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Influence of Spinal Sagittal Alignment in Sitting Posture on the Swallowing Speed of Older Adult Women: A Cross-Sectional Study

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Abstract

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.

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Data Availability

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

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Acknowledgements

I would like to thank Nanami Mizukami and Suzuka Komatsu for their contribution to data collection. This work was conducted with the support of Kawasaki Medical School. This study was supported by grants from the KAWASAKI Foundation for Medical Science and Medical Welfare.

Funding

This study was supported by grants from the KAWASAKI Foundation for Medical Science and Medical Welfare.

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Authors and Affiliations

  1. Division of Speech-Language-Hearing Therapy, Rehabilitation Center, Kawasaki Medical School Hospital, Kurashiki, Okayama, Japan

    Katsuya Nakamura

  2. Graduate School of Comprehensive Scientific Research, Prefectural University of Hiroshima, Shobara, Hiroshima, Japan

    Katsuya Nakamura

  3. Department of Speech-Language Pathology and Audiology, Faculty of Rehabilitation, Kawasaki University of Medical Welfare, Kurashiki, Okayama, Japan

    Shinsuke Nagami, Shinya Fukunaga, Yuhei Kodani & Naoya Obama

  4. Division of Physical Therapy, Rehabilitation Center, Kawasaki Medical School Hospital, Kurashiki, Okayama, Japan

    Atsushi Shinonaga

  5. Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, Mihara, Hiroshima, Japan

    Shusaku Kanai

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  1. Katsuya Nakamura
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Contributions

KN contributed to the protocol design, data collection and analysis, and writing of the manuscript. SN contributed to the protocol design, data collection and analysis, and writing of the manuscript and supervised the study. SF contributed to the protocol design, data collection and analysis, and writing of the manuscript. AS performed the data collection and reviewed the manuscript. YK and NO contributed to the review of the manuscript. SK contributed to the protocol design, data collection and analysis, and writing of the manuscript.

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Correspondence to Shinsuke Nagami.

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All study protocols were approved by the Ethics Committee of the Kawasaki Medical School in Okayama, Japan (Approval No. 5794-00), and all participants provided written informed consent.

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Nakamura, K., Nagami, S., Fukunaga, S. et al. Influence of Spinal Sagittal Alignment in Sitting Posture on the Swallowing Speed of Older Adult Women: A Cross-Sectional Study. Dysphagia (2024). https://doi.org/10.1007/s00455-023-10657-z

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