2009 Volume 13 Issue 1 Pages 3-9
In this study, changes in swallowing activity due to different cervical rotations and trunk inclination angles were examined. The basic posture was set at 60° semi-Fowler's position and the following three posture conditions were established in consideration of the mutual relationship between cervical rotation and trunk inclination angle: (1) Posture A: cervical median position, median trunk position, (2) Posture B: 30°cervical rotation, trunk median position, and (3) Posture C: cervical median position, 30° trunk inclination angle. The subjects enrolled in this study included 11 normal elderly volunteers with no disturbed swallowing in daily activities (normal group) and 13 patients with cerebrovascular disorder (disease group). In the two groups, the water swallowing test (WST) and repetitive saliva swallowing test (RSST) were performed. The result of WST was assessed to be negative or positive according to the profile, while that of RSST was assessed by comparing the determined frequencies between various postures. As a result, no significant difference was observed in the results of WST and of RSST between various postures in the normal group. Comparing the results of WST in the disease group, on the other hand, a negative result was observed significantly often for Postures A and C as compared with Posture B. Concerning RSST as well, significantly higher values were obtained for Postures A and C as compared with Posture B. In the comparison of WST between the normal and disease groups, the result in the normal group was significantly better than that in the disease group. In the comparison of RSST between the two groups, significantly higher values were observed in the normal group than in the disease group for all Postures A, B and C. These results suggest it is effective to establish the cervical median position at the basic posture of 60°semi-Fowler’s position. Furthermore, it is also suggested that not only to rotate the neck alone but also to establish the trunk at a inclination position while maintaining the neck at the median position is useful in patients with dysphagia due to disturbed pharyngeal passing on the paralyzed side.