Evaluating the efficacy of Mendelsohn maneuver and Shaker exercise on dysphagia outcomes in patients with acute stroke: A study protocol

BACKGROUND: Dysphagia, a common sequela of stroke, significantly impacts the patient’s quality of life and increases the risk of serious complications such as aspiration pneumonia. It involves weakened or uncoordinated muscles in the oral, pharyngeal, and esophageal phases, impaired sensory feedback, and disrupted neurological control, leading to difficulties in forming, propelling, and safely swallowing food or liquid. Current rehabilitation approaches focus on enhancing the strength and coordination of oral and pharyngeal muscles. Mendelsohn maneuver is known to aid in laryngeal elevation, and the Shaker exercise improves hyolaryngeal movement, both critical for safe swallowing. AIM: This research aims to evaluate the combined efficacy of the Mendelsohn maneuver and Shaker exercise on dysphagia outcomes in patients with acute stroke. SUBJECTS AND METHODS: This study is a double-blinded, prospective randomized controlled trial (RCT) that includes 30 patients of stable acute stroke with dysphagia aged 30–70 years. Primary outcomes will be dysphagia severity, functional oral intake and swallowing ability, while quality of life will be a secondary outcome. Participants will be randomly allocated to either an experimental or control group, with 15 in each group. The experimental group will perform the Mendelsohn maneuver, Shaker exercise, and conventional treatment twice daily for 2 weeks. The control group will receive oral strengthening exercises and patient education on proper eating/swallowing postures. RESULTS AND CONCLUSION: The findings of this RCT will enhance our understanding of the combined effect of these interventions and may guide the development of an effective rehabilitation program which improves both physiological and psychosocial health, leading to a better prognosis for patients with dysphagia.