The effect of a wheelchair designed to prevent forward head posture on swallowing duration and integrated electromyography of suprahyoid muscles

Abstract

Aspiration is a severe problem for elderly patients with disabilities. The causes of aspiration include forward head posture and muscle weakness. Forward Head Posture leads to a chin-up posture and affects the activity of the suprahyoid muscles. This study aimed to assess the utility of a wheelchair incorporating an increased seat to back support angle to improve swallowing. The study cohort included 21 healthy individuals (9 males and 12 females; mean age = 20.8 ± 0.9 years). Two wheelchairs were used in this study: model RX-1 and model RX_ABS Lo, which is a modification of RX-1 with a different back support system. Subjects were instructed to sit in each wheelchair and swallow 15 mL of water. Suprahyoid muscle activity was measured in a resting position and during swallowing, while posture in the sagittal plane was recorded using a digital video camera. We also measured buttock and back support pressure distribution. Swallowing duration, integrated electromyography, posture and pressure distribution between the two wheelchairs were compared using paired-samples t-tests. After the exclusion of five subjects, 16 were included for analysis. Swallowing duration and integrated electromyography significantly were decreased with RX_ABS Lo compared to RX-1. Head and neck alignment were more erect and trunk alignment more inclined in RX_ABS Lo compared to RX-1. RX_ABS Lo led to decreased buttock pressure and increased back support pressure; further, the improved forward head posture observed with RX_ABS Lo facilitated better chin alignment. In conclusion, use of RX_ABS Lo resulted in decreased swallowing duration and integrated electromyography due to improvement in forward head posture.

Effects of Neuromuscular Electrical Stimulation (NMES) Plus Upper Cervical Spine Mobilization on Forward Head Posture and Swallowing Function in Stroke Patients with Dysphagia

“…Forward head posture is characterized by upper cervical extension and lower cervical flexion. As a result, the length of suprahyoid muscles increase, and the activity of the suprahyoid muscles weaken during swallowing, making it difficult to swallow [37,38]. In this study, upper cervical spine mobilization was applied to increase the craniocervical flexion range of motion.…”

The effect of a wheelchair with pelvic support belt on respiratory function

“…For position, the head angle, neck angle, and trunk angle are measured. The definition of each angle is shown below [13,[16][17][18][19].…”

“…The pelvic support belt supports the pelvis like an arch, while the thoracic support belt supports the lower thorax. Many reports have suggested that respiratory function is affected by changes in posture, such as standing or sitting [11][12][13]. However, there are few studies on wheelchairs and chairs [14,15].…”