Effect of Direct Chin-tuck Against Resistance on Swallowing Function

NCT07479680 | Recruiting

• 1 other identifier: 202405166RINC
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Dysphagia

Keywords

direct Chin-tuck Against Resistance(dCTAR); hyoid-larynx complex; dysphagia

Outcome Measures

Primary Outcomes (1)

• hyoid-larynx movement

  Use ultrasound to measure the movement of the hyoid-larynx complex during swallowing during normal swallowing and dCTAR movements.

  2-3 weeks

Secondary Outcomes (2)

• Function Oral lntake Scale

  2-3 weeks

• Tongue pressure

  2-3 weeks

Study Arms (2)

Post-stroke dysphagia patients

EXPERIMENTAL

Other: dCTAR

healthy subjects

NO INTERVENTION

Interventions

dCTAR OTHER

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.

Post-stroke dysphagia patients

Eligibility Criteria

• Age: 18 Years - 90 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• 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)

You may not qualify if:

• 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

Sponsors & Collaborators

• National Taiwan University Hospital: lead

Study Sites (1)

National taiwan university hospital

Taipei, Taipei, 100, Taiwan

RECRUITING

Related Publications (13)

• 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 BACKGROUND

• 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 BACKGROUND

• 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 BACKGROUND

• 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 BACKGROUND

• 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 BACKGROUND

• 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 BACKGROUND

• 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 BACKGROUND

• 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 BACKGROUND

• Macrae PR, Jones RD, Myall DJ, Melzer TR, Huckabee ML. Cross-sectional area of the anterior belly of the digastric muscle: comparison of MRI and ultrasound measures. Dysphagia. 2013 Sep;28(3):375-80. doi: 10.1007/s00455-012-9443-8. Epub 2013 Jan 20.

  PMID: 23334304 BACKGROUND

• Van Den Engel-Hoek L, Lagarde M, Van Alfen N. Ultrasound of oral and masticatory muscles: Why every neuromuscular swallow team should have an ultrasound machine. Clin Anat. 2017 Mar;30(2):183-193. doi: 10.1002/ca.22818. Epub 2017 Jan 24.

  PMID: 27935170 BACKGROUND

• Van Den Engel-Hoek L, Van Alfen N, De Swart BJ, De Groot IJ, Pillen S. Quantitative ultrasound of the tongue and submental muscles in children and young adults. Muscle Nerve. 2012 Jul;46(1):31-7. doi: 10.1002/mus.23277. Epub 2012 May 29.

  PMID: 22644805 BACKGROUND

• Yabunaka K, Konishi H, Nakagami G, Sanada H, Iizaka S, Sanada S, Ohue M. Ultrasonographic evaluation of geniohyoid muscle movement during swallowing: a study on healthy adults of various ages. Radiol Phys Technol. 2012 Jan;5(1):34-9. doi: 10.1007/s12194-011-0132-3. Epub 2011 Aug 23.

  PMID: 21861155 BACKGROUND

• Hsiao, M.-Y., L.K. Wahyuni, and T.-G. Wang, Ultrasonography in Assessing Oropharyngeal Dysphagia. Journal of Medical Ultrasound, 2013. 21(4): p. 181-188.

  BACKGROUND

MeSH Terms

Conditions

Deglutition Disorders

Condition Hierarchy (Ancestors)

Esophageal Diseases; Gastrointestinal Diseases; Digestive System Diseases; Pharyngeal Diseases; Otorhinolaryngologic Diseases

Central Study Contacts

Ming-Yen Hsiao, Ph.D

CONTACT

886-2-23123456; myferrant@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: June 13, 2024
• First Posted: March 18, 2026
• Study Start: August 14, 2024
• Primary Completion (Estimated): July 10, 2026
• Study Completion (Estimated): July 10, 2026
• Last Updated: March 18, 2026

Record last verified: 2025-11

Locations

TW (1)