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Improving Dysphagia in Stroke Patients With Chin Tuck Against Resistance Exercise

1 juni 2026 bijgewerkt door: HUANG CHIAO LIN, Taichung Veterans General Hospital

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.

Studie Overzicht

Toestand

Voltooid

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

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 commonly associated with neurological deficits such as hemiparesis, dysarthria, facial asymmetry, and dysphagia. Approximately 42-67% of stroke patients experience swallowing difficulties.

Dysphagia in stroke patients is primarily related to dysfunction of pharyngeal muscles and impaired coordination of the swallowing mechanism, often accompanied by central nervous system impairment. Common clinical manifestations include choking, coughing during or after meals, drooling, difficulty chewing and swallowing, which may lead to serious complications such as aspiration pneumonia and malnutrition.

Chin tuck against resistance (CTAR), first introduced by Yoon et al. in 2014, is a simple and non-invasive exercise designed to strengthen suprahyoid muscles, improve pharyngeal contraction, enhance bolus control, and facilitate coordination between the pharynx and upper esophageal sphincter. Previous studies have demonstrated that CTAR exercise can effectively improve swallowing-related muscle function.

However, there remains a lack of evidence focusing on acute stroke patients in hospital settings. Therefore, this study is designed as a randomized controlled trial (RCT) to evaluate the effectiveness of CTAR exercise in improving dysphagia among hospitalized stroke patients.

Participants will be randomly assigned to an experimental group or a control group. The experimental group will perform CTAR exercise once daily, five days per week, for two consecutive weeks, in addition to routine rehabilitation. The control group will receive routine rehabilitation alone at the same frequency.

Swallowing function will be evaluated using a 90 mL water swallowing test and the Eating Assessment Tool-10 (EAT-10). Baseline assessments will be conducted prior to intervention, followed by repeated measurements every two days during the study period. Additional outcomes include changes in EAT-10 scores and the rate of nasogastric tube removal before discharge.

This study aims to determine whether CTAR exercise provides additional benefits over conventional rehabilitation in improving swallowing function in stroke patients, and to provide evidence for clinical rehabilitation practice.

Studietype

Ingrijpend

Inschrijving (Werkelijk)

112

Fase

  • Niet toepasbaar

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

  • Taiwan
      • Taichung, Taiwan, 407
        • Taichung Veterans General Hospital

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

  • Volwassen
  • Oudere volwassene

Accepteert gezonde vrijwilligers

Nee

Beschrijving

Inclusion Criteria:

  • 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

Exclusion Criteria:

  • 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

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Behandeling
  • Toewijzing: Gerandomiseerd
  • Interventioneel model: Parallelle opdracht
  • Masker: Geen (open label)

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: Experimental Group
Participants receive routine rehabilitation plus chin tuck against resistance (CTAR) exercise.
Gedragsmatig: Chin Tuck Against Resistance (CTAR)
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.
Ander: Routine Rehabilitation
Participants receive routine rehabilitation therapy once daily, five days per week, for two consecutive weeks.
Actieve vergelijker: Control Group
Participants receive routine rehabilitation therapy only.
Ander: Routine Rehabilitation
Participants receive routine rehabilitation therapy once daily, five days per week, for two consecutive weeks.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Swallowing function assessed by 90 mL water swallowing test
Tijdsspanne: Baseline and every 2 days during the 2-week intervention period
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

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Swallowing-related quality of life assessed by EAT-10
Tijdsspanne: Baseline and once weekly during the 2-week intervention period
The total score ranges from 0 to 40, with higher scores indicating more severe dysphagia symptoms. A score of 3 or higher is considered indicative of a risk of dysphagia
Baseline and once weekly during the 2-week intervention period

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

Taichung Veterans General Hospital

Onderzoekers

  • Hoofdonderzoeker: Hsiao-Chi Nieh, Nursing Supervisor, Taichung Veterans General Hospital

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Werkelijk)

26 oktober 2024

Primaire voltooiing (Werkelijk)

20 april 2026

Studie voltooiing (Werkelijk)

23 april 2026

Studieregistratiedata

Eerst ingediend

1 juni 2026

Eerst ingediend dat voldeed aan de QC-criteria

1 juni 2026

Eerst geplaatst (Werkelijk)

5 juni 2026

Updates van studierecords

Laatste update geplaatst (Werkelijk)

5 juni 2026

Laatste update ingediend die voldeed aan QC-criteria

1 juni 2026

Laatst geverifieerd

1 juni 2024

Meer informatie

Termen gerelateerd aan deze studie

Trefwoorden

Aanvullende relevante MeSH-voorwaarden

Andere studie-ID-nummers

  • CF24234C

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

NEE

Beschrijving IPD-plan

Individual participant data (IPD) will not be shared due to privacy and confidentiality concerns. The dataset contains sensitive clinical information, and sharing is restricted to protect participant identity in accordance with institutional policies and ethical regulations.

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

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