Effect of the Effortful Swallow and the Mendelsohn Maneuver on Tongue Pressure Production against the Hard Palate

Fukuoka, Tatsuyuki; Ono, Takahiro; Hori, Kazuhiro; Tamine, Kenichi; Nozaki, Sonoko; Shimada, Kenji; Yamamoto, N.; Fukuda, Yoshihiro; Domen, Kazuhisa

doi:10.1007/s00455-013-9464-y

Cited by 51 publications

(26 citation statements)

References 30 publications

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“…In addition, recent studies of the Mendelsohn maneuver, a technique which prolongs maximum elevation of the hyolaryngeal complex during swallowing, have reported increased opening of the upper esophageal sphincter and improved swallow coordination following treatment in stroke survivors with dysphagia [17]. Additional work incorporating healthy volunteers has documented increased tongue-palate contact pressure during application of this swallowing maneuver [18]. Finally, a simple jaw opening exercise has been shown to improve opening of the upper esophageal sphincter during swallowing [19].…”

Section: Examples Of Exercise Based Dysphagia Therapiesmentioning

confidence: 99%

Adoption into clinical practice of two therapies to manage swallowing disorders

Crary¹,

Carnaby²

2014

Current Opinion in Otolaryngology & Head and Neck Surgery

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Purpose of review This article reviews recent literature depicting a shift in dysphagia rehabilitation in adults. Distinguishing rehabilitation from compensation in dysphagia management, a review of basic exercise principles is followed by description of recent publications depicting exercise based therapies. Subsequently, transcutaneous electrical stimulation is reviewed as it may contribute to exercise based dysphagia rehabilitation in adults. Recent findings Surveys have documented extensive variability in the clinical application of dysphagia therapy techniques. Despite this variability, two trends are emerging in dysphagia rehabilitation research: 1- documentation of physiologic plus functional changes within the swallowing mechanism subsequent to therapy; and 2- prophylactic exercise based therapies. In addition, extensive efforts have emerged describing the potential application of transcutaneous electrical stimulation in dysphagia rehabilitation. Though results of these efforts are conflicted, transcutaneous electrical stimulation may serve a useful role as an adjunct to well-developed exercise based rehabilitation for dysphagia. Summary The focus of dysphagia rehabilitation in adults is changing. Current efforts indicate that exercise based therapies should incorporate multiple principles of exercise physiology and document physiologic change within the impaired swallowing mechanism. Transcutaneous electrical stimulation may function as an adjunctive modality; however, current practices should be evaluated to develop additional parameters of stimulation that are focused toward specific dysphagia impairments.

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Section: Examples Of Exercise Based Dysphagia Therapiesmentioning

confidence: 99%

Adoption into clinical practice of two therapies to manage swallowing disorders

Crary¹,

Carnaby²

2014

Current Opinion in Otolaryngology & Head and Neck Surgery

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“…The posterior thrust of the tongue was said to be strongly related to residues in the vallecula, whereas shortening and constriction of the pharynx are related to residues in pyriformis sinus (Stokely et al, 2015). Pharyngeal strengthening exercise through effortful swallow is designed to increase the basic motion of the tongue to the posterior and also the pharyngeal wall movement to anterior so that, there will increase the pressure for pushing the bolus and then reduce pharynx residual (Fukuoka et al, 2013;Palmer et al, 2000). Movement of the bolus during swallowing depends on the synergistic action of the oropharyngeal propulsion and hypopharyngeal suction.…”

Section: Discussionmentioning

confidence: 99%

“…Contact that occurs between the anterior part of the tongue and the palate becomes an important part of tongue movement which will keep the bolus in the oral cavity and ensure proper transport of the bolus. Fukuoka et al (2013) evaluated the tongue pressure against the hard palate during swallowing with effortful swallow and obtained increased results when compared to normal swallowing without effortful swallow. Huckabee et al (2008) said that tongue pressure to the palate during effortful swallow will increase submental activation, orolingual pressure, and upper pharyngeal pressure.…”

Section: Discussionmentioning

confidence: 99%

The effectivity of pharyngeal strengthening exercise, hyolaryngeal complex range of motion exercise, and swallowing practice in swallowing function of ischemic stroke patients with neurogenic dysphagia

Kusumaningsih¹,

Lestari²,

Harris³

et al. 2019

J Exerc Rehabil

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Dysphagia is associated with an increased risk of aspiration pneumonia which often results in death in stroke patients. Therefore, effective and efficient management is important. Behavioral therapy for swallowing rehabilitation based on the principles of neuroplasticity such as oropharyngeal strengthening and range of motion exercises are the alternative ones that often be used. This study aimed to assess the changes in swallowing function in ischemic stroke patients with neurogenic dysphagia after pharyngeal strengthening exercise, hyolaryngeal complex range of motion exercise and swallowing practice. Swallowing function was assessed using Penetration Aspiration Scale (PAS) and Functional Oral Intake Scale (FOIS) based on Flexible Endoscopic Evaluation of Swallowing before and after interventions. The interventions were given every day with a duration of 30-45 minutes for 4 weeks. There were six subjects who completed the study. The PAS before the interventions were 6.00± 1.79 and after the interventions was 1.67± 0.82 (P= 0.003). Meanwhile, the FOIS score before the interventions was 3 (1-5) and after the interventions were 5.00± 2.10 (P= 0.041). There was an improvement of PAS and FOIS after the interventions. Therefore, the interventions can be suggested to be used as one of the treatments to improve swallowing function in ischemic stroke patients with neurogenic dysphagia.

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“…Thus, the decrease in tongue pressure observed in some cases of stroke was basically associated with the presence of dysphagia. Several studies in the literature have related the decrease in tongue pressure to the symptom of dysphagia (10,20,21,22,23,24) . The results of this study indicated that tongue pressure in the subjects affected with stroke could trigger dysphagia.…”

Section: Discussionmentioning

confidence: 99%

Fatores associados à pressão de língua em pacientes pós-acidente vascular cerebral

Oliveira

Valentim

Vicente

et al. 2017

Audiol., Commun. Res.

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Introduction:The clinical practice of speech pathology in hospitals shows that there is a high prevalence of dysphagia in post-stroke patients. Purpose: To verify whether the time of occurrence, type of stroke, affected hemisphere, severity of neurological deficit, presence or absence of dysphagia, and degree of dysphagia interfere with tongue pressure in post-stroke patients. Methods: This study was conducted in 31 stroke patients. Three evaluations were performed, one of tongue mobility, another of dysphagia, and another of tongue pressure using the Iowa Oral Performance Instrument. Three measurements were performed of anterior and three of posterior tongue pressure. Data were analyzed using appropriate statistics, considering a significance level of 5%. Results: Only the presence of dysphagia was associated with tongue pressure. Post-stroke patients with dysphagia had lower anterior and posterior tongue pressure (mean and maximum) than those without dysphagia. The time of occurrence, type, and affected hemisphere of the stroke and severity of the neurological deficit were not associated with tongue pressure. Regarding the degree of dysphagia, of the 15 participants who had swallowing difficulties, 14 were classified with mild and one with moderate dysphagia. Conclusion: Dysphagia was the most important factor in the decrease of tongue pressure in post-stroke patients.

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Effect of the Effortful Swallow and the Mendelsohn Maneuver on Tongue Pressure Production against the Hard Palate

Cited by 51 publications

References 30 publications

Adoption into clinical practice of two therapies to manage swallowing disorders

Adoption into clinical practice of two therapies to manage swallowing disorders

The effectivity of pharyngeal strengthening exercise, hyolaryngeal complex range of motion exercise, and swallowing practice in swallowing function of ischemic stroke patients with neurogenic dysphagia

Fatores associados à pressão de língua em pacientes pós-acidente vascular cerebral

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