Synchrony: Mendelsohn Maneuver
Mendelsohn Maneuver is not commonly utilized as a swallowing intervention, but has been shown to provide lasting rehabilitative effects.
PHYSIOLOGIC BENEFITS:
• Improved duration of hyoid elevation, excursion, and hyolaryngeal movement (McCullough, 2013).
• Increased duration of UES opening, possibly decreasing pyriform sinus residue (Kahrilas, 1991).
• Prolonged and increased tongue to palate contact, helping to prevent loss of bolus over back of tongue (Fukuoka, 2013).
DIRECTIONS:
• “When I tell you to swallow, I want you to hold your Adam’s Apple up for a few seconds, squeezing with your throat and neck muscles and
not letting go.”
Mendelsohn Maneuver can be challenging for patients to understand and perform, but using biofeedback has been shown to improve complex motor learning tasks.
BIOFEEDBACK BENEFITS:
• Using sEMG can help patients learn new and/or unfamiliar movements that are difficult to monitor.
• Virtual reality motivates patients to exercise at greater intensities for longer periods of time.
| Kangaroo Kangaroo jumps with swallow and glides through the air during sustained contraction, capturing coins |
Work/Rest Trace elevates with swallow initiation and displays during contraction in green column (work) then returns to baseline in white column (rest) |
Diver Axolotl rises to capture clams in high position during swallow initiation and contraction |
References
Fukuoka, T., Ono, T., Hori, K., Tamine, K., Nozaki, S., Shimada, K., & Domen, K. (2013). Effect of the Effortful Swallow and the Mendelsohn Maneuver on Tongue Pressure Production Against the Hard Palate.
Dysphagia, 28(4), 539-547. https://doi.org/10.1007/s00455-013-9464-y
Kahrilas, P. J., Logemann, J. A., Krugler, C., & Flanagan, E. (1991). Volitional Augmentation of Upper Esophageal Sphincter Opening during Swallowing. American Journal of Physiology, 260(3 Pt 1), G450-456.
https://doi.org/10.1152/ajpgi.1991.260.3.g450
McCullough, G. H., & Kim, Y. (2013). Effects of the Mendelsohn Maneuver on Extent of Hyoid Movement and UES Opening Post-stroke. Dysphagia, 28(4), 511-519. https://doi.org/10.1007/s00455-013-9461-1