Effect of Direct Chin-tuck Against Resistance on Swallowing Function
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: dCTAR.
- Who it may be relevant to
- Registry conditions: Dysphagia. Basic parameters: 18 years — 90 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Taiwan
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
Unsure about the terms? Read our patient guide →
Overview
Chin-tuck Against Resistance (CTAR) is a widely used training method in swallowing rehabilitation that strengthens the suprahyoid muscles, enhancing their contraction during swallowing and promoting the anterior-superior movement of the hyoid-larynx complex, thus improving the swallowing process. In 2022, Dr. Meng et al. discovered that for a patient with ineffective relaxation of the cricopharyngeal muscle, swallowing while performing CTAR significantly increased the immediate relaxation of the cricopharyngeal muscle, allowing the contrast agent to enter the esophagus smoothly. This method is named direct Chin-tuck Against Resistance (dCTAR). This study aims to evaluate the effectiveness of dCTAR in improving swallowing function, its impact on suprahyoid muscle contraction and hyoid-larynx complex movement, and further explore the relationship between tongue strength and bite force with the effectiveness of dCTAR. The study will recruit healthy subjects and dysphagia patients to investigate the relationship between tongue strength, bite force, and the effectiveness of dCTAR. This study uses ultrasound to measure changes in the cross-sectional area of the suprahyoid muscles and the elevation of the hyoid-larynx complex during swallowing before and after dCTAR; and the changes in these parameters after a total of 10 repeated CTAR training sessions over two weeks.
Interventions
- Other dCTAR
Perform repeated CTAR exercise training for 15 minutes a day for a total of about 10 times in two weeks. After training, the swallowing function (FOIS), the movement amount and speed of the hyoid-larynx complex during swallowing, the thickness and cross-sectional area of the suprahyoid muscles, and changes in tongue muscle strength were tracked.
Primary outcome measures
- hyoid-larynx movement [Time frame: 2-3 weeks]
Secondary outcome measures (2)
- Function Oral lntake Scale [Time frame: 2-3 weeks]
- Tongue pressure [Time frame: 2-3 weeks]
Eligibility criteria
Inclusion criteria
- Age 18-90 years old
- Be conscious and able to cooperate with the inspection
- Patients with dysphagia after stroke (Functional oral intake scale, FOIS 1-6) or healthy subjects (FOIS 7)
Exclusion criteria
- Have a history of head and neck cancer
- Other medical history known to cause dysphagia (such as neck surgery, intubation, etc.)
- Ultrasound examination cannot be performed if there are wounds, air incisions or other structural abnormalities in the neck
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: Yes
Study design
- Allocation
- Non-randomized
- Model
- Parallel assignment
- Masking
- Open label
- Primary purpose
- Treatment
Study locations
Taiwan · 1 center
- National taiwan university hospital — Taipei
Publications
- Park JS, An DH, Oh DH, Chang MY. Effect of chin tuck against resistance exercise on patients with dysphagia following stroke: A randomized pilot study. NeuroRehabilitation. 2018;42(2):191-197. doi: 10.3233/NRE-172250. PMID 29562558
- Park JS, Hwang NK. Chin tuck against resistance exercise for dysphagia rehabilitation: A systematic review. J Oral Rehabil. 2021 Aug;48(8):968-977. doi: 10.1111/joor.13181. Epub 2021 Jun 12. PMID 33973284
- Sze WP, Yoon WL, Escoffier N, Rickard Liow SJ. Evaluating the Training Effects of Two Swallowing Rehabilitation Therapies Using Surface Electromyography--Chin Tuck Against Resistance (CTAR) Exercise and the Shaker Exercise. Dysphagia. 2016 Apr;31(2):195-205. doi: 10.1007/s00455-015-9678-2. Epub 2016 Feb 2. PMID 26837612
- Yoon WL, Khoo JK, Rickard Liow SJ. Chin tuck against resistance (CTAR): new method for enhancing suprahyoid muscle activity using a Shaker-type exercise. Dysphagia. 2014 Apr;29(2):243-8. doi: 10.1007/s00455-013-9502-9. Epub 2013 Dec 15. PMID 24337867
- Meng NH, Tsou YA, Yang PY, Chen HC, Chang CW. Dysphagia in a Patient with Esophageal and Hypopharyngeal Cancers After Esophageal Reconstruction: A Pharyngeal Clearance Facilitating Maneuver. Dysphagia. 2022 Oct;37(5):1337-1339. doi: 10.1007/s00455-021-10394-1. Epub 2022 Jan 9. No abstract available. PMID 34999931
- Chen YC, Hsiao MY, Wang YC, Fu CP, Wang TG. Reliability of Ultrasonography in Evaluating Hyoid Bone Movement. J Med Ultrasound. 2017 Apr-Jun;25(2):90-95. doi: 10.1016/j.jmu.2017.01.002. Epub 2017 Feb 16. PMID 30065466
- Hsiao MY, Chang YC, Chen WS, Chang HY, Wang TG. Application of ultrasonography in assessing oropharyngeal dysphagia in stroke patients. Ultrasound Med Biol. 2012 Sep;38(9):1522-8. doi: 10.1016/j.ultrasmedbio.2012.04.017. Epub 2012 Jun 12. PMID 22698507
- Kwan BC, Butler JE, Hudson AL, McKenzie DK, Bilston LE, Gandevia SC. A novel ultrasound technique to measure genioglossus movement in vivo. J Appl Physiol (1985). 2014 Sep 1;117(5):556-62. doi: 10.1152/japplphysiol.01257.2013. Epub 2014 Jun 26. PMID 24970850
Identifiers
NCT: NCT07479680 · 202405166RINC