title: Effect of the effortful swallow and the Mendelsohn maneuver on tongue pressure production against the hard palate.
abstract: Although effortful swallow and the Mendelsohn maneuver are commonly used in dysphagia rehabilitation, little is known about their effects on tongue-palate pressure production. The purpose of this study was to investigate the effects of effortful swallow and the Mendelsohn maneuver on tongue pressure production. Fourteen healthy volunteers (10 men, 4 women; age range = 21-41 years) participated. Tongue pressures during dry swallow, water swallow, effortful swallow, and the Mendelsohn maneuver were measured using a sensor sheet system with five measurement points on the hard palate. Sequential order, duration, maximal magnitude, and the integrated value of tongue pressure at each measurement point were compared among the four tasks. Onset of tongue pressure at the posterior-circumferential parts occurred first in the Mendelsohn maneuver; that at the anterior-median part was earlier than at other parts in the effortful swallow. At all measurement points, tongue pressure duration was significantly longer in the Mendelsohn maneuver than in other tasks. Effortful swallow was most effective in increasing tongue pressure. The integrated value of tongue pressure at the posterior-circumferential parts in the Mendelsohn maneuver and at the median parts in the effortful swallow showed a tendency to increase. These results suggest that tongue pressure increases along a wide part of the hard palate in effortful swallow because the anchor of tongue movement is emphasized at the anterior part of the hard palate. The Mendelsohn maneuver provides prolonged and accentuated tongue-palate contact at the posterior-circumferential parts, which might be important for hyoid-laryngeal elevation during swallowing.
authors.affiliation: Division of Rehabilitation, Sasayama Medical Center, Hyogo College of Medicine, 5 Kuro-oka, Sasayama, 669-2321, Japan.
authors.forename: Tatsuyuki
authors.initials: T
authors.lastname: Fukuoka
authors.forename: Takahiro
authors.initials: T
authors.lastname: Ono
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hori
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Tamine
authors.forename: Sonoko
authors.initials: S
authors.lastname: Nozaki
authors.forename: Kenji
authors.initials: K
authors.lastname: Shimada
authors.forename: Noriyasu
authors.initials: N
authors.lastname: Yamamoto
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Fukuda
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Domen
mesh_terms: D000328:Adult; D003679:Deglutition / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D009068:Movement; D010159:Palate; D011312:Pressure; D013997:Time Factors; D014059:Tongue / Q000502:physiology*; D055815:Young Adult