- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT07479680
Effect of Direct Chin-tuck Against Resistance on Swallowing Function
March 15, 2026 updated by: National Taiwan University Hospital
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.
Study Overview
Study Type
Interventional
Enrollment (Estimated)
60
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Ming-Yen Hsiao, Ph.D
- Phone Number: 67316 886-2-23123456
- Email: myferrant@gmail.com
Study Locations
-
-
Taipei
-
Taipei, Taipei, Taiwan, 100
- Recruiting
- National Taiwan University Hospital
-
Contact:
- Ming-Yen Hsiao
- Phone Number: 886-2-23123456 ex 61316
- Email: myferrant@gmail.com
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Yes
Description
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
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
Experimental: Post-stroke dysphagia patients
|
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.
|
|
No Intervention: healthy subjects
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
hyoid-larynx movement
Time Frame: 2-3 weeks
|
Use ultrasound to measure the movement of the hyoid-larynx complex during swallowing during normal swallowing and dCTAR movements.
|
2-3 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Function Oral lntake Scale
Time Frame: 2-3 weeks
|
score 1-7, higher indicate better outcomes
|
2-3 weeks
|
|
Tongue pressure
Time Frame: 2-3 weeks
|
Tongue pressure measured by IOPI
|
2-3 weeks
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
General Publications
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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. Erratum In: Dysphagia. 2013 Sep;28(3):381.
- 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.
- 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.
- 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.
- 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.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
August 14, 2024
Primary Completion (Estimated)
July 10, 2026
Study Completion (Estimated)
July 10, 2026
Study Registration Dates
First Submitted
June 13, 2024
First Submitted That Met QC Criteria
March 15, 2026
First Posted (Actual)
March 18, 2026
Study Record Updates
Last Update Posted (Actual)
March 18, 2026
Last Update Submitted That Met QC Criteria
March 15, 2026
Last Verified
November 1, 2025
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 202405166RINC
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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