"Shaker Exercise Versus Masako Maneuver Combined With Conventional Therapy on Swallowing Function and Health-Related Quality of Life in Patients With Post-Stroke Dysphagia: A True Experimental Study"

Abstract:  Background: Post-stroke dysphagia is a common and potentially life-threatening complication associated with aspiration pneumonia, malnutrition, prolonged hospitalization, and reduced health-related quality of life (HRQoL). Exercise-based rehabilitative interventions such as the Shaker exercise and Masako maneuver are increasingly implemented; however, comparative evidence from randomized experimental studies remains limited.

Aim: To compare the effectiveness of Shaker exercise versus Masako maneuver, each combined with conventional swallowing therapy, on swallowing function and HRQoL in patients with post-stroke dysphagia.

Design: Prospective, parallel-group, true experimental randomized controlled study.

Methods: Thirty patients with videofluoroscopically confirmed oropharyngeal dysphagia within three months of stroke onset were randomly allocated into two groups (n=15 each). Group I received Shaker exercise plus conventional therapy, and Group II received Masako maneuver plus conventional therapy. Interventions were administered five days per week for four weeks. Swallowing function and HRQoL were assessed using the Eating Assessment Tool (EAT-10) at baseline and post-intervention. Data were analyzed using paired and independent t-tests.

Results: Both groups demonstrated statistically significant improvement in EAT-10 scores after four weeks (p < 0.001). The Shaker group showed greater mean improvement compared to the Masako group; however, between-group differences were not statistically significant (p = 0.067). Clinically meaningful reductions in dysphagia severity were observed in both groups.

Conclusion: Both Shaker exercise and Masako maneuver combined with conventional therapy significantly improve swallowing function and HRQoL in post-stroke dysphagia. The Shaker exercise demonstrated comparatively greater clinical benefit. Structured exercise-based swallowing rehabilitation should be incorporated into nursing-led stroke care programs.