Treatment of Dysphagia Using the Mendelsohn Maneuver

Study Overview
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Brief Summary
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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
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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.

Official Title
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Treatment of Dysphagia Using the Mendelsohn Maneuver

Conditions
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Stroke, Dysphagia

Intervention / Treatment
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* Behavioral: Mendelsohn Maneuver


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Stroke (1-18 months post) Pharyngeal Dysphagia Exclusion Criteria: Other neurologic or structural abnormality to oropharynx History of dysphagia prior to latest stroke

Ages Eligible for Study
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Minimum Age: 21 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Within subjects treatment, no-treatment<br>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). | Behavioral: Mendelsohn Maneuver<br>* Mendelsohn Maneuver with Surface Electromyography<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Duration of Superior Hyolaryngeal Movement | Change in duration of superior elevation of hyoid bone. | baseline and six weeks | 
| Change in Duration of Hyoid Maximum Anterior Excursion | Change in the duration of maximum anterior movement of the hyoid bone during swallowing. | Baseline and 6 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Oral Intake Ability | 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. | Baseline and 6 weeks | 
| Change in Duration of Opening of Upper Esophageal Sphincter | Change in duration of pre- and post-treatment duration of UES opening. | Baseline and 6 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Deglutition Disorders, Mendelsohn Maneuver, SEMG