title: Effect of 45° reclining sitting posture on swallowing in patients with dysphagia.
abstract: OBJECTIVE
  To determine the effect of a 45° reclining sitting posture on swallowing in patients with dysphagia.
  
  
  METHODS
  Thirty-four patients with dysphagia were evaluated. Videofluoroscopic swallowing study was performed for each patient in 90° upright and in 45° reclining sitting posture. Patients swallowed 5 types of boluses twice: sequentially 2 mL thin liquid, 5 mL thin liquid, thick liquid, yogurt, and cooked rice. Data such as the penetration-aspiration scale (PAS), oral transit time (OTT), pharyngeal delay time (PDT), pharyngeal transit time (PTT), residue in valleculae and pyriform sinuses, premature bolus loss, and nasal penetration were obtained.
  
  
  RESULTS
  The mean PAS on the 2 mL thin liquid decreased significantly in the 45° reclining sitting posture (p=0.007). The mean PAS on 5 mL thin liquid in the 45° reclining sitting posture showed decreasing tendency. The residue in valleculae decreased significantly for all boluses in the 45° reclining sitting posture (p<0.001, p=0.002, p=0.003, p<0.001, p=0.020, respectively). The residue in pyriform sinuses increased significantly on 5 mL thin liquid, thick liquid, and yogurt (p=0.031, p=0.020, p=0.002, respectively). There were no significant differences in OTT, PDT, PTT, premature bolus loss, and nasal penetration between both postures.
  
  
  CONCLUSIONS
  PAS on 2 mL thin liquid and residue in valleculae on all types of boluses were decreased in a 45° reclining sitting posture. Therefore, we believe that the 45° reclining sitting posture on swallowing is beneficial for the patients with penetration or aspiration on small amounts of thin liquid and large amounts of residue in valleculae.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Institute for Medical Sciences, Chonbuk National University Medical School, Chonbuk National University Hospital, 567 Baekje-daero, Deokjin-gu, Jeonju 561-756, Korea.
authors.forename: Byung-Hyun
authors.initials: BH
authors.lastname: Park
authors.forename: Jeong-Hwan
authors.initials: JH
authors.lastname: Seo
authors.forename: Myoung-Hwan
authors.initials: MH
authors.lastname: Ko
authors.forename: Sung-Hee
authors.initials: SH
authors.lastname: Park
mesh_terms: D000328:Adult; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000503:physiopathology*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning; D011187:Posture
keywords: Dysphagia; posture; swallowing
references.citation: AJR Am J Roentgenol. 1993 May;160(5):1005-9
references.pmid: 8470567
references.citation: Arch Phys Med Rehabil. 2001 May;82(5):677-82
references.pmid: 11346847
references.citation: Dysphagia. 1996 Fall;11(4):225-33
references.pmid: 8870348
references.citation: Dysphagia. 1996 Spring;11(2):93-8
references.pmid: 8721066
references.citation: Acta Paediatr. 1995 Jun;84(6):689-92
references.pmid: 7670257