Improving Dysphagia in Stroke Patients With Chin Tuck Against Resistance Exercise

NCT07630116 | Completed

• 1 other identifier: CF24234C
• Study Type: interventional
• Target: 112
• Locations: 1 country
• Sites: 1

Brief Summary

According to a 2014 report from the Ministry of Health and Welfare, cerebrovascular disease is one of the leading causes of death, with a mortality rate of 51.6 per 100,000 population, ranking fourth among the top ten causes of death. Stroke is often associated with symptoms such as unilateral weakness, slurred speech, facial asymmetry, and swallowing or speech difficulties, with approximately 42-67% of patients experiencing dysphagia. Dysphagia is primarily associated with dysfunction of the pharyngeal muscles and impaired coordination, often accompanied by central nervous system dysfunction. Common symptoms include choking, coughing after eating, drooling, difficulty eating, and swallowing problems, which may lead to complications such as pneumonia and malnutrition. Chin tuck against resistance (CTAR), developed by Yoon et al. in 2014, is a simple and non-invasive exercise aimed at improving pharyngeal muscle contraction, chewing and bolus formation, and coordination between the pharynx and upper esophagus. Previous studies suggest that CTAR exercises can effectively improve swallowing-related muscle function. However, there is a lack of research targeting acute stroke patients in hospital settings. Therefore, this study is designed as a randomized controlled trial (RCT) to evaluate the effectiveness of CTAR exercises in improving dysphagia. Participants will be randomly assigned to an experimental group or a control group. The experimental group will perform CTAR exercises once daily, five days per week, for two weeks, in addition to routine rehabilitation exercises until discharge. The control group will receive routine rehabilitation exercises once daily, five days per week. Effectiveness will be assessed using a 90 mL water swallowing test and the Eating Assessment Tool-10 (EAT-10). Baseline measurements will be conducted prior to the intervention, and subsequent assessments will be performed every two days during the study period. Additional outcomes include changes in EAT-10 scores and the removal rate of nasogastric tubes before discharge.

Conditions

Stroke; Dysphagia

Keywords

Chin Tuck Against Resistance; Stroke; Dysphagia

Outcome Measures

Primary Outcomes (1)

• Swallowing function assessed by 90 mL water swallowing test

  Swallowing function is evaluated using a 90 mL water swallowing test. Participants are assessed at baseline and every 2 days during the intervention period. The outcome is recorded as pass or fail to determine improvement in swallowing ability.

  Baseline and every 2 days during the 2-week intervention period

Secondary Outcomes (1)

• Swallowing-related quality of life assessed by EAT-10

  Baseline and once weekly during the 2-week intervention period

Study Arms (2)

Experimental Group

EXPERIMENTAL

Participants receive routine rehabilitation plus chin tuck against resistance (CTAR) exercise.

Behavioral: Chin Tuck Against Resistance (CTAR); Other: Routine Rehabilitation

Control Group

ACTIVE COMPARATOR

Participants receive routine rehabilitation therapy only.

Other: Routine Rehabilitation

Interventions

Chin Tuck Against Resistance (CTAR) BEHAVIORAL

Participants perform chin tuck against resistance (CTAR) exercise once daily, five days per week, for two consecutive weeks. The exercise is conducted in addition to routine rehabilitation therapy to improve swallowing function.

Experimental Group

Routine Rehabilitation OTHER

Participants receive routine rehabilitation therapy once daily, five days per week, for two consecutive weeks.

Control Group; Experimental Group

Eligibility Criteria

• Age: 20 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients aged ≥ 20 years diagnosed with ischemic stroke
• NIH Stroke Scale (NIHSS) score between 6 and 20
• Conscious and able to communicate in Mandarin or Taiwanese
• Failed the 90 mL water swallow test

You may not qualify if:

• Cognitive impairment
• Brainstem stroke or intracerebral hemorrhage
• Diagnosed psychiatric disorder or dementia
• Unstable vital signs
• Presence of endotracheal tube or tracheostomy
• History of cervical spine injury
• Head-of-bed elevation restricted to less than 30 degrees
• Nil per os (NPO) status as ordered by a physician

Sponsors & Collaborators

• Taichung Veterans General Hospital: lead

Study Sites (1)

Taichung Veterans General Hospital

Taichung, 407, Taiwan

Location

MeSH Terms

Conditions

Stroke; Deglutition Disorders

Condition Hierarchy (Ancestors)

Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases; Esophageal Diseases; Gastrointestinal Diseases; Digestive System Diseases; Pharyngeal Diseases; Otorhinolaryngologic Diseases

Study Officials

• Hsiao-Chi Nieh, Nursing Supervisor

  Taichung Veterans General Hospital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Masking Details: Due to the nature of the rehabilitation intervention, participants and therapists are not blinded.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Registered Nurse

Study Record Dates

• First Submitted: June 1, 2026
• First Posted: June 5, 2026
• Study Start: October 26, 2024
• Primary Completion: April 20, 2026
• Study Completion: April 23, 2026
• Last Updated: June 5, 2026

Record last verified: 2024-06

Data Sharing

• IPD Sharing: Will not share

Locations

TW (1)