Rehabilitation Strategies

Question 1

Mendelssohn manoeuvre

Answer 1

What it is - swallow and hold swallow at peak elevation. Prolong swallow by prolonging upper esophageal sphincter opening
Why you do it - designed to elevate larynx and open esophagus to prevent food/liquid from falling into airway

Question 2

Masako manoeuvre

Answer 2

What it is - swallow while holding tongue between teeth
Why you do it - designed to improve inadequate Base of Tongue (BOT) to posterior pharyngeal wall (PPW) approximation

Question 3

Shaker exercise

Answer 3

What it is - lie flat on back, lift head and look at feet for one minute. Rest for one minute and repeat twice. Or lift head and look at feet 20 times.
Why you do it - or patients with poor upper esophageal sphincter opening and increase anterior hyolaryngeal excursion (closure of the larynx to seal the entrance to the trachea)

Question 4

Chin tuck against resistance

Answer 4

What it is - person sitting upright, placing a resistance object between chin and sternum and lowering chin to chest to squeeze ball as hard as possible
Why you do it - an alternative to Shaker’s which many clients can’t tolerate. Activates suprahyoid (lifts hyoid)

Question 5

Expiratory muscle strength Training

Answer 5

what is it - patients blow into a tube against resistance to develop improved airway protection
why do it - improves effectiveness of cough and swallowing efficiency. Strenghtens the expiratory and sub-mental muscles
who is it for - parkinsons disease and post-stroke dysphagia