![]() Instructions to press the anteriorly placed bulb against palate as hard as possible for 5 seconds, repeated for 3 times with 2 minute rest intervals. The maximum value in five measurements was accepted for statistical analysis“Īnterior Tongue Pressure Force Measurement (IOPI) Test was repeated 5 times with rest intervals of 60 s. ![]() “In order to measure maximum suprahyoid muscle activation, individuals were asked to perform opening their jaw maximum as hard as possible for 10 s against the cervical neck orthosis. Semirigid cervical neck orthosis was worn to the subjects” Maximum Suprahyoid Muscle Activation (EMG)īecause the exact image is within the article, this is a good example of the orthosis used□ The authors give a pretty good detailed description for how, when, and what they measured: So they took their 36 HEALTHY participants (ages 18-40) who got randomly divided into the 3 intervention groups:Īll subjects had to score less than 3 points on the Turkish EAT-10 for inclusion, and nobody could participate if they had a history of disk herniation, mechanical neck pain and/or pathology in the cervical region, any neurological/systemic disease, or history of surgery/radiotherapy treatment for heck/neck areas (for obvious reasons). Chin tuck exercise with theraband involves craniocervical flexion in isometric and isotonic forms which are performed with the resistance of theraband attached to the patient’s forehead with a fixed point at the back.” p.2 “Considering the advantages of theraband, we thought that we may perform resistance training of chin tuck exercise with theraband. Given the authors’ physical thinking brains, they were curious about if using a Theraband could also be a practical alternative for the same purpose□. Then, because of the difficulty and somewhat discomfort in implementing this horizontal exercise, Chin Tuck Against Resistance was discovered as an alternative. ![]() The article starts with a quick ‘n dirty history behind these 2 exercises, explaining how since “impaired laryngeal elevation is usually the underlying cause of inadequate airprotection” and “suprahyoid muscles are primarily reposnible for laryngeal elevation,” first came the Shaker. As clinicians we’re always on the lookout for new or better interventions, so I wanted to look into a more recent article that gives an interesting perspective (from PTs!) that compares these and a novel approach to improve those stubborn suprahyoid muscles for better airway protection! And before we had CTAR, we had (and still have) the Shaker. Just because Tom does well with the chin tuck and it is very effective for him, does not mean it will be the same for Rick.Before we had microwaves, we had ovens. Not all patients will benefit from a chin tuck. Make sure to observe multiple trials of the chin tuck under fluoro to ensure that it is effective in your patient. The moral to the story: Don’t assume the chin tuck will always work because it won’t. The patients had no penetration or aspiration until a chin tuck was introduced, which was when the patient aspirated. I have also seen exactly the opposite where patients tried the chin tuck to eliminate vallecular residue. It has been effective at times in prevention of laryngeal penetration or aspiration. In my own practice, I have seen the chin tuck as both effective and ineffective. ![]() They found it may be contraindicated in patients with weak pharyngeal contraction pressure as it decreased pharyngeal contraction pressure and duration. Studies (Robbins et al 2005, Shaker et al 2002) found the chin tuck to be effective in 72% of the patients studied. The study found more aspiration with the chin tuck group than with the thickened liquid group, however there were more adverse effects with the group on thickened liquids (dehydration, UTI, fever). nectar thick liquids and honey thick liquids. One study (Robbins and Hind 2008) compared using a chin tuck with thin liquids vs. ![]() We often have patient tuck their chin to eliminate vallecular residue and to help in the prevention of laryngeal penetration or aspiration. We have patients use a chin tuck to widen the valleculae, push the tongue base back placing the epiglottis more posterior and to narrow the airway, according to the research. We use the chin tuck with patients for a variety of reasons. Somewhere down the road, we’ve made the chin tuck the end-all be-all in therapy, just after thickening liquids and diet modification. That strategy that we’ve taught so well that nurses, respiratory therapists and doctors all tell patients, if you’re having trouble swallowing, just tuck your chin. I’m not talking about Chin Tuck Against Resistance (CTAR), I’m talking about the compensatory strategy. ![]()
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