Chin Tuck: Long Hold

SKILL: Swallowing

BRIEF RATIONALE: This exercises strengthens the muscles in the throat for swallowing safety.

Before beginning the treatment, you will read precautions and agree to continue. The speech therapist will provide guidance on what resistive object to use (e.g. a ball, rolled towel, a neckline slimmer, etc.). You will learn how to perform the exercise via written instructions and a simple video demonstration.

In Chin Tuck: Long Hold, you will press your chin against an object and hold the position for up to a minute.

After completing the hold, you will rate your fatigue and take a rest break based on your rating. You can always extend the break if needed.

REPLAY VIDEO: A replay button is available in the lower-left corner of the screen to review the video demonstration.

FOR THE CLINICIAN:

Both the isometric and isokinetic Chin Tuck Against Resistance (CTAR) exercises strengthen the suprahyoid muscle complex, which is responsible for moving the larynx, hyoid bone, and epiglottis and for opening the upper esophageal sphincter (UES).

According to a systematic review by Liu and colleagues (2023), the CTAR is more effective in improving swallow safety and physiological condition compared to the Shaker exercise or no exercise. It's also more effective in improving oral intake ability compared to no exercise conditions.

It's important to consider neuroplastic principles when assigning dysphagia exercises, like repetition, intensity, frequency and duration. Most studies in the systematic review used 30 consecutive repetitions for the isokinetic CTAR and 3 sets of 60-second squeezes for the isometric CTAR for 4-6 weeks.

Selected References:

1. Liu, J., Wang, Q., Tian, J., Zhou, W., Gao, Y., Chen, X., Zhang, W., Gao, Y., & Zhou, L. (2023a). Effects of chin tuck against resistance exercise on post-stroke Dysphagia Rehabilitation: A systematic review and meta-analysis. Frontiers in Neurology, 13. https://doi.org/10.3389/fneur.2022.1109140