Effects of Forward Head Posture on Submental Muscle Activations During Swallowing Tasks, Dysphagia Limit, and Tongue Pressure Force in Healthy Volunteers
摘要
Swallowing is a complex function depending on head and neck biomechanics. Forward Head Posture (FHP) is one of the most researched postural problems in swallowing rehabilitation. However, there are conflicting results regarding the relationship between FHP and swallowing related structures. The aim of this study is to investigate the effect of FHP on submental muscle activation (SMA), dysphagia limit (DL), and anterior and posterior tongue pressure force in healthy volunteers. Fifty-four healthy volunteers were included in the study. All volunteers were photographed from the lateral plane during the water swallowing task for head and neck biomechanics evaluations. The images were analyzed in the ImageJ and the craniovertebral angle (CVA) and cranial rotation angle (CRA) were measured. The volunteers were divided into two groups: Presence of FHP and normal head posture (NHP). For SMA, surface electromyography (sEMG) was recorded during 10 mL normal and 10 mL effortful swallows. The DL of the volunteers was recorded with the help of sEMG. Tongue strength was recorded with the Iowa Oral Pressure Instrument, including anterior and posterior tongue pressure force. There was a significant difference between the SMAs recorded during effortful swallowing between the FHP and NHP groups (p < 0.05). There was no difference between the groups regarding SMA during normal swallow and DL (p > 0.05). There was no difference in anterior and posterior tongue pressure force between the groups (p > 0.05). In the present study, volunteers with FHP had lower SMA during effortful swallow. There was no difference between the groups in terms of SMA during normal swallowing, DL, and anterior and posterior tongue pressure force. These results indicate that correct head and neck posture during swallowing leads to greater SMA. This suggests that considering posture in swallowing rehabilitation may support swallowing function.