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Chin Tuck Against Resistance Exercises for Dysphagia

Dysphagia (swallowing difficulties) can be a major health concern for many patients, especially those who have suffered from a stroke or have neurological disorders. One effective exercise for dysphagia rehabilitation is the chin tuck against resistance (CTAR) exercise. This exercise involves strengthening the suprahyoid muscles that play a vital role in laryngeal elevation during swallowing. In this article, we will discuss the benefits of CTAR exercise and how it can help patients with dysphagia.

What is Chin Tuck Against Resistance?

Chin tuck against resistance is a technique used to improve swallowing by strengthening the muscles used in swallowing. It specifically targets the suprahyoid muscles, which are responsible for laryngeal movement. During the CTAR exercise, the patient pulls their chin down toward their upper chest and squeezes a rubber ball or similar object that is placed between their chin and chest while sitting. 

Choosing the Right Resistance

CTAR exercises can be easily modified by using different resistance levels or positions to target specific muscles and improve muscle coordination during swallowing. It is important for patients to select the appropriate level of resistance based on their physical condition and therapy goals. A common approach involves starting with a softer ball and gradually increasing the resistance. However, a speech-language pathologist (SLP) or other healthcare professional can provide guidance on the suitable resistance level and progression. 

Choosing an appropriate tool can also make a big difference in the success of these exercises. The AliMed® SupraBall®, for example, is specifically designed for CTAR exercises, providing easy, dedicated support and resistance. This therapy ball is safe and effective for use with elderly clients and for those with neck difficulties.

How to Perform CTAR Exercises

The following basic steps outline how to perform CTAR exercises—however, it is important to consult with an SLP, physical therapist, or other medical professional to determine a treatment plan that fits your individual needs.  

1. Preparation: Sit comfortably with an inflatable rubber ball (or a similar object) in hand. 
2. Positioning: Place the ball between your chin and chest. 
3. Chin Tuck: Tuck your chin down toward your chest, compressing the ball. 
4. Resistance: Apply steady pressure to the ball, creating resistance. There are two main types of tasks in CTAR exercises—isometric and isokinetic. 
   • Isometric Task: Squeeze the ball and hold the pressure for a specified duration, usually 5-10 seconds.
   • Isokinetic Task: Squeeze the ball repeatedly with maximum effort for a set number of repetitions.
5. Rest and Repeat: Relax for a few moments and then repeat the exercise. Typically, it is recommended to perform multiple sets of repetitions daily. 

Benefits of CTAR

Chin tuck against resistance exercises provide several benefits, including improved laryngeal elevation and tongue pressure, which are essential for proper swallowing function. Additionally, this exercise helps to improve muscle strength and endurance, leading to better overall swallow function.  

A systematic review conducted on CTAR exercises showed that they are effective in improving swallow function in patients with dysphagia following stroke. The study demonstrated that CTAR exercises significantly improved laryngeal elevation, tongue pressure, and overall swallow function when compared to traditional therapy approaches alone.  

The repetition of CTAR exercises helps to reinforce proper muscle activation patterns during swallowing. It is important to consult with a medical professional before beginning any exercise regimen to ensure safe and effective treatment. By strengthening the suprahyoid muscles responsible for laryngeal elevation during swallowing, CTAR exercises can significantly improve overall swallow function in patients with dysphagia.