Effects of chin tuck against resistance exercise versus Shaker exercise on dysphagia and psychological state after cerebral infarction

Eur J Phys Rehabil Med. 2017 Jun;53(3):426-432. doi: 10.23736/S1973-9087.16.04346-X. Epub 2016 Nov 10.


Background: The incidence of stroke is high in China. The dysphagia caused by cerebral infarction (CI), seriously affects patients' life quality, and even endangers patients' lives. It is necessary to explore how to improve dysphagia caused by CI.

Aim: To compare the effects of rehabilitation training on dysphagia and psychological state after CI between Shaker exercise and chin tuck against resistance (CTAR) exercise.

Design: Control study. Blind.

Setting: Inpatients.

Population: A total of 90 patients with dysphagia after CI were divided into CTAR group, Shaker group and control group by random digit table (each group with 30 patients).

Methods: Video fluoroscopic swallowing study (VFSS) and Self-Rating Depression Scale (SDS) were performed on all patients before intervention. VFSS was evaluated based on Penetration-Aspiration Scale. All patients received routine treatments including internal medicine, traditional rehabilitation training and routine nursing. The patients in control group only receive the routine treatments. Besides the routine treatments, the patients in CTAR group also received CTAR exercise, and the patients in Shaker group also received Shaker exercise. VFSS was performed again on all patients, respectively, 2, 4, and 6 weeks after exercise. SDS was performed again on all patients 6 weeks after exercise.

Results: There were no statistical differences amongst the three groups in VFSS and SDS before intervention (P>0.05). After intervention, all patients had various degrees of improvement for dysphagia in the three groups, especially between 2 and 4 weeks in CTAR and Shaker groups. The total effective rate was significantly higher in CTAR group (86.67%) and Shaker group (76.67%) than in control group (43.33%) (all P<0.05). The scores of SDS was significantly lower in CTAR group than in Shaker group and control group 6 weeks after intervention (all P<0.05).

Conclusions: For the patients with dysphagia after CI, CTAR exercise can significantly relieve depression and has the similar effect on improving swallowing function as compared with Shaker group.

Clinical rehabilitation impact: This study suggests that in conscious patients CTAR exercises have greater impact on CI-related depression than Shaker exercises.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cerebral Infarction / complications*
  • Cerebral Infarction / psychology*
  • Cerebral Infarction / rehabilitation
  • Chin*
  • Deglutition Disorders / diagnosis
  • Deglutition Disorders / etiology
  • Deglutition Disorders / rehabilitation*
  • Depressive Disorder / diagnosis
  • Depressive Disorder / etiology
  • Depressive Disorder / rehabilitation*
  • Exercise Therapy / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Treatment Outcome