Treatment of Dysphagia Using the Mendelsohn Maneuver

Phase 1

Completed

Brief Summary: The primary goal of the investigation is to determine the effects of the Mendelsohn maneuver on the physiology of the swallow in individuals who have suffered a stroke and exhibit signs of pharyngeal dysphagia.

Detailed Description: The primary goal of the investigation is to determine the effects of the Mendelsohn maneuver (voluntary prolongation of laryngeal excursion at the midpoint of the swallow) on the physiology of the swallow in individuals who have suffered a stroke and exhibit signs of pharyngeal dysphagia (specifically, reduced duration of hyoid maximum elevation, reduced extent of hyoid maximum elevation, reduced duration of hyoid maximum anterior excursion, reduced extent of hyoid maximum anterior excursion, and reduced duration of upper esophageal sphincter (UES) opening with subsequent residue in the pyriform sinuses and, potentially, aspiration). Participants are assessed with videofluoroscopy at the initiation of the study and after each week of the study. After the 4 weeks of participation are complete, all participants will be discharged from treatment and will be brought back to the clinic for a final Videofluoroscopic Swallow Study (VFSS) evaluation after 2 weeks. This means that individuals in Group 1 will be re-analyzed after 1 month of additional no-treatment, and Group 2 will be re-analyzed after 2 additional weeks of no-treatment.

Recruitment & Eligibility

Inclusion Criteria

Exclusion Criteria

Arm && Interventions

Group	Intervention	Description
Within subjects treatment, no-treatment	Mendelsohn Maneuver	Within subject, treatment and no-treatment periods. Each participant served as his/her own control in this AABB/BBAA alternating treatment conditions design. Results were also compared across groups (treatment v. no-treatment).

Primary Outcome Measures

Name	Time	Method
Change in Duration of Superior Hyolaryngeal Movement	baseline and six weeks	Change in duration of superior elevation of hyoid bone.
Change in Duration of Hyoid Maximum Anterior Excursion	Baseline and 6 weeks	Change in the duration of maximum anterior movement of the hyoid bone during swallowing.

Secondary Outcome Measures

Name	Time	Method
Change in Oral Intake Ability	Baseline and 6 weeks	Oral Intake Ability was measure with the Dysphagia Outcome and Severity Scale. A 7 is normal and a 1 is complete inability to consume any food safely. The means reported for treatment and no treatment periods are mean changes in scores throughout the period.
Change in Duration of Opening of Upper Esophageal Sphincter	Baseline and 6 weeks	Change in duration of pre- and post-treatment duration of UES opening.