To evaluate the combined effect of Mendelsohn maneuver and Shaker exercise on dysphagia severity, functional oral intake and swallowing ability in patients of acute stroke with dysphagia.

**Title: "To evaluate the combined effect of Mendelsohn maneuver and Shaker exercise on dysphagia severity, functional oral intake and swallowing ability in patients of acute stroke with dysphagia".****Methods/Design:**This study is a double-blind, parallel group, active control, prospective and randomized controlled trial (RCT) investigating the effects of a 2-week supervised Mendelsohn maneuver and Shaker exercise on 20 patients of acute stroke and dysphagia. Main inclusion criteria are diagnosed acute (up to 2 weeks post stroke), stable stroke having difficulty in swallowing; alert and cooperative patients without any cognitive deficit (having MMSE > 22). The primary outcome measures are: Dysphagia Severity Rating Scale (DSRS), Functional Oral Intake Scale (FOIS) and Eating Assessment Tool (EAT-10). Secondary outcome measure include the Dysphagia Handicap Index (DHI). Participants randomized to the interventional group will participate in 2 supervised exercise sessions daily for 2 weeks. Participants randomized to the control group will receive oral strengthening exercise using straw and are taught about the compensatory measures to be adopted while eating swallowing.

Discussion: This RCT explores the combined effect of Mendelsohn maneuver and Shaker exercise in patients of acute stroke with dysphagia. Results will contribute to a better understanding of combined effect of Mendelsohn maneuver and Shaker exercise and inform intervention programs that will optimally improve physiological and psychosocial health in patients of acute stroke with dysphagia, and that are ultimately aimed at improving prognosis. The study results will contribute to the design of better rehabilitation programs for patients of acute stroke with dysphagia.