International Journal of Physical Medicine & Rehabilitation
Open Access

Abstract

Effects of Posture on Subjective Swallowing Difficulty during Screening Tests for Dysphagia

Yoshitaka Shinjo, Ayako Okitsu, Ikumi Ukeda, Ayako Miyagi, Kazuhisa Domen and Tetsuo Koyama

Objective: To assess how postural adjustment affects subjective swallowing difficulty during swallowing rehabilitation.

Subjects: Sixteen normal volunteers.

Design: Three screening tests – repetitive saliva swallowing, water swallowing, and food swallowing – were performed in 7 positions: upright, backrest, slouching, reclining 60° supine, reclining 60° lateral, reclining 30° supine, and reclining 30° lateral. Subjective swallowing difficulty was assessed using a visual analogue scale (VAS; 0 - 10).

Results: Patients indicated minimum difficulty while upright, and responses showed that the further from perpendicular was the reclining angle, the more difficulty they reported in swallowing. During food swallowing in supine positions, when reclining 60° VAS score was 3.06, and at 30° was 4.62. In lateral positions, VAS score increased along the same lines. Results were similar for all three swallowing tests.

Conclusion: Postural adjustment nduced considerably higher subjective swallowing difficulty. When imposing postural adjustment, clinicians should be aware of the subjective difficulty that patients have in swallowing.