Effects of Tongue-Holding Maneuver Compared with Mendelsohn Maneuver on Swallowing Function in Stroke Patients

Sun Eun Jung; Mi Ah Han; Jong Park; Seong Woo Choi

doi:10.15384/kjhp.2015.15.2.83

Korean J Health Promot > Volume 15(2); 2015 > Article

Jung, Han, Park, and Choi: Effects of Tongue-Holding Maneuver Compared with Mendelsohn Maneuver on Swallowing Function in Stroke Patients

Original Article

Korean Journal of Health Promotion 2015;15(2):83-90.

Published online: December 19, 2015

DOI: https://doi.org/10.15384/kjhp.2015.15.2.83

Effects of Tongue-Holding Maneuver Compared with Mendelsohn Maneuver on Swallowing Function in Stroke Patients

Sun Eun Jung^1,², Mi Ah Han³, Jong Park³, Seong Woo Choi³

¹Department of Public Health, Graduate School of Health Science, Chosun University, Gwangju, Korea

²Department of rehabilitation, Chosun University Honam Regional Rehabilitation Hospital, Gwangju, Korea

³Department of Preventive Medicine, Chosun University College of Medicine, Gwangju, Korea

Corresponding author：Mi Ah Han, MD, PhD Department of Preventive Medicine, Chosun University College of Medicine, 309 Pilmun-daero, Dong-gu, Gwangju 501-759, Korea
Tel: +82-62-230-6481, Fax: +82-62-225-8293 Email: mahan@chosun.ac.kr

This article is a condensed form of the first author's master's thesis from Chosun University.

Received March 05, 2015 Accepted April 23, 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

ABSTRACT

Background

Dysphagia is a common complication in stroke patients. This study aimed to investigate the effects of the tongue-holding maneuver over an 8-week period on the swallowing function in stroke patients.

Methods

Twenty-eight stroke patients with dysphagia diagnosed within 1 year were randomly allocated to the experimental or control groups. The experimental (n=15) and control groups (n=13) performed the tongue-holding and Mendelsohn maneuver, respectively. And both groups additionally participated in traditional dysphagia therapy. The maneuvers were conducted for thirty minutes a day, five days a week, for six weeks, totaling forty sessions. Swallowing function with the functional dysphagia scale and swallowing pain with the visual analogue scale between the 2 groups were tested by chi-square tests, Mann-whitney testes, and Wilcoxon signed rank tests.

Results

The general characteristics, including age, sex, and disease history, between the two groups did not differ. After 8 weeks of intervention, swallowing function at the oral phase and the pharyngeal phase and the total score was significantly improved in both experimental and control groups. Also, swallowing pain decreased significantly in both groups. However, the change to swallowing function and pain between the groups were not different.

Conclusions

The tongue-holding maneuver practiced over an eight-week period improved the swallowing function in stroke patients.

Keywords: Deglutition disorders, Occupational therapy, Pain, Stroke

Figure 1.

Tongue-holding maneuver.

Figure 2.

Mendelsohn maneuver.

Table 1.

Basic characteristics of subjects

	Experimental group (n=15)	Control group (n=13)	P
Sex
Male	8 (53.3)	6 (46.2)	0.705
Female	7 (46.7)	7 (53.8)
Age, y
<65	10 (66.7)	6 (46.2)	0.274
≥65	5 (33.3)	7 (53.8)
Diagnosis
Infarction	8 (53.3)	9 (69.2)	0.390
Hemorrhage	7 (46.7)	4 (30.8)
Duration
<6	7 (46.7)	8 (61.5)	0.431
≥6	8 (53.3)	5 (38.5)
Lifetime smoking experience
Yes	4 (26.7)	4 (30.8)	0.811
No	11 (73.3)	9 (69.2)
Lifetime drinking experience
Yes	10 (66.7)	7 (53.8)	0.488
No	5 (33.3)	6 (46.2)
Operation history
Yes	3 (20.0)	6 (46.2)	0.139
No	12 (80.0)	7 (53.8)
Disease history
Yes	11 (73.3)	8 (61.5)	0.505
No	4 (26.7)	5 (38.5)
Therapist
A	11 (73.3)	9 (69.2)	0.811
B	4 (26.7)	4 (30.8)

Values are presented as n (%).

Table 2.

Comparison of changes on the functional dysphagia scale before and after intervention

	Experimental group	Control group	P
Oral phase
Pre	4.6±3.0	5.5±3.2	0.433
Post	3.0±3.4	4.4±2.8	0.113
Difference (pre-post)	1.6±1.5	1.2±1.5	0.331
P	0.006	0.020
Pharyngeal phase
Pre	29.2±12.5	32.6±14.3	0.711
Post	20.4±10.9	24.8±13.3	0.546
Difference (pre-post)	8.8±5.5	7.9±5.7	0.469
P	0.001	0.001
Total
Pre	33.8±13.1	38.2±15.7	0.419
Post	23.4±11.8	29.2±14.7	0.278
Difference (pre-post)	10.4±5.0	9.0±5.9	0.276
P	0.001	0.001

Values are presented as mean±SD.

Table 3.

Comparison of pain changes on the visual analogue scale before and after intervention

	Experimental group	Control group	P
Pre	7.3±1.1	6.6±1.1	0.164
Post	4.9±0.8	4.7±0.9	0.675
Difference (pre-post)	2.4±0.9	1.9±0.8	0.199
P	0.001	0.001

Values are presented as mean±SD.

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