Abstract
Ota K, Saitoh E, Kagaya H, Sonoda S, Shibata S. Effect of postural combinations-the reclined seated position combined with head rotation-on the transport of boluses and aspiration. Jpn J Compr Rehabil Sci 2011; 2: 36-41
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.
