Effects of sitting posture and bolus volume on activation of swallowing-related muscles.

Abstract

The pharyngeal phase is a particularly important clinical factor related to swallowing dysfunctions. Head and neck posture, as well as bolus volume, are important factors affecting the pharyngeal stages of normal swallowing. The aim of our study was to identify the effects of sitting posture and bolus volume on the activation of swallowing-related muscles. Twenty-four subjects participated in the study. The subjects were positioned in three sitting postures-slump sitting (SS), lumbo-pelvic upright sitting (LUS), and thoracic upright sitting (TUS). While sitting in the chair, the subject was instructed to swallow 10 and 20mL of water. Surface electromyography (EMG) was used to measure the muscle activity of the supra-hyoid (SH) and infra-hyoid (IH) muscles. Also, sitting posture alignment (head, cervical and shoulder angle) was also performed. Data were analysed with a repeated measures analysis of variance (RMANOVA) using a generalised linear model. There was no significant difference in terms of the head angle (P=.395). However, significant differences were found in relation to the cervical angle (P<.001) and shoulder angle (P<.001). The TUS produced the lowest SH EMG activity (P=.001), in comparison to SS and LUS. The bolus volume for 20mL showed greater SH and IH EMG activity (P<.001) than did the bolus volume for 10mL. Correcting sitting posture from SS to TUS may better assist swallowing-related muscles with less effort, irrespective of the bolus volume.