SKILL: Swallowing
BRIEF RATIONALE: This exercise strengthens the throat muscles to improve swallowing safety.
Swallowing treatments are only available in the Clinician plan. They can be assigned for homework for patients working with the member clinician. They are not available in the Home plan.
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: Quick Press, you will press your chin against an object, squeeze for 1 second, release, and repeat.
After completing the repetitions, you will rate your fatigue and take a rest break based on your rating. You can always extend the break if needed.
- 1 or 2 rating: 60-second rest
- 3 or 4 rating: 90-second rest
- 5 rating: 120-second rest
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, as well as opening the upper esophageal sphincter (UES).
According to a systematic review by Liu and colleagues (2023), the CTAR is more effective at improving swallowing safety and physiological conditions than the Shaker exercise or no exercise. It's also more effective at improving oral intake 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.
Learn more in the blog, What SLPs Need to Know: Dysphagia Exercises
Selected References:
- 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.