Efficacy of modified chin tuck against resistance exercise using hand‐free device for dysphagia in stroke survivors: A randomised controlled trial

Abstract

Background Chin tuck against resistance exercise was recently reported as a novel method for improving the swallowing function of patients with post‐stroke dysphagia. However, as this exercise involves holding and fixing the device using the hand, physically weak patients may find it difficult to perform it. Objectives This study aimed to investigate the effect of modified chin tuck against resistance (mCTAR) exercise on patients with post‐stroke dysphagia. Methods In total, 30 patients with dysphagia were recruited in this study. They were randomly assigned to either the experimental or control group. The experimental group performed mCTAR exercise and received traditional dysphagia treatment, whereas the control group received only traditional dysphagia treatment. mCTAR exercise involved isometric and isotonic exercises. Aspiration and oral diet were evaluated using penetration‐aspiration scale (PAS) and functional oral intake scale (FOIS), respectively. Moreover, the rate of nasogastric tube removal was analysed. Results Compared with the control group, the experimental group showed statistically significant improvement in PAS and FOIS (P < 0.001, both). The rates of nasogastric tube removal were 25% and 15% in the experimental and control groups, respectively. Conclusion This study demonstrated that mCTAR exercise can reduce aspiration and improve dietary levels in patients with post‐stroke dysphagia. Therefore, mCTAR exercise is expected to be beneficial for physically vulnerable patients with dysphagia who have limited hand strength and range of motion.

Chin tuck against resistance exercise for dysphagia rehabilitation: A systematic review

“…In interventions using a flexible resistance bar or another resistant elastic tool, the exercise is performed by placing a bar or tool on the chin, chest or neck to maintain proper posture and pulling the chin down against the chin pad. In CTAR with a flexible resistance bar, Park et al 9 used a flexible resistance bar that was maintained in the proper position by hand, and Kim et al 13 used a flexible resistance bar that was fixed to the table without requiring the use of a hand. Park et al 12 used game‐based CTAR training with a hand‐held resistance bar and sensor.…”

Dose in Exercise-Based Dysphagia Therapies: A Scoping Review

“…Two articles [95,96] examined effects of jaw opening exercise on hyoid movement and reported significant increases in hyoid elevation (p<0.05). Other articles in this category looked at Penetration Aspiration Scale (PAS) [108] ratings [94,97], laryngeal elevation and epiglottic closure [91]. Articles in this category had a wide range of methodologies in treatment administration and outcome measurement, making it difficult to make comparisons regarding exercise dosing and statistical findings.…”

An overview of dysphagia rehabilitation for stroke patients

“…All included studies evaluated patients diagnosed with stroke. A total of 12 different therapies have been studied with a variety of study designs: [1] electrical stimulation (n = 14; 36.8% of the total) [7][8][9][10][11][12][13][14][15][16][17][18][19][20] , [2] transcranial magnetic stimulation techniques (n = 3; 7.9%) [21][22][23] , [3] active pharyngeal electrostimulation (n = 3; 7.9%) [24][25][26] , [4] exercises with Mendelsohn maneuver (n = 2; 5.3%) 27,28 , [5] transcranial direct current stimulation (n = 3; 7.9%) [29][30][31] , [6] CTAR exercise (n = 5; 13.6%) [32][33][34][35][36] , [7] Shaker exercise (n = 2; 5.3%) 33,37 , [8] acupuncture (n = 3; 7.9%) [38][39][40] , [9] resistance to tongue pressure (n = 2; 5.3%) 41,42 , [10] modified jaw opening exercise (n = 1; 2.6%) 43 and [11] ce...…”