The study aims to Compare the effect of Mendelsohn maneuver, effortful swallow training, and the Shaker exercise on neurogenic dysphagia among stroke patients.
An adult patient diagnosed with stroke.
Patients who had been diagnosed with dysphagia after stroke.
Patients who are hemodynamically stable, conscious and have adequate cognitive ability to follow simple instructions and able to sit upright for at least 30 minutes.
Unstable angina and myocardial infarction)MI(.
History of seizure.
Head injury or neurological disease other than stroke, neurosurgery .
Oral and maxillofacial surgery.
Parallel
Compare the effect of Mendelsohn maneuver, effortful swallow training, and the Shaker exercise on neurogenic dysphagia among stroke patients.
Other interventionTo achieve single blind in this trial, the participant is kept blinded to their group assignment (interventions and control groups) throughout the study. The data collector administers the assigned intervention (Mendelsohn maneuver, effortful swallow training, and the Shaker exercise ) without revealing the participant's group assignment. The researcher retains knowledge of group allocation to ensure Single blind. Interventions are randomized, and assess Effect of Mendelsohn maneuver, effortful swallow training, and the Shaker exercise on swallowing Ability without knowing the type of maneuvers received, ensuring that participants' expectations do not influence the results. These procedures reduce the influence of prior expectations and ensure an effective study.
Gugging swallowing screen
Gugging Screen: The instrument focuses on the swallowing screen (guss) developed by Michaela Trapl et al. 2007, S, which will be used to assess the severity of dysphagia in participants. The English version will be used.Two component are involved in the GUSS that's are: part 1 (indirect swallow test) also called the preliminary assessment, and part 2 (the direct swallow test). A point system was chosen, with a maximum of five points that can be scored in each subtest, where higher numbers indicate healthier performance. To move on to the next subtest, you have to reach this maximum. Every test item has a value of either one point (physiologic) or zero points (pathologic). We employed a new rating inside the direct swallowing test's scoring criteria for "deglutition." Pathologic swallowing receives 0 points, delayed swallowing receives 1 point, and normal deglutition receives 2 points. To receive the maximum score of five points on the subtest.
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