2008 Volume 12 Issue 2 Pages 118-123
【Purpose】Reclining the body backward to make the bolus pass smoothly from the oral cavity to the pharynx shortens the transit time in patients with oral phase disorder. We investigated how the transit time of bolus through the oral cavity differs by changing the eating posture, food form and feeding therapy with the aims of safer eating and improvement of patients' self-support in eating.
【Subject and methods】Twenty-nine patients were enrolled in this study (16 males and 13 females, average age 73 years). In these patients, video-fluorography (VF) examination was performed using gelatin jelly, rice porridge and thickened water as test foods. Barium sulfate with 30% concentration was used to contrast these test foods. The eating postures were set at 30 to 45 degrees and 60 to 90 degrees from the horizontal. The time between the moment when the bolus reached the middle of the tongue and the moment when the end part of the bolus reached the narrow palate arch was measured as the transit time by viewing VF images.
【Results】The transit time of jelly was 4.6 ± 4.8 seconds, that of rice porridge was 8.3 ± 8.1 seconds, and that of thickened water was 2.2 ± 2.1 seconds at 30 to 45 degrees, while the transit time of jelly was 6.9 ± 7.0 seconds, that of rice porridge was 7.0±6.6 seconds, and that of thickened water was 3.1±2.7 seconds at 60 to 90 degrees. The transit tme of thickened water was shorter than that of gelatin jelly and that of rice porridge for any posture. The transit time of rice porridge was the longest for any posture. The jelly was transferred more quickly at 30 to 45 degrees than at 60 to 90 degrees (p ＜ 0.05).
【Conclusion】We recommend using jelly at the beginning of feeding therapy. It is better to set the eating posture at 30 to 45 degrees to improve patients' safety and reduce their burden. On the other hand, when thickened water and rice porridge is used for rehabilitaion, the transit time did not differ significantly according to eating posture. However, the eating posture of 60 to 90 degrees might enhance the level of patients' daily activity if the patients do not have any serious disorder in the pharyngeal swallowing phase.