Dysphagia最新文献

{"title":"Adherence To Prophylactic Swallowing Exercises in Head and Neck Cancer Patients (PRESTO-TRIAL) - the ROLE of Personality Characteristics.","authors":"Alice Vergauwen, Margot Baudelet, Leen Van den Steen, Ann Goeleven, Sandra Nuyts, Daan Nevens, Hanne Massonet, Fréderic Duprez, Gwen Van Nuffelen","doi":"10.1007/s00455-025-10920-5","DOIUrl":"10.1007/s00455-025-10920-5","url":null,"abstract":"<p><p>Prophylactic swallowing exercises (PSE) can mitigate (the consequences of) radiation associated dysphagia (RAD) in head and neck cancer (HNC) patients, provided patients adhere to a high-intensity program. However, patient adherence, a multifactorial concept influenced by several confounders, has been found to vary considerably between studies and individuals. PSE-related adherence confounders such as gender, smoking at baseline, baseline depression and high baseline fatigue levels have already been postulated. The influence of personality on adherence to PSE has not yet been investigated. Therefore, the aim of this secondary analysis of the Presto-trial is to examine the influence of personality traits on overall adherence rates to a PSE-program. One hundred fifty patients with a stage III or IVA-B (TNM7) newly diagnosed squamous cell carcinoma of the oropharynx -treated with (chemo)radiotherapy (C)RT - were included in the PRESTO-trial. One hundred sixteen out of the 150 participants completed the NEO Five Factor Inventory (NEO-FFI) personality questionnaire prior to starting RT. The NEO-FFI is a validated 60 item self-report questionnaire with 12 items per personality trait (neuroticism, extraversion, altruïsm, conscientiousness and openness). Statistical analysis was performed using simple and multiple regression models for the 5 personality traits. This study shows that the personality trait openness significantly influences overall adherence rates to PSE in HNC (p = 0.047). Higher scores on the personality trait openness increase overall adherence rates (β = 0.058, SE = 0.0290). Although, this singular statistical result has a very small effect size (OR 1.06), meaning that it is not likely a meaningful difference to consider any practice change. The personality traits extraversion, neuroticism, conscientiousness and altruism are not significantly related to overall adherence during PSE. This study is the first to explore the relationship between personality traits and adherence to PSE in HNC. While openness showed a statistically significant association with overall adherence, the effect size was very small and is unlikely to be of clinical relevance. No other personality traits demonstrated a significant relationship with adherence.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"682-691"},"PeriodicalIF":2.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13290804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146141035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid Bolus Inflow into the Esophagus in a Patient with a Tracheostomy after Surgical Treatment for Dysphagia.","authors":"Kenjiro Kunieda, Takashi Shigematsu, Hideaki Kanazawa, Akiko Nomoto, Kyoko Hojo, Ichiro Fujishima","doi":"10.1007/s00455-025-10904-5","DOIUrl":"10.1007/s00455-025-10904-5","url":null,"abstract":"<p><p>This report describes a case in which a patient with an open tracheostomy, following surgery for severe dysphagia, acquired vacuum swallowing and exhibited rapid bolus inflow into the esophagus. A 39-year-old man with bulbar palsy caused by medullary surgery demonstrated impaired pharyngeal contraction and upper esophageal sphincter opening. After undergoing laryngeal suspension and cricopharyngeal myotomy, videofluoroscopic evaluation of swallowing revealed rapid passage of the bolus from the pharynx into the esophagus. High-resolution manometry demonstrated markedly negative intraesophageal pressure accompanied by simultaneous elevation of lower esophageal sphincter pressure during swallowing. These findings suggest that the patient had spontaneously acquired vacuum swallowing despite the presence of a tracheostoma communicating with the atmosphere. Recognition of this compensatory mechanism is important because it may facilitate bolus transport in individuals with tracheostomy. Increased awareness of this swallowing pattern may prevent underdiagnosis and offer new insights into rehabilitation strategies for dysphagia.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"692-696"},"PeriodicalIF":2.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13290859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145530658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Swallowing Impairments in Patients with Myasthenia Gravis: A Scoping Review.","authors":"Loni Arrese, Maria Di Meglio, Laura Byrne, Cagla Kantarcigil","doi":"10.1007/s00455-025-10913-4","DOIUrl":"10.1007/s00455-025-10913-4","url":null,"abstract":"<p><p>This scoping review aims to describe the oropharyngeal and esophageal swallowing profiles of individuals with Myasthenia Gravis (MG). Given the high prevalence of dysphagia in this population, this review seeks to synthesize existing literature on swallowing impairments and highlight the need for early identification in dysphagia management. This scoping review was conducted in accordance with Joanna Briggs Institute methodology for scoping reviews. Four databases were systematically searched to identify studies that examined swallowing impairments in MG using instrumental assessments. Studies were screened and selected if they utilized instrumental assessments, including Videofluoroscopic Swallowing Study (VFSS), Fiberoptic Endoscopic Evaluation of Swallowing (FEES), and/or esophageal manometry. Included studies were analyzed by two independent reviewers to provide a comprehensive overview of dysphagia across oral, pharyngeal, and esophageal domains using Covidence. A total of 4,305 manuscripts were identified; 1,959 remained after removing duplicates. Following screening titles, abstracts, and full texts, 13 remained. Findings indicate that MG-associated dysphagia affects all domains of swallowing. Disease severity, classified using the Myasthenia Gravis Foundation of America (MGFA) and Osserman classification, was associated with increased dysphagia severity. Studies reported a significant prevalence of silent aspiration, with 75% of silent aspirators developing aspiration pneumonia. This review highlights the high prevalence of dysphagia in MG and the importance of objective assessments in identifying swallowing impairments. Routine instrumental evaluations are essential for managing dysphagia and preventing serious complications such as aspiration pneumonia and myasthenic crisis. Future research should focus on standardizing dysphagia screening and assessment tools for MG.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"603-612"},"PeriodicalIF":2.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145707830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Combined Rehabilitation Approaches in Post-Stroke Dysphagia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Ibrahim M Alayaseh, Ponnusamy Subramaniam, Thanzeem Razak, Yaser S Natour, Marissa A Barrera, Shobha Sharma","doi":"10.1007/s00455-025-10919-y","DOIUrl":"10.1007/s00455-025-10919-y","url":null,"abstract":"<p><p>This systematic review and meta-analysis critically examine the efficacy of combined rehabilitation strategies, specifically the integration of swallowing exercises, neuromuscular electrical stimulation (NMES), and neuromuscular taping (NMT), in the management of post-stroke dysphagia. Four databases (Scopus, ScienceDirect, Cochrane Library, and PubMed) were searched for studies published from January 1990 to December 2024. Reference lists from relevant articles were also reviewed. A total of 372 studies were identified. After screening titles, abstracts, and full texts, 18 studies met the inclusion criteria.</p><p><strong>Population: </strong>Adults (≥ 18 years) with post-stroke dysphagia in the acute or subacute phases.</p><p><strong>Intervention: </strong>Swallowing exercises, NMES, NMT, or a combination.</p><p><strong>Comparator: </strong>Control groups with single interventions, usual care, or traditional therapies.</p><p><strong>Outcomes: </strong>Primary outcomes included swallowing function, aspiration pneumonia reduction, and quality of life. Secondary outcomes examined the timing, intensity, and type of interventions. Data were extracted using a standardized form in Microsoft Excel, focusing on study characteristics, participant demographics, intervention details, and outcome measurements. This systematic review supports the effectiveness of combined intervention approaches for post-stroke dysphagia. The meta-analysis revealed a significant improvement in swallowing function, with a pooled effect size of -1.27, indicating reduced Penetration-Aspiration Scale (PAS) scores. The random-effects pooled effect size was - 1.49 (95% CI: -1.92 to -1.06). Substantial heterogeneity (I² = 67.37%) was observed, likely attributable to differences in study methodologies, intervention protocols, and participant characteristics. The findings support the efficacy of combined rehabilitation strategies for post-stroke dysphagia. Certain combined interventions, particularly those incorporating NMES, show promise of effectiveness. However, the effectiveness of other modalities, such as kinesiology taping and chin tuck against resistance, remains less consistent and requires further investigation.</p><p><strong>Registration number: </strong>PROSPERO Registration ID: CRD42025645917.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"657-681"},"PeriodicalIF":2.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146141108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One-year Swallowing Outcomes in a Head and Neck Cancer Cohort: The Impact of Adherence to Swallowing Exercises and Feeding Tube Use.","authors":"Heather M Starmer, Liane McCarroll, Tessa Goldsmith, Jennifer Kizner, Jocelen Hamilton, Theresa Yao, Beth M Beadle","doi":"10.1007/s00455-025-10918-z","DOIUrl":"10.1007/s00455-025-10918-z","url":null,"abstract":"<p><p>For patients with head and neck cancer (HNC), radiation therapy is associated with short-term, chronic, and late-onset dysphagia [1-3]. Swallowing exercises and oral intake during radiation may reduce dysphagia shortly after radiation [4-6]. The purpose of this study was to explore the relationship between exercise adherence and feeding tube use and one-year swallowing outcomes. Secondary analysis of RCT of swallowing therapy during definitive radiation-based HNC treatment. Adherence was defined as completing at least 50% of prescribed swallowing exercises during radiotherapy. Feeding tube use was prospectively collected. Outcome measures included the MD Anderson Dysphagia Inventory, Performance Status Scale - Head and Neck, Functional Oral Intake Scale, Penetration Aspiration Scale, Modified Barium Swallow Impairment Profile, and Dynamic Imaging Grade of Swallowing Toxicity scores. One-year follow-up data was available for 64 participants. Adherence criteria was met by 26 participants (41%) while feeding tube use (during treatment) was present in 8/64 participants (12%); only 1 patient had a feeding tube at one year. Adherence was associated with more normal MDADI scores one-year post-treatment (91 vs. 80: p = 0.003), as well as higher PSS normalcy of diet scores (p = 0.03). Feeding tube use was associated with worse maximum PAS scores (p < 0.001), DIGEST scores (Safety p = 0.04; overall grade p = 0.01), and MBS-ImP pharyngeal composite scores (p = 0.008). Adherence to swallowing exercises during radiation therapy is associated with better patient perceived swallow function and diet scores while avoidance of feeding tube placement is associated with better physiologic swallow function one year following radiation therapy.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"650-656"},"PeriodicalIF":2.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145676689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Swallowing Dysfunction Following Uncomplicated Thyroid and Parathyroid Surgery: A Prospective Evaluation of Early and Late Postoperative Changes.","authors":"Sibel Alicura Tokgöz, Güleser Saylam, Ömer Bayır, Mehmet Murat Günay, Gökhan Toptaş, Mümüne Merve Parlak, Ebru Umay, Mehmet Hakan Korkmaz","doi":"10.1007/s00455-025-10906-3","DOIUrl":"10.1007/s00455-025-10906-3","url":null,"abstract":"<p><p>Dysphagia is a complication that may occur after thyroidectomy or other head and neck surgeries. This complaint is usually associated with inferior and superior laryngeal nerve dysfunction, but it can also occur without nerve damage. The aim of this study is to evaluate the frequency, severity, and clinical course of dysphagia developing in the early and late periods after thyroid and parathyroid surgeries, to determine its effects on patients' postoperative quality of life, and to contribute to optimal management strategies. Between January 2016 and September 2017, a total of 76 patients were prospectively evaluated: 25 who underwent parathyroidectomy (Group 1), 26 who underwent total thyroidectomy with central neck dissection (Group 2), and 25 who underwent total thyroidectomy without central neck dissection (Group 3). Swallowing function and postoperative quality of life were assessed using fiberoptic endoscopic evaluation of swallowing (FEES), the Swallowing Quality of Life questionnaire (Swal-QoL), and the Eating Assessment Tool (EAT-10), applied preoperatively, at postoperative week 1 (early postoperative period, EPO), and at week 8 (late postoperative period, LPO). Early postoperative swallowing changes were observed in 16% of parathyroidectomy patients, 20% of thyroidectomy patients without central neck dissection, and 36% of those with central dissection. Significant between-group differences were found for FEES liquid swallows (p = 0.006), EAT-10 (p = 0.003, p = 0.001), and Swal-QoL scores (p = 0.011, p = 0.001). Longitudinal analysis showed significant changes in EAT-10 and Swal-QoL across all periods (p < 0.001). While parathyroidectomy patients showed only minimal transient changes, thyroidectomy with central dissection caused early FEES impairments and persistent subjective complaints, and thyroidectomy without dissection mainly affected patient-reported outcomes despite normal FEES findings. This study demonstrates that dysphagia is common after thyroid and parathyroid surgery and that its course is closely related to the extent of surgery. While swallowing function is largely preserved after parathyroidectomy, thyroidectomy without central neck dissection may lead to significant reductions in quality of life. In patients undergoing thyroidectomy with central neck dissection, early objective impairments and persistent late subjective complaints were observed. As the extent of surgery increases, the risk of dysphagia also rises, and subjective symptoms may persist even after objective findings return to normal. Therefore, routine postoperative swallowing assessment, comprehensive preoperative counseling, and, when necessary, early rehabilitation programs are critical to preserving long-term quality of life.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"541-553"},"PeriodicalIF":2.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145556500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refining the Protocol and Clinical Pathway for Oesophageal Screening in Videofluoroscopic Swallow Studies: An Examination of Clinical and Operational Impacts Over Five Years.","authors":"Kellie McCarthy, Emma Finch, Anna Miles","doi":"10.1007/s00455-025-10917-0","DOIUrl":"10.1007/s00455-025-10917-0","url":null,"abstract":"<p><p>Current international practice guidelines recommend videofluoroscopic swallow studies (VFSSs) include oesophageal screening. However, the clinical application of oesophageal screening is not well established. A multidisciplinary dysphagia team at one hospital refined their oesophageal screening protocol and clinical pathway over five years, exploring clinical and operational impacts. Retrospective chart audits were conducted for 100 consecutive 2024 VFSS patients (refined protocol group). VFSS reports, gastroenterologist (GE) consultations and clinical pathway adherence were compared to previously published VFSS cohorts at the research site (pre-protocol group, 2019-20, n = 100; protocol group, 2020-21, n = 160). There were no differences between the three groups for age (p > .05) or oropharyngeal dysphagia severity (p > .05). Rates of oesophageal screening significantly increased (p < .001) following protocol introduction. In the refined protocol group, there was a significant increase (83% versus 6%, p < .001) in speech-language pathologists (SLPs) providing oesophageal strategy advice and no difference in patient VFSS radiation dose (p > .05) compared to the protocol group when oesophageal screening was conducted. There was no difference between the three groups for new GE consultation rates (p > .05). Post-audit, SLP + GE case discussions were added to the clinical pathway to allow for more individualised management of complex patients. The refined oesophageal screening protocol and clinical pathway expanded clinician understanding of patients' dysphagia by marrying reported symptoms with VFSS findings and led to targeted intervention without adverse impacts. Ongoing work is required to further optimise multidisciplinary dysphagia team collaboration and patient outcomes.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"635-649"},"PeriodicalIF":2.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Videofluoroscopic Pulse Rate on Measures of Swallow Safety in Infants and Adults with Feeding and Swallowing Disorders.","authors":"Phyllis M Palmer, Aaron H Padilla, Mahshid Rashidi","doi":"10.1007/s00455-025-10911-6","DOIUrl":"10.1007/s00455-025-10911-6","url":null,"abstract":"<p><p>This investigation assessed the impact of videofluoroscopic resolution on measures of swallow safety. Thirty adult and twenty infant swallow studies, all acquired at 30 frames and 30 pulses per second (fps, pps), were obtained from a publicly available repository of swallow studies. All swallow studies were altered to simulate 15 and 5 pulses per second. Safety was assessed using the penetration-aspiration score and a modified DIGEST safety score. Analysis of outcome measures was performed and compared across the three temporal resolutions (30, 15, and 5 pps). Significant differences in measures of safety occurred when lower pulse rates were employed. All 20 infant participants were classified as having safe swallows at 5 pps, despite 11 demonstrating unsafe swallows (PAS > 2) at 30 pps. This pattern was also observed in adult participants to a lesser extent. Reducing pulse rates below 30 pps significantly compromises the accuracy of swallow safety assessment for all age groups. The systematic underestimation of safety violations has direct implications for clinical decision-making and patient risk assessment. These findings support maintaining 30 fps/pps as the standard for videofluoroscopic swallow studies (VFSS) when swallow safety evaluation is paramount and suggest that alternative radiation reduction strategies should be prioritized over pulse rate reduction.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"585-591"},"PeriodicalIF":2.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146141147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of Calf Circumference in Predicting Swallowing Penetration in Sarcopenic Older Adults: A FEES-Based Study.","authors":"Nermin Karakurt, Emirhan Akyol, Hakan Gölaç, Güzide Atalık, Halit Nahit Şendur, Tijen Ceylan, Hacer Dogan Varan","doi":"10.1007/s00455-025-10908-1","DOIUrl":"10.1007/s00455-025-10908-1","url":null,"abstract":"<p><p>This study investigated clinical and anthropometric parameters, including ultrasound-derived swallowing muscle measurements, for predicting clinically significant swallowing penetration in sarcopenic older adults. Eighty adults aged ≥ 65 years (50 sarcopenic, 30 controls) attending a university hospital geriatric clinic were enrolled. Exclusion criteria were major neurological disorders, malignancy, head and neck surgery/radiotherapy, advanced organ failure, severe COPD, and rheumatologic disease. All underwent comprehensive geriatric assessments, including frailty (Fried criteria), cognitive and nutritional screening, EAT-10, and ultrasound-based sarcopenia assessment. Sarcopenia was defined as low handgrip strength and low STAR index (anterior thigh muscle thickness/BMI) using national cut-offs. Swallowing-related muscle thickness (genioglossus, geniohyoid, tongue), geniohyoid area, and elevation were measured ultrasonographically. Sarcopenic patients consenting to fiberoptic endoscopic evaluation of swallowing (FEES) were assessed using the Penetration-Aspiration Scale (PAS); PAS ≥ 3 indicated clinically significant penetration. Participants' mean age was 75.86 ± 6.89 years. Sarcopenic individuals were older, predominantly male, with lower genioglossus and tongue thickness, higher frailty scores, lower MMSE, and greater prevalence of diabetes and coronary artery disease. Among sarcopenic patients, 20% exhibited significant penetration. These patients had smaller arm/calf circumferences, slower gait speed, and higher EAT-10 scores, but no significant differences in swallowing muscle measurements or cognitive and nutritional status. Multivariate analysis identified lower calf circumference as the sole independent predictor (OR: 0.772, 95% CI: 0.613-0.972, p = 0.027). A threshold ≤ 32 cm yielded an AUC of 0.733 (p = 0.025), with 70% sensitivity and 77.5% specificity. In sarcopenic older adults, calf circumference is an independent, non-invasive predictor of clinically significant swallowing penetration, outperforming ultrasound-based swallowing muscle metrics in aspiration risk screening.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"564-572"},"PeriodicalIF":2.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Submental Muscle Activation and Tongue Pressure of Tongue Hold, Effortful Swallow and Mendelsohn Maneuvers in Different Gravitational Positions.","authors":"Emre Cengiz, Rabia Yıldırım, Ömer Faruk Yaşaroğlu, Numan Demir, Selen Serel Arslan","doi":"10.1007/s00455-026-10961-4","DOIUrl":"10.1007/s00455-026-10961-4","url":null,"abstract":"<p><p>This study aimed to investigate the effects of Tongue Hold Maneuver (THM), Mendelsohn Maneuver (MM), and Effortful Swallow Maneuver (ESM) performed under different gravitational positions (90° sitting, 45° sitting, supine, and lateral decubitus) on submental muscle activation (SMA) and oral pressure in healthy young adults. Thirty-three healthy volunteers aged 18-30 years participated. SMA was recorded using surface electromyography (sEMG), and oral pressure was measured with the Iowa Oral Performance Instrument (IOPI). Each maneuver was performed in four gravitational positions in a randomized order. SMA values were normalized with the maximum isometric voluntary contraction (MVC), and oral pressure was expressed in kilopascals. Repeated-measures ANOVA was used to compare submental muscle activation (%MVC) and tongue pressure (kPa) across swallowing maneuvers (THM, MM, ESM) and gravitational positions (90° sitting, 45° sitting, supine, lateral decubitus) within subjects. SMA varied significantly across positions and maneuvers (p < 0.05). The lowest activation was observed in the lateral decubitus position for all maneuvers, while ESM produced the highest activations.Oral pressure was significantly affected by maneuver type (p < 0.001), with ESM showing the highest and THM the lowest values. However, no significant effect of body position on oral pressure was found. Swallowing maneuvers showed different results of SMA and oral pressure under different gravitational conditions. Muscle activation decreased as gravity was eliminated, with the lowest values in lateral decubitus position, whereas oral pressure was influenced mainly by maneuver type. Using gravity-eliminated positions in rehabilitation may be considered as a starting point for patients with altered muscle strength and may facilitate gradual progression in rehabilitation. Accordingly, these findings should be interpreted within the limits of physiological measurements and not as indicators of clinical safety or therapeutic benefit.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148004739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}