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The Masako Maneuver

Byline: Jan Pryor, CCC-SLP, BRS-S

The swallowing exercise with the strangest name……

No, this is not a Sumo wrestling move, it is a swallowing exercise for people with dysphagia!

What is it?

The Masako Maneuver was introduced by Jerilyn Logemann and Masako Fujiu around 1996 as a pharyngeal strengthening exercise.

How do you do it?

This exercise is performed by protruding your tongue between your front teeth, holding it in place by gently biting down on the anterior portion of your tongue and maintaining this posture while swallowing saliva.

Who would benefit from this exercise?

Individuals who have known pharyngeal weakness. Simply put, if you have had a Modified Barium Swallowing Evaluation and the findings were incomplete contact between the posterior pharyngeal wall and the base of the tongue, this exercise might be for you. If you haven’t had a Modified Barium Swallow Study, but have pooling of saliva or food in your throat, which might be noticed by a “wet” or “gurgly” voice quality, this exercise might benefit you.

How does it work?

A  1996 study by Jerilyn Logemann and Masako Fujiu of 10 young, healthy individuals under fluoroscopy showed increased posterior pharyngeal wall movement while performing the “tongue hold” maneuver. Dr. Logemann has written that anchoring the anterior tongue causes the glossopharyngeal portion of the superior constrictor muscle to use more force in contracting. On video swallowing studies, posterior pharyngeal wall bulging was observed before and during this maneuver.  Strengthening the pharyngeal constrictors (posterior pharyngeal wall bulging is part of pharyngeal constriction, don’t forget about lateral wall medialization) aids in the speed and efficiency of bolus transport through the pharynx during the swallow via increased pharyngeal pressure.

Anatomy of SwallowingCould this exercise be dangerous?

The Masako Maneuver should not be performed with actual food or liquid because it alters the position and function of the muscles involved in the pharyngeal swallow and has been seen to result in aspiration.

Is there anyone who should not perform this exercise?

Research has shown that the use of this maneuver decreases the anterior movement of the hyoid and would suggest that someone with decreased anterior hyoid movement may not benefit from this exercise unless this is performed in conjunction with the head lift exercise (Shaker maneuver) in order to compensate for decreased anterior hyoid movement.

Click here to be directed to additional oral strengthening exercises.

 

References

Fujiu, M., Logemann, J.A. (1996). Effect of a tongue-holding maneuver on posterior pharyngeal wall movement during deglutition. American Journal of Speech-Language Pathology, 5, 25-30.

Doeltgen, S.H., Witte, U., Gumbley, F., & Huckabee, M. (2009). Evaluation of manometric measures during tongue-hold swallows. American Journal of Speech-Language Pathology, 18, 65-73.

Logemann, J. A. (2006, May 16). Medical and rehabilitative therapy of oral, pharyngeal motor disorders. GI Motility Online.

For on-Line References on efficacy of swallowing maneuvers check out:

dysphagiagroup.weebly.com