[Effect of body position on coordination of breathing and swallowing]. / Einfluss der Körperposition auf die Atem-Schluck-Koordination.

BACKGROUND: To allow passage of food, the swallowing process closes off the larynx and interrupts respiratory flow. Both the timing of the interruption of respiratory flow and the body position can affect the results of the swallowing process. OBJECTIVE: The effect of body position on the swallowing process and the coordination of breathing and swallowing is investigated. MATERIALS AND METHOD: A combined EMG/bioimpedance measurement system and a piezoelectric sensor were used to investigate coordination of breathing and swallowing of a range of food consistencies in three different body positions (90°, 45° and 0°) in healthy subjects. RESULTS: Investigations were carried out on 21 healthy subjects (12 ♂, 9 ♀). 762 swallows were recorded. Changing body position was found to have a statistically significant effect on swallow-related parameters (maximum laryngeal elevation and speed of laryngeal elevation) and breathing pattern (pre- and post-swallow breathing phases). The laryngeal elevation as well as the speed of the laryngeal elevation is influenced significantly by the consistency to be swallowed. The breathing pattern changes from saliva to solid food of inspiration/swallow/inspiration to expiration/swallow/expiration. A change of body position influences the parameters specific for swallowing and the breathing patterns significantly. CONCLUSIONS: This study demonstrates that body position affects coordination of breathing and swallowing and swallow-related parameters in healthy subjects. Our results indicate that patients should be enabled to adopt a position in which they are sitting at an angle of at least 45°.

[Electric stimulation in dysphagia therapy--a review]. / Elektrische Stimulation in der Dysphagietherapie - Eine Ubersicht.

In the last years an increased interest in the electrical stimulation has consisted in the treatment of dysphagia. In the article we introduce the anatomical and physiological premises for the method. In a critical analysis the present state of art is represented, the clinical results are checked and the chances for the future are examined.