Clinical advantages of eating positions of the mid-neck on swallowing function

Abstract

[Purpose] There is an established theory that slightly flexed neck positions are ideal for all patients with swallowing disorders. However, we noted that this theory needs further study of the effects of the mid-neck positions on the extended line from the trunk on swallowing function. [Subjects and Methods] Examinations were made using video fluorography (VF) recording of 10 swallowing disorder patients without aspiration in the upright seated position, and another 10 in the reclining position. We edited the recordings to obtain frame-by-frame static images, and examined time and extents of oral and the pharyngeal transits, and laryngeal elevation, using two-dimensional image analysis software. [Results] The results show there was a significantly longer oral transit time and a shorter pharyngeal transit time in the reclining position group compared to the upright seated group. However, there was no significant difference in either laryngeal transit time or the extent of laryngeal elevation. [Conclusions] The results suggest that apart from the uniform application of a slightly flexed neck position for all patients, the mid-neck angle adjustment is useful for making fine adjustment of oral and pharyngeal transit times in order to secure safe bolus transit in rehabilitation strategies.