Variations in Head-Neck Posture and Hyoid Kinematics in Patients With Stroke and Aspiration Risk: A Cross-Sectional Observational Study.

Researchers investigated how head and neck posture affects swallowing problems in stroke patients. This study examined 24 stroke patients, comparing 12 with high aspiration risk (risk of food or liquid entering the airway) to 12 with low aspiration risk. The research team measured head-neck alignment using the craniovertebral angle, neck curvature, and range of motion, while also tracking hyoid bone movement during swallowing.

The findings revealed that patients at high risk for aspiration demonstrated significantly poorer head-neck posture, characterized by forward head position and reduced neck mobility. These patients also showed decreased hyoid bone movement during swallowing. Importantly, the study found positive correlations between abnormal head-neck posture and impaired swallowing mechanics, suggesting that forward head posture may contribute to swallowing difficulties after stroke.

For patients considering acupuncture, these findings are relevant because acupuncture and related traditional Chinese medicine therapies often address postural alignment and muscle function in the head-neck region. Acupuncture treatments may help improve neck mobility, reduce muscle tension, and support better postural mechanics, which this research suggests could positively influence swallowing function. Additionally, techniques like electroacupuncture and manual therapies such as tui na may complement conventional stroke rehabilitation by addressing the musculoskeletal components affecting swallowing.

While this study did not directly investigate acupuncture interventions, it identifies head-neck posture as a modifiable factor in post-stroke swallowing problems, an area where acupuncture practitioners often work. Stroke patients experiencing swallowing difficulties should discuss integrative approaches with their healthcare team. If considering acupuncture as part of stroke recovery, seek a licensed acupuncturist with experience in neurological rehabilitation and post-stroke care.

This cross-sectional observational study (N=24) examined head-neck posture and hyoid kinematics in stroke patients stratified by aspiration risk. Researchers measured craniovertebral angle (CVA), C2-C7 Cobb angle, cervical range of motion (CROM), and hyoid displacement parameters. The high aspiration risk group (n=12, median age 72.50 years) demonstrated significantly smaller CVA, reduced CROM, and diminished hyoid displacement compared to low-risk controls (n=12, median age 66.00 years) (P<.05). Active extension CROM exceeded passive extension in high-risk patients (z=-2.937, P=.003). Correlation analysis revealed significant positive relationships between head-neck postural parameters (CVA, active/passive extension CROM) and hyoid displacement metrics (superior and anterior horizontal displacement) (P<.001). These findings suggest forward head posture and reduced cervical mobility correlate with impaired swallowing mechanics post-stroke. Clinical implications include addressing cervical musculoskeletal dysfunction through manual therapy, postural re-education, and potentially acupuncture interventions targeting neck mobility and hyoid complex function in dysphagia rehabilitation protocols.