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Spine (Phila Pa 1976). 2005 Apr 1;30(7):E179-82.

The influences of Halo-vest fixation and cervical hyperextension on swallowing in healthy volunteers.

Author information

1
Department of Rehabilitation, Toyohashi Municipal Hospital, Aichi, Japan. mnaohito@katch.ne.jp

Abstract

STUDY DESIGN:

Radiographic and electromyographic evaluation of swallowing functions was performed for different positions with a Halo-vest brace.

OBJECTIVES:

The aim of this study was to clarify the mechanism of dysphagia of cervical hyperextension with a Halo-vest brace in neurologically normal adult volunteers.

SUMMARY OF BACKGROUND DATA:

Garfin et al reported that 3 of 179 patients had dysphagia attributable to the Halo-vest brace after cervical spinal cord injury. Readjustment of the position of the head in the Halo-vest brace was required in those cases. They concluded that the head-extended position with a Halo-vest brace made it difficult to swallow. However, the details of this dysphagia were not known.

METHODS:

Six healthy adults volunteers between the ages of 24 and 33 participated in this study. Subjects were radiographically and electromyographically observed swallowing thin liquids at the neutral position without a Halo-vest brace (N-HV), the neutral position with a Halo-vest brace (N+HV) and at hyperextension with a Halo-vest brace (E+HV).

RESULTS:

In the durational measurements, there were significant changes between the N-HV and E+HV in pharyngeal transit time. The motion measurements showed that the initial hyoid position placed lower from the mandibular plane, and vertical hyoid movement was prolonged in the E+HV. In the electromyographic measurements, greater activity was observed from the suprahyoid muscles in the E+HV. One subject had laryngeal penetration already in the N-HV, and the same subject exhibited aspiration in the E+HV. Another two subjects exhibited penetration in the E+HV.

CONCLUSION:

The result of this study demonstrated that cervical hyperextension with the Halo-vest brace caused mechanical changes in the swallowing of normal healthy adult volunteers.

PMID:
15803067
[Indexed for MEDLINE]

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