Several studies have reported on Chin Tuck against resistance exercise (CTAR) as an alternative to overcome the limitations of HLE (8–10). This, in turn, negatively affects performance compliance, and participants may fail to complete the exercise protocol, resulting in drop-out. Given that HLE affects not only the submental muscles of the target muscle, but also the sternocleidomastoid muscle, it causes a high level of fatigue of the neck and results in discomfort, muscle aches, and temporary pain (7, 8). Nonetheless, HLE is a very challenging exercise and is therefore difficult to perform. Thus, in clinical practice, HLE is used to improve swallowing function in patients with dysphagia. ![]() Previous studies have shown that HLE is effective in activating the submental muscles, which reduces airway aspiration and helps open the upper oesophageal sphincter in patients with dysphagia after stroke (4–6). While the patient is in the supine position they are asked to repeatedly lift their head and maintain a head-lift position for a specific time (4). Head-lift exercise (HLE), also called Shaker exercise, is a representative dysphagia treatment aimed at strengthening the submental muscles. Training to strengthen the submental muscles is therefore important for safe swallowing in elderly individuals or patients with stroke who are susceptible to swallowing problems, such as airway aspiration (3). During swallowing, contraction of these muscles pulls the hyoid and larynx upwards, resulting in normal swallowing (2). The submental muscles are a group of muscles located between the hyoid bones just under the jaw, which include the geniohyoid, mylohyoid, and digastric muscles (1). Comparing the compliance with the 2 exercises, the scores for motivation and interest/enjoyment items were significantly higher, and the scores for physical effort needed and muscle fatigue were significantly lower, in the experimental group than in the control group.Ĭonclusion: Game-based Chin Tuck against Resistance exercise not only has a similar effect to head-lift exercise on swallowing function of patients with dysphagia, but is also a less strict and more enjoy-able and interesting method. Results: After intervention, there was no significant difference in VDS, PAS, and FOIS between the 2 groups. ![]() Finally, the numerical rating self-report scale was used to assess compliance (motivation, interest/enjoyment, physical effort needed, muscle fatigue) with the 2 exercises. In addition, the func-tional oral intake scale (FOIS) was used for dietary assessment. The videofluoroscopic dysphagia scale (VDS) and penetration-aspiration scale (PAS) were used to evaluate swallowing function. The experimental group performed game-based chin tuck against resistance exercise, whereas the control group performed traditional head-lift exercise. Patients and methods: A total of 37 patients with stroke were randomly assigned to 2 groups. Objective: To compare the effects of game-based Chin Tuck against resistance exercise and head-lift exercise on swallowing function and compliance of patients with dysphagia after stroke.
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