Mendelsohn Maneuver

The Mendelsohn maneuver is a swallowing exercise. Swallowing exercises are rehabilitative techniques designed to create lasting change in an individual’s swallowing over time by improving underlying physiological function. The Mendelsohn maneuver can be used outside of meals to strengthen muscles for improved function during meals (Crary & Groher, 2010; Langmore & Pisegn, 2015).

If appropriate, the Mendelsohn Maneuver can also be used as a compensatory strategy during mealtime to reduce the risk of aspiration (Crary & Groher, 2010).

Purpose (McCullough & Kim, 2013; Sapienza et al., 2008):

To increase the extent of hyolaryngeal elevation during the swallow
To increase the width and prolong the cricopharyngeal opening
To reduce pooling in the pyriform sinuses
To improve coordination of the whole swallow sequence

Population: Persons with swallow deficits at the pharyngeal stage who have a good prognosis for recovery of swallow function (e.g. acute stroke) and cognitive abilities to follow directions.

Procedure: Palpate hyoid/thyroid notch and hold the larynx suspended for 2 seconds. See the video below for an example.

Objective: Patient will use the Mendelsohn maneuver during mealtimes for _____ consistencies 10x/day for 8 weeks, as evidenced through SLP and patient data collection.

Data Collection: Determine the best method for collecting data (patient, caregiver, etc.). Provide a table for at-home data collection, as necessary. The patient/caregiver can add a check or plus to demonstrate the task was completed. Provide directions and photo below for support.

E.g.

Week 1:
Monday _ _ _ _ _ _ _ _ _ _
Tuesday _ _ _ _ _ _ _ _ _ _
Wednesday _ _ _ _ _ _ _ _ _ _
Thursday _ _ _ _ _ _ _ _ _ _
Friday _ _ _ _ _ _ _ _ _ _
Saturday _ _ _ _ _ _ _ _ _ _
Sunday _ _ _ _ _ _ _ _ _ _

Video

This video provides an explanation and demonstration of the Mendelson maneuver.

Directions

Sit or stand comfortably.
Start to swallow normally.
When your Adam's apple is at its highest point, squeeze your throat muscles to hold it in that position for 3 counts, and then relax.
You can use your fingers to help you hold your Adam's apple at its highest point.
Repeat these steps as many times as directed.

(Sapienza et al., 2008)

MendelsohnManeuver.pdf

Article

This study by McCullough and Kim (2013) suggests the Mendelsohn maneuver is effective in creating psysiologic changes in the extent of the hyoid bone during the swallow and concurrent opening of the upper esophageal sphincter (UES) in post-stroke patients.

(McCullough & Kim, 2013; Sapienza et al., 2008)

Swallowing_Exercises_Handout_2021_The_Adult_Speech_Therapy_Workbook.pdf

Handout

This PDF provides a visual of several evidence-based swallowing exercises, including the Mendelsohn maneuver.

References
Crary, M.A., & Groher, M.E. (2010). Dysphagia: Clinical management in adults and children, Mosby Elsevier, Maryland Heights, MO.
Fukuoka, T., Ono, T., Hori, K., Tamine, K., Nozaki, S., Shimada, K., Yamamoto, N., Fukuda, Y., & 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
Langmore, S. E., & Pisegna, J. M. (2015). Efficacy of exercises to rehabilitate dysphagia: A critique of the literature.
International Journal of Speech-Language Pathology, 17(3), 222–229. https://doi.org/10.3109/17549507.2015.1024171
McCullough, G.H., & Kim, Y. (2013). Effects of the Mendelsohn Maneuver on extent of hyoid movement and UES opening
post-stroke. Dysphagia 28, 511–519. https://doi-org.csumb.idm.oclc.org/10.1007/s00455-013-9461-1
Sapienza, C., Wheeler-Hegland, K., Stewart, K., & Nocera, J. (2008). Exercise prescription for dysphagia: Intensity and
duration manipulation. Perspectives on Swallowing and Swallowing Disorders (Dysphagia), 17(2), 50–58.
https://doi.org/10.1044/sasd17.2.50

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