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 45in a
reclined seated position with a 30head 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 45reclined seated position.
Conclusion: These findings suggest that certain
postural combinations may increase the risk of
aspiration.
Key words: dysphagia, aspiration, posture, rehabilitation, stroke