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Chin Tuck Against Resistance (CTAR): New Method for Enhancing Suprahyoid Muscle Activity Using a Shaker-type Exercise


For patients with dysphagia resulting from upper esophageal sphincter dysfunction, strengthening the suprahyoid muscles through therapeutic exercise has proved effective in restoring oral feeding. The aim of this study was to compare the maximum and mean surface electromyography (sEMG) activity of the suprahyoid muscles during the Chin Tuck Against Resistance (CTAR) exercise and the Shaker exercise for both isokinetic and isometric tasks. During the CTAR exercises, the participant is seated while tucking the chin to compress an inflatable rubber ball, whereas during the Shaker exercise, the participant is lay supine while lifting the head to look at the feet. Forty healthy participants (20 males, 20 females) aged 21–39 years completed all four tasks in counterbalanced order, with measures of resting activation taken prior to each exercise. Although subjective feedback suggested that the sitting position for CTAR is less strenuous than the supine position for Shaker, the results of separate analyses showed significantly greater maximum sEMG values during the CTAR isokinetic and isometric exercises than during the equivalent Shaker exercises, and significantly greater mean sEMG values were observed for the CTAR isometric exercise than for the Shaker isometric exercise. Clinical trials are now needed, but the CTAR exercises appear effective in exercising the suprahyoid muscles, and they could achieve therapeutic effects comparable to those of Shaker exercises, with the potential for greater compliance by patients.

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The authors declare that there were no conflicts of interest, commercial or otherwise, associated with the conduct of this research project or the findings therein.

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Correspondence to Wai Lam Yoon.

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Yoon, W.L., Khoo, J.K.P. & Rickard Liow, S.J. Chin Tuck Against Resistance (CTAR): New Method for Enhancing Suprahyoid Muscle Activity Using a Shaker-type Exercise. Dysphagia 29, 243–248 (2014). https://doi.org/10.1007/s00455-013-9502-9

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  • Deglutition disorders
  • Deglutition
  • Dysphagia exercises
  • Surface electromyography