Type of Article:  Original Research

Volume 11; Issue 4 (August 2023)

Page No.: 4611-4620

DOI: https://dx.doi.org/10.16965/ijpr.2023.144

Effect of Shaker Exercise and Masako Maneuver on Swallowing Function and Quality of Life in Patients with Dysphagia following Stroke: An Interventional Comparative Study

Jahanvi Barot *1, Pragna Landge 2, Happy Patel 3.

1 MPT (Neurology & Psychosomatic disorders), BITS Institute of Physiotherapy, Varnama, Vadodara, Gujarat, India.

2 Assistant professor, Krishna School of Physiotherapy & Rehabilitation, KPGU, Vadodara, Gujarat, India.

3 MPT (Neurology & Psychosomatic Disorders) BITS institute of physiotherapy, Varnama, Vadodara, Gujarat, India.

Corresponding Author: Dr. Jahanvi Barot, MPT (Neurology & Psychosomatic disorders), B/27, Mangalam Society, Near Tirupati metro mall, kansa road, Visnagar, Gujarat, India – 384315.

E-Mail: jahanvibarot324@gamail.com


Background: Dysphagia is a condition that affects the normal deglutition leading to difficulty in swallowing food and liquid. It is a common problem in stroke survivors. Dysphagia after stroke can cause various complications, especially aspiration pneumonia, which can be life-threatening. Some rehabilitation methods reduce the severity of swallowing, improve quality of life, reduce the L-tube intubation period, and reduce the hospital stay duration in patients with dysphagia after stroke. The study compares the effect of the Shaker exercise with conventional therapy and the Masako maneuver with conventional therapy on post-stroke dysphagia. Some studies show the individual effectiveness of the shaker exercise and the Masako maneuver in post-stroke patients. Hence the need arises to evaluate the effectiveness of the Masako maneuver and Shaker exercises in post-stroke dysphagia patients.

Aim: To study the effects of the Shaker exercise with conventional therapy and Masako maneuver with conventional therapy in patients with dysphagia following stroke.

Methodology: convenient sampling was done for the selection of participants. Thirty patients who met the inclusion criteria were recruited from various hospitals in Vadodara. There were 11 men and 19 women among the 30 participants. The patients were divided into two groups. Group 1 received Shaker exercise along with conventional therapy, and Group 2 was received Masako maneuver along with conventional therapy. Baseline data were collected by EAT-10 scale. After 4 weeks, the participants were evaluated again. 

Result: The data were analyzed using the paired t-test. During the between-group comparison, group 1 (Shaker Group) showed greater improvement on EAT-10 scale than Group 2 (Masako Group). The SPSS version 23 used for data analysis and the p-value is 0.05.

Conclusion & Clinical Implication: the present study concluded that Shaker exercise along with conventional therapy showed greater improvement in swallowing function and quality of life in patients with post stroke dysphagia. Shaker exercise obtained better results with regards to quality of life and swallowing function than Masako maneuver with conventional therapy.

Key words: stroke, dysphagia, Shaker Exercise, Masako Maneuver, EAT-10 scale, swallowing, and quality of life.


[1]. Langdon C, Blacker D. Dysphagia in stroke: a new solution. Stroke research and treatment. 2010 Jun 30;2010.
[2]. Burkhead LM, Sapienza CM, Rosenbek JC. Strength-training exercise in dysphagia rehabilitation: principles, procedures, and directions for future research. Dysphagia. 2007 Jul;22(3):251-65.
[3]. Martino R, Foley N, Bhogal S, Diamant N, Speechley M, Teasell R. Dysphagia after stroke: incidence, diagnosis, and pulmonary complications. stroke. 2005 Dec 1;36(12):2756-63.
[4]. Krishnamurthy R, Premkumar PK, Balasubramanium RK. Incidence of dysphagia and associated pneumonia in stroke patient from India: A systematic review. medRxiv. 2020 Jan 1.
[5]. P. orlandoni, et al. Health-related quality of life and functional health status questionnaires in oropharyngeal dysphagia, the journal of aging research & lifestyle, 2020; 81:1-8.
[6]. Byeon H. Effect of the Masako maneuver and neuromuscular electrical stimulation on the improvement of swallowing function in patients with dysphagia caused by stroke. Journal of physical therapy science. 2016;28(7):2069-71.
[7]. Byeon H. Combined Effects of NMES and Mendelsohn Maneuver on the Swallowing Function and Swallowing–Quality of Life of Patients with Stroke-Induced Sub-Acute Swallowing Disorders. Biomedicines. 2020 Jan;8(1):12.
[8]. Logemann JA, Rademaker A, Pauloski BR, Kelly A, Stangl-McBreen C, Antinoja J, Grande B, Farquharson J, Kern M, Easterling C, Shaker R. A randomized study comparing the Shaker exercise with traditional therapy: a preliminary study. Dysphagia. 2009 Dec 1;24(4):403.
[9]. Choi JB, Shim SH, Yang JE, Kim HD, Lee DH, Park JS. Effects of Shaker exercise in stroke survivors with oropharyngeal dysphagia. NeuroRehabilitation. 2017 Jan 1;41(4):753-7.
[10]. Kumaresan A, et al. Effectiveness of Masako maneuver on post-stroke dysphagia. International general of research in pharmaceutical sciences, Nov 2018; 9(4): 1457-1459.
[11]. Hamidon BB, Nabil I, Raymond AA. Risk factors and outcome of dysphagia after an acute ischaemic stroke. Medical Journal of Malaysia. 2006 Dec 1;61(5):553.
[12]. Hasan ZN, Al-Shimmery EK, Taha MA. Evaluation of neurogenic dysphagia in Iraqi patients with acute stroke. Neurosciences Journal. 2010 Apr 1;15(2):90-6.
[13]. Steinhagen V, Grossmann A, Benecke R, Walter U. Swallowing disturbance pattern relates to brain lesion location in acute stroke patients. Stroke. 2009 May 1;40(5):1903-6.
[14]. Paciaroni M, Mazzotta G, Corea F, Caso V, Venti M, Milia P, Silvestrelli G, Palmerini F, Parnetti L, Gallai V. Dysphagia following stroke. European neurology. 2004;51(3):162-7.
[15]. de Alencar Nunes MC, Jurkiewicz AL, Santos RS, Furkim AM, Massi G, Pinto GS, Lange MC. Correlation between brain injury and dysphagia in adult patients with stroke. International archives of otorhinolaryngology. 2012 Jul;16(03):313-21.
[16]. Arnold RJ, Bausek N. Effect of respiratory muscle training on dysphagia in stroke patients—A retrospective pilot study. Laryngoscope Investigative Otolaryngology. 2020 Dec;5(6):1050-5.
[17]. Park JS, Lee G, Jung YJ. Effects of game-based chin tuck against resistance exercise vs head-lift exercise in patients with dysphagia after stroke: an assessor-blind, randomized controlled trial. Journal of rehabilitation medicine. 2019 Nov 5;51(10):749-54.
[18]. Jeon YH, Cho KH, Park SJ. Effects of Neuromuscular Electrical Stimulation (NMES) Plus Upper Cervical Spine Mobilization on Forward Head Posture and Swallowing Function in Stroke Patients with Dysphagia. Brain Sciences. 2020 Aug;10(8):478.
[19]. Jung YJ, Kim HJ, Choi JB, Park JS, Hwang NK. Effect of Dysphagia Rehabilitation Using Kinesiology Taping on Oropharyngeal Muscle Hypertrophy in Post-Stroke Patients: A Double Blind Randomized Placebo-Controlled Trial. InHealthcare 2020 Dec (Vol. 8, No. 4, p. 411). Multidisciplinary Digital Publishing Institute.
[20]. Chang MY, Lee G, Jung YJ, Park JS. Effect of Neuromuscular Electrical Stimulation on Masseter Muscle Thickness and Maximal Bite Force among Healthy Community-Dwelling Persons Aged 65 Years and Older: A Randomized, Double Blind, Placebo-Controlled Study. International Journal of Environmental Research and Public Health. 2020 Jan;17(11):3783.
[21]. Wang ZY, Chen JM, Ni GX. Effect of an indwelling nasogastric tube on swallowing function in elderly post-stroke dysphagia patients with long-term nasal feeding. BMC neurology. 2019 Dec;19(1):1-7.

Cite this article: Jahanvi Barot, Pragna Landge, Happy Patel. Effect of Shaker Exercise and Masako Maneuver on Swallowing Function and Quality of Life in Patients with Dysphagia Following Stroke: An Interventional Comparative Study. Int J Physiother Res 2023;11(4):4611-4620. DOI: 10.16965/ijpr.2023.144