Swallowing function in healthy subjects with C spine immobilisation
Research type
Research Study
Full title
Swallowing function in healthy adults with and without C spine immobilisation
IRAS ID
270414
Contact name
Michael Fertleman
Contact email
Sponsor organisation
Imperial College Healthcare NHS Trust
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Research Summary
We aim to test swallowing function in adults wearing a spinal collar to immobilise the spine and compare this to their swallowing function without the collar. In addition the study will collect demographic data.
Our hypothesises are:
1. The spinal collar affects swallowing function.
2. The swallowing function is more affected in the elderly population.Summary of Results
An increase in the median MBSImPTM© score amongst all participants in the oral phase of swallow (p=0.01) and combined oral and pharyngeal phase of swallow (p=0.006) was seen when volunteers were fitted with the Miami-J® collar, compared to no collar.
When wearing the collar, deterioration in swallow function and small increases in PAS (Penetration Aspiration Scale) level were more marked in the older cohort, but these latter findings were not statistically significant.
Cervical hard collars change swallowing physiology in younger and older volunteers. Whilst we did not measure a statistically significant difference in the PAS level pre- and post- collar wearing, we feel it is important to highlight these changes in swallowing physiology and speculate that with collar use there is a potential risk of aspiration associated with these changes.
Potential risk of aspiration should be carefully balanced with the benefit gained from collar use in the management of cervical spine injury (both in conservative and postoperative management). Although this is a small study it is important to highlight an area of concern of particular importance in the older population who have physiological changes to the swallow that occur with age (presbyphagia) and where baseline risk of aspiration is higher.
Summary of results
An increase in the median MBSImPTM© score amongst all participants in the oral phase of swallow (p=0.01) and combined oral and pharyngeal phase of swallow (p=0.006) was seen when volunteers were fitted with the Miami-J® collar, compared to no collar.
When wearing the collar, deterioration in swallow function and small increases in PAS (Penetration Aspiration Scale) level were more marked in the older cohort, but these latter findings were not statistically significant.
Cervical hard collars change swallowing physiology in younger and older volunteers. Whilst we did not measure a statistically significant difference in the PAS level pre- and post- collar wearing, we feel it is important to highlight these changes in swallowing physiology and speculate that with collar use there is a potential risk of aspiration associated with these changes.
Potential risk of aspiration should be carefully balanced with the benefit gained from collar use in the management of cervical spine injury (both in conservative and postoperative management). Although this is a small study it is important to highlight an area of concern of particular importance in the older population who have physiological changes to the swallow that occur with age (presbyphagia) and where baseline risk of aspiration is higher.
REC name
East Midlands - Nottingham 1 Research Ethics Committee
REC reference
20/EM/0194
Date of REC Opinion
23 Sep 2020
REC opinion
Further Information Favourable Opinion