OBJECTIVE: To investigate the feasibility of cervical spine mobilization in elderly dementia patients with dysphagia, and its effect on swallowing capacity. METHODS: Fifteen nursing home residents (9 women, 6 men, age range 77 to 98 years) with severe dementia (median Mini Mental State Examination score 8/30, percentile (P) 25 to 75 4 to 13) and known dysphagia participated in a randomized controlled trial with cross-over design. Cervical spine mobilization was administered by trained physiotherapists. Control sessions consisted of socializing visits. Feasibility (attendance, hostility, complications) and maximal swallowing volume (water bolus 1 to 20 ml) were assessed following one session and one week (3 sessions) of treatment and control. RESULTS: Ninety percent of cervical spine mobilization sessions were completed successfully (3 sessions could not be carried out due to the patient's hostility and 2 due to illness) and no complications were observed. Swallowing capacity improved significantly after cervical spine mobilization (from 3 ml (P25 to P75 1 to 10) to 5 ml (P25 to P75 3 to 15) after one session p = 0.01 and to 10 ml (P25 to P75 5 to 20) (+230%) after one week treatment p = 0.03) compared with control (no significant changes, difference in evolution after one session between treatment and control, p = 0.03). CONCLUSION: Cervical spine mobilization is feasible and can improve swallowing capacity in cognitively impaired residents in nursing homes. Given the acute improvements following treatment, it is probably best provided before meals.

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