The Influence of a Change of Posture on Swallowing Function

― Change of Swallowing Function with Posture of Neck, Trunk and Lower Limbs ―

Abstract

We reviewed the influence of a change of posture on swallowing. The subjects were 21 normal adults (average age：30.6 ± 9.7 years old). We performed a survey and examination after obtaining informed consent. We took the sitting position without using a support for the back and set four postures making neck position free without limitation： ① Posture (a)：hip flexion 90 degrees, knee flexion 90 degrees, ② Posture (b)：crotch flexure 135 degrees, knee flexure 90 degrees, ③ Posture (c)：crotch flexure 90 degrees, knee flexure zero degree, and ④ posture (d)：elevation of both lower extremities. With the subjects in these postures, we performed videofluorography and the repetitive saliva swallowing test. In each posture, 15 ml of 70％ diluted barium solution were swallowed at a given signal, and we performed a Logemann assay, and measured the pharynx transit time by videofluorography. We performed RSST for similar postures and measured the number of deglutition times by palpation. In addition, we performed one-way analysis of variance in statistical processing and examined the results by Tukey's multiple comparison tests. As a result, we compared the pharynx transit time of postures (a) and (b), and no significant difference was observed. In comparison with the pharynx transit time of postures (c) (p＜0.05) and (d) (p＜0.01) by videofluorography, however, significantly lower values were shown. Also, the pharynx transit time of posture (b) was significantly lower than that of posture (c) (p＜0.05). The results obtained by RSST were similar to those by videofluorography. For dysphagia, there are few reports on the positioning of the lower limbs. It is assumed that a change of posture including the lower limbs had an influence on swallowing function. From the above, it is suggested that the posture is important when considering appendicular mutual relations of the neck and trunk.