A study to compare the effects of two different physiotherapy exercise along with tongue strengthening on initiation of swallowing among post-stroke subjects

INTERVENTION: Intervention1: Group A shakers exercise : Group A was given a shakers exercise with a directional lingual strengthening exercise for 4 weeks Position of the subject The subjects were asked to lie on their back Position of the therapist The therapist was standing beside the subject Procedure ISOMETRIC sustained three head lifts held for 60 seconds without moving the shoulder in a supine position with a 60‐second rest between lifts ISOTONIC The subject performed 30 consecutive repetitions of head lift without holding in the same supine position Resting time 1 minute Sets and repetitions ISOMETRIC 1 set of 3 repetitions ISOTONIC 1 set of 30 repetitions Frequency of exercise On alternate days 3 times per day for 4 weeks Intervention2: Group B Eccentric chin closure: Group B was given an eccentric chin closure exercise with a directional lingual strengthening exercise for 4 weeks Position of the subject Subjects were asked to sit upright on a back‐supported chair Position of the therapist The therapist was standing beside the subject Procedure The subjects were asked to open their mouth as much as possible and were asked to place their thumb on the tip of the mandible and apply the resistance the subjects were asked to close their chin against upward resistance in a controlled manner starting from maximum mouth opening. They were also instructed that the resistance should be met with muscle force and should not help with chin closure At the end of the Eccentric chin exercise the jaw is closed and returns to the starting position Resting time 1‐2 minutes Sets and repetitions 3 sets of 10‐15 repetitions Frequency of exercise On alternate days 1‐2 times per day for 4 weeks Control Intervention1: Group c Directional lingual strengthening exercise: Directional lingual strengthening exercise Both groups received directional lingual strengthening exercises as a common intervention Position of the subject Subjects were asked to sit upright on a back‐supported chair Position of the therapist The therapist was standing beside the subject Procedure The subjects were asked to do the free lingual exercise in all the directions from anterior through protrusion and then to both sides and then to upward and downward After that they were advised to do the same exercise using the ice stick for resistance on the anterior side both lateral sides and the superior and inferior sides Resting time 1‐2 minutes Sets and repetitions 3 sets of 10 repetitions CONDITION: Health Condition 1: I693‐ Sequelae of cerebral infarction PRIMARY OUTCOME: Iowa oral performance instrument for tongue strength and endurance ; Eat assessment tool 10 ; Functional Oral Intake Scale ; Dysphagia Outcome and Severity ScaleTimepoint: 8 weeks SECONDARY OUTCOME: nilTimepoint: nil INCLUSION CRITERIA: Both genders in the age group of 30‐50 years Subjects with unilateral ischemic stroke diagnosed by head CT or MRI with less than 3 months of onset Subjects with positive water swallow test and assessed with evaluation strategies Subjects with Oropharyngeal dysphagia after stroke conformed by videofluoroscopy Liquid aspiration or penetration on videofluoroscopy Subjects those without any cognitive deficit more than22 points in the Mini Mental Status Examination