Abstract
Purpose: Stroke patients often experience dysphagia, which can significantly impact nutritional intake and lead to complications such as aspiration pneumonia, prolonged hospitalization, and increased mortality. In clinical stroke rehabilitation, swallowing training is primarily conducted by physical therapists or speech therapists; however, the effectiveness of this rehabilitation is often limited by constraints related to time, space, and available personnel. The Chin Tuck Against Resistance (CTAR) exercise is safe and easy to learn, allowing patients to perform it independently. The aim of this study is to explore the effects of the CTAR exercise on stroke patients with dysphagia.
Methods: This is a two-group, pre- and post-test, parallel, non-blind randomized controlled trial. Seventy-seven patients with stroke currently undergoing treatment at a regional hospital of southern Taiwan were randomly divided into an experimental group (n = 38) or a control group (n = 39). The experimental group received a four-week CTAR protocol along with regular dysphagia care, while the control group received only regular dysphagia care. The CTAR exercise consists of tightening a rubber ball placed between the chin and the sternum, performing three cycles of both isometric and isotonic exercises each time, three times a day, five days a week, over the course of four weeks. The dysphagia-related physiological indicators, including the Functional Oral Intake Scale (FOIS), Modified Water Swallowing Test (MWST), and swallowing improvement rate, was used to assess differences between pre-test and four-week post-test results following the intervention. An independent t-test was utilized to compare the changes between the two groups.
Results: The CTAR exercise significantly improved the scores of the FOIS (MD = 1.60 points, p < .0001) and the MWST (MD = 1.19 points, p < .0001). Additionally, there was a significant increase improvement rate in the FOIS (OR = 42.95, p < .0001) and MWST (OR = 100.80, p < .0001). However, the rate of aspiration pneumonia (RR = 0.51, p = 1.0000) and the removal rate of the nasogastric tube (OR = 3.00, p = .5710) were not statistically significant.
Conclusion: The results of this intervention indicate that the CTAR exercise effectively improved swallowing function in stroke patients with dysphagia. The CTAR exercise is simple to teach and easy for patients to learn. Therefore, we recommend promoting the use of the CTAR exercise in clinical settings.
Notes
References:
Gao, J., & Zhang, H. J. (2017). Effects of chin tuck against resistance exercise versus Shaker exercise on dysphagia and psychological state after cerebral infarction. European Journal of Physical and Rehabilitation Medicine, 53(3), 426-432. https://doi.org/10.23736/s1973-9087.16.04346-x
Kim, H. H., & Park, J. S. (2019). Efficacy of modified chin tuck against resistance exercise using hand-free device for dysphagia in stroke survivors: A randomised controlled trial. Journal of Oral Rehabilitation, 46(11), 1042-1046. https://doi.org/10.1111/joor.12837
Park, J. S., An, D. H., Oh, D. H., & Chang, M. Y. (2018). Effect of chin tuck against resistance exercise on patients with dysphagia following stroke: A randomized pilot study. Neuro Rehabilitation, 42(2), 191-197. https://doi.org/10.3233/nre-172250
Park, J. S., Lee, G., & Jung, Y. J. (2019). Effects of game-based chin tuck against resistance exercise vs head-lift exercise in patients with dysphagia after stroke: An assessor-blind, randomized controlled trial. Journal of Rehabilitation Medicine, 51(10), 749-754. https://doi.org/10.2340/16501977-2603
Sigma Membership
Non-member
Type
Poster
Format Type
Text-based Document
Study Design/Type
Randomized Controlled Trial
Research Approach
Quantitative Research
Keywords:
Pimary Care, Acute Care, Implementation Science, Chin Tuck, Dysphagia, Stroke
Recommended Citation
Kuo, Chia-Chi and Chao, Kuo-Li, "Effects of Chin Tuck Against Resistance Exercise on Patients with Dysphagia After Stroke: RCT" (2025). International Nursing Research Congress (INRC). 84.
https://www.sigmarepository.org/inrc/2025/posters_2025/84
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Effects of Chin Tuck Against Resistance Exercise on Patients with Dysphagia After Stroke: RCT
Seattle, Washington, USA
Purpose: Stroke patients often experience dysphagia, which can significantly impact nutritional intake and lead to complications such as aspiration pneumonia, prolonged hospitalization, and increased mortality. In clinical stroke rehabilitation, swallowing training is primarily conducted by physical therapists or speech therapists; however, the effectiveness of this rehabilitation is often limited by constraints related to time, space, and available personnel. The Chin Tuck Against Resistance (CTAR) exercise is safe and easy to learn, allowing patients to perform it independently. The aim of this study is to explore the effects of the CTAR exercise on stroke patients with dysphagia.
Methods: This is a two-group, pre- and post-test, parallel, non-blind randomized controlled trial. Seventy-seven patients with stroke currently undergoing treatment at a regional hospital of southern Taiwan were randomly divided into an experimental group (n = 38) or a control group (n = 39). The experimental group received a four-week CTAR protocol along with regular dysphagia care, while the control group received only regular dysphagia care. The CTAR exercise consists of tightening a rubber ball placed between the chin and the sternum, performing three cycles of both isometric and isotonic exercises each time, three times a day, five days a week, over the course of four weeks. The dysphagia-related physiological indicators, including the Functional Oral Intake Scale (FOIS), Modified Water Swallowing Test (MWST), and swallowing improvement rate, was used to assess differences between pre-test and four-week post-test results following the intervention. An independent t-test was utilized to compare the changes between the two groups.
Results: The CTAR exercise significantly improved the scores of the FOIS (MD = 1.60 points, p < .0001) and the MWST (MD = 1.19 points, p < .0001). Additionally, there was a significant increase improvement rate in the FOIS (OR = 42.95, p < .0001) and MWST (OR = 100.80, p < .0001). However, the rate of aspiration pneumonia (RR = 0.51, p = 1.0000) and the removal rate of the nasogastric tube (OR = 3.00, p = .5710) were not statistically significant.
Conclusion: The results of this intervention indicate that the CTAR exercise effectively improved swallowing function in stroke patients with dysphagia. The CTAR exercise is simple to teach and easy for patients to learn. Therefore, we recommend promoting the use of the CTAR exercise in clinical settings.
Description
Purpose: to explore the effects of the CTAR exercise on stroke patients with dysphagia.
Methods: RCT. The experimental group received a four-week CTAR protocol along with regular dysphagia care, the control group received only regular dysphagia care.
Results: CTAR exercise significantly improved the swallowing scores on the FOIS and MWST.
Conclusion: CTAR exercise effectively improved swallowing function in stroke patients with dysphagia. We recommend promoting CTAR exercise in clinical settings.