Abstract
Posture changes are used as therapy techniques for several types of patients with dysphagia. Postural strategies for dysphagia are designed to eliminate the risk of aspiration by altering the bolus flow and pharyngeal dimensions during swallowing. When postures are selected to match the anatomic and physiologic aspects of swallowing disorders, the postural techniques have been demonstrated to eliminate aspiration effectively. It is important to diagnose the anatomic and physiological features of swallowing disorders, and then select the appropriate posture according to the swallowing problem. Recently videofluorographic and/or videoendoscopic examinations are used as precise diagnostic and management tools.
The head down (chin down) posture is widely used as a safe position with swallowing disorders. Chin down produces space in the vallecula, so that bolus entering the vallecula remains until the pharyngeal swallowing is triggered. Head rotation to the damaged side allows bolus passage down the intact contralateral side. Head back provides gravity assistance to the bolus flow through the oral cavity and pharynx. Combinations of these strategies can be used with added effect.
Postural techniques are helpful to prevent aspiration through redirected bolus flow or changed pharyngeal dimensions. However, as definitions of posture positions have never been clear, we should define postural positions and their physical effects on swallowing functions.
