<Effects of Cervical Kyphosis on Recovery From Dysphagia After Stroke>

<Ann Rehabil Med 2016;40(5):816-825>

Suk Kyoung Kim, MD, Sang Jun Mo, MD, Won Sik Moon, MD, Po Song Jun, MD, Chung Reen Kim, MD

Department of Rehabilitation Medicine, Dong-Eui Medical Center, Busan; Department of Physical Medicine and Rehabilitation, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea

Objective
To determine the effects of cervical kyphosis on the recovery of swallowing function in subacute stroke patients.

Methods 
Baseline and 1-month follow-up videofluoroscopic swallowing studies (VFSSs) of 51 stroke patients were retrospectively analyzed. The patients were divided into the cervical kyphosis (Cobb’s angle <20 , n=27) and control (n=24) groups. The penetration-aspiration scale (PAS), American Speech-Language-Hearing Association National Outcomes Measurement System swallowing scale (ASHA NOMS), and videofluoroscopic dysphagia scale (VDS) were used to determine the severity of dysphagia. Finally, the prevalence of abnormal VFSS findings was compared between the two groups.

Results 
There were no significant differences in baseline PAS, ASHA NOMS, and VDS scores between the two groups. However, the follow-up VDS scores in the cervical kyphosis group were significantly higher than those in the control group (p=0.04), and a follow-up study showed a tendency towards worse ASHA NOMS scores (p=0.07) in the cervical kyphosis group. In addition, the cervical kyphosis group had a higher occurrence of pharyngeal wall coating in both baseline and follow-up studies, as well as increased aspiration in follow-up studies (p<0.05).

Conclusion 
This study showed that stroke patients who had cervical kyphosis at the time of stroke might have impaired recovery from dysphagia after stroke.

Keywords 
Kyphosis, Degulgitation disorders, Stroke, Respiratory aspiration, Fluoroscopy