Improving Dysphagia in Stroke Patients With Chin Tuck Against Resistance Exercise
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.
Visão geral do estudo
Status
Intervenção / Tratamento
Descrição detalhada
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.
Tipo de estudo
Inscrição (Real)
Estágio
- Não aplicável
Contactos e Locais
Locais de estudo
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Taichung, Taiwan, 407
- Taichung Veterans General Hospital
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Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
- Adulto
- Adulto mais velho
Aceita Voluntários Saudáveis
Descrição
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
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Nenhum (rótulo aberto)
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
|---|---|
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Experimental: Experimental Group
Participants receive routine rehabilitation plus chin tuck against resistance (CTAR) exercise.
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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.
Participants receive routine rehabilitation therapy once daily, five days per week, for two consecutive weeks.
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Comparador Ativo: Control Group
Participants receive routine rehabilitation therapy only.
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Participants receive routine rehabilitation therapy once daily, five days per week, for two consecutive weeks.
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O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Swallowing function assessed by 90 mL water swallowing test
Prazo: Baseline and every 2 days during the 2-week intervention period
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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.
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Baseline and every 2 days during the 2-week intervention period
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Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Swallowing-related quality of life assessed by EAT-10
Prazo: Baseline and once weekly during the 2-week intervention period
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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
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Baseline and once weekly during the 2-week intervention period
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Colaboradores e Investigadores
Patrocinador
Investigadores
- Investigador principal: Hsiao-Chi Nieh, Nursing Supervisor, Taichung Veterans General Hospital
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Real)
Conclusão Primária (Real)
Conclusão do estudo (Real)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
- Distúrbios Cerebrovasculares
- Doenças Cerebrais
- Doenças do Sistema Nervoso Central
- Doenças do Sistema Nervoso
- Doenças Vasculares
- Doenças cardiovasculares
- Doenças do aparelho digestivo
- Doenças Gastrointestinais
- Doenças Esofágicas
- Doenças Otorrinolaringológicas
- Doenças Faríngeas
- Derrame
- Distúrbios da Deglutição
Outros números de identificação do estudo
- CF24234C
Plano para dados de participantes individuais (IPD)
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Descrição do plano IPD
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