Effects of chin tuck against resistance exercise on post-stroke dysphagia rehabilitation: A systematic review and meta-analysis

Abstract

BackgroundChin tuck against resistance (CTAR) exercise was introduced to substitute for the commonly used Shaker exercise for dysphagia rehabilitation. The effects of CTAR exercise in stroke survivors needs to be validated.ObjectiveTo investigate the effects of Chin tuck against resistance (CTAR) exercise on the swallowing function and psychological condition in stroke survivors compared to no exercise intervention and the Shaker exercise.Materials and methodsThe Cochrane Library, PubMed, Web of Science, EMBASE, CINAHL and four Chinese databases were searched for randomized controlled trails (RCTs) and quasi-RCTs from inception to February 2022.ResultsAfter screened and assessed the methodological quality of the studies, nine studies with 548 stroke survivors were included in the systematic review. 8 studies were included in the meta-analysis using RevMan 5.4 software. The mean difference (MD) or standardized mean difference (SMD) with 95% confidence intervals (CIs) were calculated. The results revealed that CTAR exercise is effective in improving swallowing safety (MD, −1.43; 95% CI, −1.81 to −1.06; P < 0.0001) and oral intake ability (SMD, −1.82; 95% CI, −3.28 to −0.35; P = 0.01) compared with no exercise intervention, CTAR exercise is superior to Shaker exercise in improving swallowing safety (MD, −0.49; 95% CI, −0.83 to −0.16; P = 0.004). The psychological condition in CTAR group is significant better than the control group (MD, −5.72; 95% CI, −7.39 to −4.05; P < 0.00001) and Shaker group (MD, −2.20; 95% CI, −3.77 to −0.64; P = 0.006).ConclusionsOur findings support CTAR exercise as a superior therapeutic exercise for post-stroke dysphagia rehabilitation than Shaker exercise. More high-qualities RCTs from larger multicenter are needed to analysis the effects of CTAR exercise in patients with different type and phase of stroke and explore the optimal training dose.

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“…However, a combination of interventions is essential to improve and maintain function. Swallowing rehabilitation mainly focuses on strengthening swallowing-related muscle groups, and training is conducted to strengthen the tongue and suprahyoid muscles 4 . Conversely, effective therapy for decline in sensory function, including silent aspiration, has been performed using techniques such as ice massage 5 .…”