2010 Volume 14 Issue 3 Pages 238-243
Objective: Physiotherapists have found that many dysphagia patients have limited range of motion of the cervix and problems with sitting posture during dysphagia rehabilitation. Therefore, physiotherapists and speech therapists examined the range of motion of the cervix, sitting posture and hump-back, and the factors related to dysphagia.
Methods: Twenty-seven patients (11 men and 16 women) who had been diagnosed as pneumonia or cerebral vascular accident participated in this study. They were requested to perform rehabilitation from October 2008 to March 2009. We classified them into I/II groups and III/IV groups by Fujishima's grading, and for each group compared whether they had sitting posture and hump-back or not, and the range of motion of the cervix. Next, we grouped sitting postures into the bed-back rest group and the sitting group, and compared the range of motion of the cervix of the dysphagia grade I/II groups with III/IV groups. Next, we classified the patients by whether they had hump-back or not, and compared the range of motion of the cervix between grade I/II and grade III/IV.
Results: As regards the range of motion of the cervix, we found significantly limited range of motion of extension, rotation and lateral bend in I/II groups, compared with those of III/IV groups. In the sitting group, we found a significantly limited range of motion of extension, rotation and lateral bend in I/II groups, compared with those of III/IV groups. But in the bed-back rest group, we could not find any such differences. In the hump-back group and normal group, the dysphagia grade was not related to the range of motion of the cervix.
Consideration: The finding of limited range of motion of the cervix in those patients whose swallowing ability had declined suggested that decreased flexibility of the cervix limits the range of motion and impairs the swallowing ability.
In the sitting posture, a decline of the ability to maintain a seated position places strain on the cervix, causing limitation of the range of motion of the cervix and impaired swallowing ability. A comparison of the hump-back group and normal group did not show a relation between limited range of motion of the cervix and swallowing ability.
