Table 1.9-2. Rehabilitation techniques used in patients with dysphagia

Rehabilitation technique


Masako maneuver

Patient holds the tongue forward between teeth while swallowing; this is performed without food/liquid in the mouth to prevent coughing or choking. Although sometimes referred to as the Masako “maneuver,” Masako (tongue hold) is considered an exercise, not a maneuver, and its intent is to improve movement and strength of posterior pharyngeal wall during the swallow

Head lift (shaker) maneuver

Patient rests in supine position and lifts their head to look at the toes to facilitate increased opening of the upper esophageal sphincter through increased hyoid and laryngeal anterior and superior excursions

Effortful swallow

Increases posterior tongue base movement to facilitate bolus clearance. Patient is instructed to swallow and push hard with tongue against hard palate


Used to visually display swallowing physiology, it incorporates patient’s ability to sense changes and aids in treatment of feeding or swallowing disorders; eg, those with sufficient cognitive skills can be taught to interpret visual information provided by these assessments (surface electromyography, ultrasonography, FEES) and make physiologic changes during swallowing

Electrical stimulation

Used to contract muscle fibers by applying low-voltage electrical currents to muscle tissue

Strengthening exercises for cheek, jaw, lips, tongue

Patient is provided lingual resistance across exercises to increase strength (eg, tongue lateralization exercises support development of chewing skills)

FEES, fiberoptic endoscopic evaluation of swallowing.