki F, Ono T, Adachi T et al. Forceful mastication activates osteocytes and builds a stout jawbone. Sci Rep 9, 4404 (2019).
- ↑ di Vico R, Ardigò LP, Salernitano G, Chamari K, Padulo J. The acute effect of the tongue position in the mouth on knee isokinetic test performance: a highly surprising pilot study. Muscles Ligaments Tendons J. 2014;3(4):318-23.
