, Volume 28, Issue 4, pp 511–519 | Cite as

Effects of the Mendelsohn Maneuver on Extent of Hyoid Movement and UES Opening Post-Stroke

  • Gary H. McCulloughEmail author
  • Youngsun Kim
Original Article


The Mendelsohn maneuver, voluntary prolongation of laryngeal elevation during the swallow, has been widely used as a compensatory strategy to improve upper esophageal sphincter (UES) opening and bolus flow. Recent research suggests that when used as a rehabilitative exercise, it significantly improves duration of hyoid movement and positively impacts duration of UES opening (DOUESO). The data presented here were derived from that same prospective crossover study of 18 participants with dysphagia post-stroke evaluated with videofluoroscopy after treatment using the Mendelsohn maneuver versus no treatment. Results demonstrate gains in the extent of hyoid movement and UES opening and improvements in coordination of structural movements with each other as well as with bolus flow.


Deglutition Deglutition disorders Stroke Rehabilitation Mendelsohn maneuver 



This research was conducted by NIH NIDCD Grant R03 DC04942-01A2.

Conflict of interest

The authors have no conflicts of interest to declare.


  1. 1.
    Mendelsohn MS, McConnell FM. Function in the pharyngoesophageal segment. Laryngoscope. 1987;97(4):483–9.PubMedGoogle Scholar
  2. 2.
    Dodds WJ, Stewart ET, Logemann JA. Physiology and radiology of the normal oral and pharyngeal phases of swallowing. AJR Am J Roentgenol. 1990;154:953–63.PubMedCrossRefGoogle Scholar
  3. 3.
    Crary MA, Carnaby GD, Groher ME, Helseth E. Functional benefits of dysphagia therapy using adjunctive sEMG biofeedback. Dysphagia. 2004;19:160–4.PubMedGoogle Scholar
  4. 4.
    Kim Y, McCullough GH. Maximal hyoid excursion in poststroke patients. Dysphagia. 2010;25(1):20–5.PubMedCrossRefGoogle Scholar
  5. 5.
    Lazarus C, Logemann JA, Gibbons P. Effects of maneuvers on swallowing function in a dysphagic oral cancer patient. Head Neck. 1993;15:419–24.PubMedCrossRefGoogle Scholar
  6. 6.
    Lazarus C, Logemann JA, Song CW, Rademaker AW, Kahrilas PJ. Effects of voluntary maneuvers on tongue base function for swallowing. Folia Phoniatr Logop. 2002;54:171–6.PubMedCrossRefGoogle Scholar
  7. 7.
    Burkhead L, Sapienza CM, Rosenbek J. Strength-training exercise in dysphagia rehabilitation: principles, procedures, and directions for future research. Dysphagia. 2007;22:251–65.PubMedCrossRefGoogle Scholar
  8. 8.
    Bryant M. Biofeedback in the treatment of a selected dysphagic patient. Dysphagia. 1991;6:140–4.PubMedCrossRefGoogle Scholar
  9. 9.
    Huckabee ML, Cannito MP. Outcomes of swallowing rehabilitation in chronic brainstem dysphagia: a retrospective evaluation. Dysphagia. 1999;14:93–109.PubMedCrossRefGoogle Scholar
  10. 10.
    McCullough GH, Kamarunas E, Mann GC, Schmidley JW, Robbins JA, Crary M. Effects of Mendelsohn maneuver on measures of swallowing duration post-stroke. Top Stroke Rehabil. 2012;19:234–43.PubMedCrossRefGoogle Scholar
  11. 11.
    Park T, Kim Y, McCullough GH. Oropharyngeal transition of the bolus in poststroke patients. Am J Phys Med Rehabil. In press. doi: 10.1097/PHM.0b013e318269d935.
  12. 12.
    Perlman AL, Booth BM, Grayhack JP. Videofluoroscopic predictors of aspiration in patients with oropharyngeal dysphagia. Dysphagia. 1994;9:90–5.PubMedCrossRefGoogle Scholar
  13. 13.
    Kim Y, McCullough GH. Maximum hyoid displacement in normal swallowing. Dysphagia. 2008;23:274–9.PubMedCrossRefGoogle Scholar
  14. 14.
    Logemann JA, Pauloski BR, Rademaker AW, Colangelo LA, Kahrilas PJ, Smith CH. Temporal and biomechanical characteristics of oropharyngeal swallow in younger and older men. J Speech Lang Hear Res. 2000;43:1264–74.PubMedGoogle Scholar
  15. 15.
    Rosenbek JC, Robbins JA, Roecker EB, Coyle JL, Wood JL. A penetration-aspiration scale. Dysphagia. 1996;11:93–8.PubMedCrossRefGoogle Scholar
  16. 16.
    McCullough GH, Rosenbek JC, Robbins JA, Coyle JL, Wood JL. Ordinality and intervality of a penetration-aspiration scale. J Med Speech Lang Pathol. 1998;6:65–72.Google Scholar
  17. 17.
    Robbins JA, Kays SA, Gangnon RE, Hind JA, Hewitt AL, Gentry LR, Taylor AJ. The effects of lingual exercise in stroke patients with dysphagia. Arch Phys Med Rehabil. 2007;88:150–8.PubMedCrossRefGoogle Scholar
  18. 18.
    O’Neil KH, Purdy M, Falk J, Gallo L. The dysphagia outcome and severity scale. Dysphagia. 1999;14:139–45.PubMedCrossRefGoogle Scholar
  19. 19.
    Nakane A, Tohara H, Ouchi Y, Goto S, Uematsu H. Videofluoroscopic kinesiologic analysis of swallowing: defining a standard plane. J Med Dent Sci. 2006;53:7–15.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of Communication Sciences and DisordersUniversity of Central ArkansasConwayUSA
  2. 2.School of Hearing, Speech and Language SciencesCollege of Health and Human Sciences, Ohio UniversityAthensUSA

Personalised recommendations