Effects of Chin Tuck Against Resistance Exercise on Post-Stroke Dysphagia Rehabilitation: A Systematic Review and Meta-Analysis
Frontiers in Neurology
Liu, J., Wang, Q., et al. (2022).
Frontiers in Neurology, 13, 1109140.
This systematic review and meta-analysis examines the effect of chin-tuck against resistance (CTAR) exercises compared to no exercises or Shaker exercise interventions on swallowing safety and oral intake ability in adults with post-stroke dysphagia.
National Social Science Fund of China
From database inception to February 2022
Randomized controlled trials (RCTs) and quasi-RCTs
9 studies included in the systematic review. 8 studies included in the meta-analysis.
<div>"The findings of this study suggest that CTAR exercise is an effective therapeutic method for post-stroke dysphagia rehabilitation and is superior to Shaker exercise in improving swallowing safety with positive effect to patients’ psychological condition" (p. 10). Specific findings included:</div>
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<li>Chin tuck against resistance (CTAR) exercise demonstrated statistically significant improvements in swallow safety compared to no exercises (MD = −1.43) and to the Shaker exercise (MD = −0.49) as measured by penetration-aspiration scale scores.</li>
<li>Oral intake ability as measured by the Functional Oral Intake Scale (FOIS) or Fujishima Ichiro food intake level scale found a greater intervention-induced effect in the CTAR group compared with the no exercise group (SMD = −1.82); however, no significant difference in FOIS scores was found between CTAR and Shaker exercise groups.</li>
<li>Compared to no exercise interventions, CTAR showed statistically significant improvement in psychological condition, significantly better oral cavity and laryngeal elevation/epiglottic closure, decreased residue in the valleculae and pyriform sinuses scores, and higher rates of nasogastric tube removal.</li>
<li>Compared with the Shaker exercise group, one study found that the CTAR group reported significantly lower drop-out rates, more positive feedback regarding motivation, interest, and enjoyment, and lower physical fatigue.</li>
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