Effect of progressive chin tuck against resistance exercise on community-dwelling older adults with age-related dysphagia: a randomized controlled trial

Abstract

Background: Chin tuck against resistance (CTAR) exercise has been proven to be an effective intervention for improving swallowing function in older patients. However, most studies focus on fixed-resistance models and fail to fully incorporate the principle of progressive overload, a cornerstone of strength training. With this study, we explored the effects of progressive CTAR exercise on swallowing function in patients with age-related dysphagia.

Methods: Sixty-four community-dwelling older adults (mean age = 81 ± 6 years; males, n = 28, females, n = 36) with age-related dysphagia were randomly assigned to either the experimental group (n = 32) or control group (n = 32) through cluster randomization. Both groups participated in an 8-week oral flexibility training program, with the experimental group receiving additional progressive CTAR exercise. Various outcome measures that included the Standardized Swallowing Assessment (SSA), the Swallowing Quality of Life (SWAL-QOL), and the Test of Mastication and Swallowing of Solids (TOMASS) were assessed at baseline (T0), after 4 weeks of intervention (T1), and after 8 weeks of intervention (T2).

Results: Of the 64 participants, 61 completed the study protocol. Both groups showed significant differences in the SSA score, the SWAL-QOL score, and the total swallowing time at T1 and T2, but the experimental group demonstrated significantly greater improvement than the control group. However, no significant differences were found in the number of chews or swallows between groups, and the number of bites did not show a significant change compared with before the intervention.

Conclusions: Progressive CTAR exercise significantly improves swallowing function and swallowing-related quality of life in patients with age-related dysphagia.

Trial registration: This trial was registered with the Chinese Clinical Trial Registry in July 2024 under registration number ChiCTR2400087548.

Keywords: Age-related dysphagia; Chin tuck against resistance; Older adults; Progressive overload; Swallowing.