The Chin Tuck Against Resistance Exercise (The CTAR Exercise)
The CTAR exercise is a very effective dysphagia exercise, using common objects you probably already have in your home. The Chin Tuck Against Resistance (CTAR) Exercise is one of the best exercises for dysphagia. It can benefit many types of dysphagia because it targets an extremely important key component of safe and effective swallow function, which is the strength of the suprahyoid muscles.
The suprahyoid muscles, located under your chin, perform very important functions during the swallow. Having these key players working well can make all the difference in what happens when you swallow.
The CTAR Exercise is an exercise used to improve swallow function and safety. This exercise was developed by Yoon Wai Lam. He is a well known dysphagia trainer, researcher, and consultant for speech therapists and other healthcare professionals for complex cases involving swallowing difficulties in Singapore and overseas. CTAR is an award winning dysphagia exercise that is practiced worldwide.
In March 2013, Yoon Wai Lam's first scientific poster on CTAR was presented at the 21st Annual Meeting of the Dysphagia Research Society Meeting in Seattle, WA in March of 2013. It was awarded "First Place Scientific Abstract: Poster Presentation". Yoon Wai Lam's CTAR research publications currently have more than 80 citations in international journal papers and text books.
The Chin Tuck Against Resistance Exercise is really a very simple concept. You are simply tucking your chin down, or pressing or nodding your chin in a downward motion, against resistance. That resistance can be anything really. Just like there are many ways to exercise your bicep muscles in your arms, such as using machines in the gym, lifting free weights, lifting elastic bands, or even just lifting rocks or cans of beans, there are also many ways to exercise your suprahyoid muscles.
There are a few important components to obtaining optimum results from these exercises. First of all, it is very important to use good posture, with your shoulders back and your ears aligned with your shoulders. If your head is too far forward when doing these exercises, you will strengthen the back of your neck instead of your suprahyoid muscles, which is not what we want!
1.) Begin with good posture. Make sure you are sitting up straight with your ears directly over your shoulders
2.) Press your fist, a ball, a rolled up towel, or the PhagiaFlex Device firmly under your chin, pressing it up slightly to give yourself resistance
3.) Hold the resistance firmly enough to make it slightly difficult to press your chin down towards your chest, but not so much that it makes it impossible. If using the PhagiaFlex device, just hold it in place and it will bend as you press your chin down, providing movable resistance automatically. If using a ball, deflate it to the level that it provides appropriate movable resistance for you.
4.) Slowly lift your chin back up again, providing resistance in the opposite direction by resisting the push from the PhagiaFlex device, or from the ball, towel, or your hand which is pressing your chin upwards, with just enough pressure to make it an effort to make the upward movement be very slow and controlled.
5.) Repeat until the muscles under your chin feel fatigued. Do this twice daily.
The Chin Tuck Against Resistance Exercise can also be done using your hand as resistance.
Yoon Wai Lam demonstrating the Chin Tuck Against Resistance exericise, also called the CTAR exercise, with a ball.
This instructional PDF for the CTAR exercise makes a great hand out for patients for home exercises. Download it free!
This article on the Cambridge University Hospitals website is also a great hand out for patients. It is about using the PhagiaFlex Device to do the CTAR exercise.