Huang Hsiao-Dien, Brajot François-Xavier, Wang Hsin-I, Han Der-Sheng
Department of Speech-Language Pathology and Audiology, National Taipei University of Nursing and Health Sciences, 365 Mingde Road, Beitou District, 112, Taipei, Taiwan.
Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Beihu Branch, 87 Neijiang Street, Wanhua District, 108, Taipei, Taiwan.
Dysphagia. 2025 Jul 11. doi: 10.1007/s00455-025-10859-7.
The chin tuck against resistance (CTAR) is a popular exercise targeting suprahyoid muscles involved in swallowing. Its effectiveness presumably relies on proper execution. This study assessed the effect of different instructional strategies on neck muscle activation in older adults executing a sustained CTAR contraction. Ninety healthy individuals aged 65 to 90 years old were randomly assigned to one of three groups: video-only, video plus verbal instruction, or video with visual biofeedback using surface electromyography (sEMG). Surrogate measures of muscle recruitment and fatigue within both the suprahyoid and sternocleidomastoid muscles were compared across the three instructional groups. The sEMG amplitude measures were normalized with respect to maximal jaw opening and head rotation. Suprahyoid activity was significantly higher than sternocleidomastoid in terms of both normalized amplitude and fatigue. An analysis of variance failed to show significant differences in either sEMG measures as a function of instructional strategy, although the distribution of responses with biofeedback was significantly more clustered around the group mean (i.e. leptokurtic). The effects of sustained CTAR contractions on suprahyoid activity remain consistent across different instructional strategies, suggesting the technique is a robust one. Biofeedback does seem to improve groupwise performance predictability, however. Future studies should explore longitudinal effects to determine whether instructional strategy may affect outcomes over time.
对抗阻力下颌后缩（CTAR）是一种针对参与吞咽的舌骨上肌群的常见锻炼方法。其有效性大概依赖于正确的执行方式。本研究评估了不同指导策略对进行持续CTAR收缩的老年人颈部肌肉激活的影响。90名年龄在65至90岁之间的健康个体被随机分配到三组中的一组：仅视频组、视频加口头指导组或使用表面肌电图（sEMG）进行视觉生物反馈的视频组。比较了三组指导方式下舌骨上肌和胸锁乳突肌内肌肉募集和疲劳的替代指标。sEMG幅度测量值相对于最大张口和头部旋转进行了归一化。就归一化幅度和疲劳而言，舌骨上肌的活动明显高于胸锁乳突肌。方差分析未能显示出作为指导策略函数的sEMG测量值有显著差异，尽管有生物反馈时的反应分布在组均值周围明显更聚集（即尖峰态）。持续CTAR收缩对舌骨上肌活动的影响在不同指导策略下保持一致，表明该技术是可靠的。然而，生物反馈似乎确实提高了组内表现的可预测性。未来的研究应探索纵向影响，以确定指导策略是否可能随时间影响结果。
