Division of Speech-Language-Hearing Therapy, Rehabilitation Center, Kawasaki Medical School Hospital, Kurashiki, Okayama, Japan.
Graduate School of Comprehensive Scientific Research, Prefectural University of Hiroshima, Shobara, Hiroshima, Japan.
Dysphagia. 2024 Oct;39(5):772-782. doi: 10.1007/s00455-023-10657-z. Epub 2024 Jan 27.
Thoracolumbar kyphosis in sitting posture is associated with forward head posture and may adversely affect swallowing function. However, few studies have investigated the effect of spinal alignment in the sitting posture on the swallowing function of older adults. This cross-sectional study aimed to investigate whether spinal alignment in the sitting posture influences the swallowing function of older adult women. Overall, 18 older adult women (mean age, 69.78 ± 3.66 years) without dysphagia were enrolled. Participants were positioned in two sitting postures, namely, comfortable sitting (CS) and thoracic upright sitting (TUS). In each sitting posture, the kyphosis index (using a flexicurve), sagittal angles (head, cervical, shoulder, and pelvic angles; using a digital camera), and cervical range of motion (ROM) were evaluated. Swallowing speed (100-mL water swallowing test), maximum tongue pressure (MTP), and oral diadochokinesis (ODK) were also evaluated. Compared with TUS, CS showed a greater kyphosis index, anterior head translation, and posterior pelvic tilt. CS had greater flexion (p < 0.001) and less extension (p < 0.001) of cervical ROM than TUS. Swallowing speed was significantly decreased in CS compared with TUS (p = 0.008). MTP and ODK were not significantly different between CS and TUS. Thus, changes in sitting posture with spinal alignment may affect swallowing speed. Consequently, adjustments to reduce sitting postural kyphosis in older adult women may improve swallowing speed.
坐姿胸腰椎后凸与头前伸姿势有关,可能会对吞咽功能产生不利影响。然而,很少有研究调查坐姿脊柱排列对老年人吞咽功能的影响。本横断面研究旨在探讨坐姿脊柱排列是否会影响老年女性的吞咽功能。共有 18 名无吞咽困难的老年女性(平均年龄 69.78±3.66 岁)参与了本研究。参与者被置于两种坐姿中,即舒适坐姿(CS)和胸椎直立坐姿(TUS)。在每种坐姿中,评估了脊柱后凸指数(使用 Flexicurve)、矢状面角度(头部、颈椎、肩部和骨盆角度;使用数码相机)和颈椎活动度(ROM)。还评估了吞咽速度(100 毫升水吞咽测试)、最大舌压(MTP)和口腔交替发音(ODK)。与 TUS 相比,CS 表现出更大的后凸指数、头部前伸和骨盆后倾。CS 的颈椎 ROM 前屈(p<0.001)和后伸(p<0.001)均大于 TUS。CS 的吞咽速度明显低于 TUS(p=0.008)。CS 和 TUS 之间的 MTP 和 ODK 没有显著差异。因此,脊柱排列的坐姿变化可能会影响吞咽速度。因此,调整坐姿以减少老年女性的坐姿后凸可能会提高吞咽速度。