The Effect of Swallowing Exercise and Maneuver Program For Older Adults With Dysphagia in Nursing Home

University of Indonesia (UI)

Status: Not yet enrolling

Conditions: Frailty-related Dysphagia; Oropharyngeal Dysphagia; Swallowing Disorders; Nursing Homes

Treatments: Behavioral: Swallowing Exercise and Maneuver Program for Older Adults with Dysphagia

Study type: Interventional

Funder types: Other

Identifiers

NCT07049471

NKB-215/UN2.RST/HKP.05.00/2024 (Other Grant/Funding Number)

Details and patient eligibility

About

This clinical trial aimed to evaluate the effectiveness of a structured swallowing exercise and maneuver program for older adults with dysphagia living in a nursing home. Dysphagia, or difficulty in swallowing, is common in elderly populations and may lead to malnutrition, dehydration, and aspiration pneumonia.

In this study, 72 participants aged 60 years and older were randomly assigned to either an intervention group or a control group. The intervention group received a combined swallowing exercise and maneuver program-including Masako Maneuver, Chin Tuck Against Resistance, Supraglottic Swallow, and Super-Supraglottic Swallow-performed three times daily before meals over a six-week period. The control group received standard care, including upright sitting posture during meals.

Swallowing ability was measured using the EAT-10 questionnaire. The intervention group showed significant improvement in swallowing scores, while no meaningful changes were observed in the control group. This study suggests that nurse-led swallowing exercises can be a safe, simple, and effective strategy to improve swallowing function and quality of life in older adults living in long-term care settings.

Full description

Oropharyngeal dysphagia is a prevalent condition among older adults, particularly in institutionalized settings such as nursing homes. It is often underdiagnosed, misattributed to normal aging, and leads to serious complications including aspiration pneumonia, malnutrition, dehydration, and diminished quality of life. Despite its high burden, non-pharmacological interventions tailored to this population in Indonesia remain limited.

This randomized controlled trial was designed to assess the effectiveness of a structured swallowing exercise and maneuver program for older adults with dysphagia in a long-term care facility. The intervention integrated both pharyngeal element-based exercises (Masako Maneuver and Chin Tuck Against Resistance) and behavioral-based exercises (Supraglottic Swallow and Super-Supraglottic Swallow). These exercises were delivered as a video-guided program and administered three times per day before meals over six weeks by trained nursing staff.

Participants were randomly assigned to intervention and control groups using a simple random sampling method. The control group received standard care without swallowing exercises. Outcomes were measured using the Eating Assessment Tool-10 (EAT-10), a validated instrument for identifying clinically significant swallowing problems.

This study aimed to provide empirical evidence for the use of structured, nurse-delivered swallowing training as an effective and feasible approach to managing dysphagia among the elderly in nursing homes. It also explored the potential for routine implementation and integration into geriatric nursing practice across similar institutional care settings.

Enrollment: 72 estimated patients

Sex: All

Ages: 60+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• aged 60 years or older
• experiencing swallowing difficulties as assessed by the Eating Assessment Tool-10 (EAT-10)
• having no history of neurological disease
• possessing adequate communication abilities
• and being capable of performing daily activities either independently or with partial assistance

Exclusion criteria

• individuals with dermatological conditions in the anterior neck region, hypertension, orofacial pain such as trigeminal neuropathy or toothache, as well as those with significant malocclusion or facial asymmetry

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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72 participants in 2 patient groups

Swallowing Exercise and Maneuver Group

Experimental group

Description:

Participants in this arm received a structured swallowing exercise and maneuver program consisting of four techniques: Masako Maneuver, Chin Tuck Against Resistance (CTAR), Supraglottic Swallow, and Super-Supraglottic Swallow. The exercises were administered by nurses using a video-guided protocol, three times daily before meals for six weeks. The program was designed to improve pharyngeal muscle strength and enhance airway protection during swallowing.

Treatment:

Behavioral: Swallowing Exercise and Maneuver Program for Older Adults with Dysphagia

Standard Care Group

No Intervention group

Description:

Participants in this arm received standard care for dysphagia, which involved upright sitting positioning during meals without any structured swallowing exercises or maneuvers. No additional behavioral interventions were provided during the study period.