Kikuo Ota, MD, DMSc, Eiichi Saitoh, MD, DMSc, Hitoshi Kagaya, MD, DMSc, Shigeru Sonoda, MD, DMSc, Seiko Shibata, MD, DMSc
Jpn J Compr Rehabil Sci 2: 36-41, 2011
Purpose: The purpose of this study was to determine
combinations of compensatory postural maneuvers
used for dysphagic patients that could increase the risk
of aspiration.
Methods: Study 1: The pathway of the transported
bolus was examined in various combinations of 30°
head flexion, head rotation to the right (0°, 30°, or 60°)
and reclined seated position (90°, 60°, or 45°) by using
synchronized imaging of videofluoroscopic (VF; AP
view) and videoendoscopic (VE) evaluation of
swallowing in 5 healthy volunteers (24-45 years).
Study 2: The occurrence of aspiration was evaluated in
combinations of 30° head flexion, head rotation (0°
and 30° left and right), and a reclined seated position
(90°, 60°, or 45°) by using VF lateral view in 10
dysphagic patients (74.7 ± 6.7 years).
Results: Study 1: In a combined posture of 45°in a
reclined seated position with a 30°head rotation to the
right, the bolus reached the pyriform sinus on the side
of rotation before the onset of the swallowing reflex in
2 of the 5 healthy volunteers. Study 2: The aspiration
rate was highest (40%) at a combined posture of 30°
head rotation and 45°reclined seated position.
Conclusion: These findings suggest that certain
postural combinations may increase the risk of
aspiration.
Key words: dysphagia, aspiration, posture, rehabilitation, stroke