AbstractThe chin tuck against resistance (CTAR) exercise is a therapeutic method developed to activate and strengthen the oropharyngeal muscles related to swallowing in patients experiencing post-stroke dysphagia. However, existing CTAR exercises could be improved by considering the complex characteristics of the suprahyoid muscles.

。然而，通过考虑舌骨上肌的复杂特征，可以改进现有的CTAR练习。

To investigate the efficacy of multidirectional (md-) CTAR on tongue pressure and suprahyoid muscle activity in older adults. Thirty-four older adults were enrolled and randomly assigned to two groups (n = 17/group). Group 1 performed md-CTAR exercises in the left and right diagonal and vertical directions, using the prototype device developed for this study.

探讨多向（md-）CTAR对老年人舌压力和舌骨上肌活动的疗效。招募了34名老年人，随机分为两组（n=17/组）。第一组使用为本研究开发的原型设备，在左右对角线和垂直方向上进行md CTAR练习。

In contrast, group 2 performed only the vertical-directional (vd-) CTAR exercise using the same device as group 1. Both groups performed the same exercise for 5 days over 6 weeks. Outcome measures were tongue pressure, tongue thickness, and suprahyoid muscle activity, which were evaluated using the Iowa Oral Performance Instrument, ultrasound, and surface electromyography, respectively.

相反，第2组仅使用与第1组相同的设备进行垂直方向（vd-）CTAR运动。两组在6周内进行了5天的相同运动。结果指标是舌头压力，舌头厚度和舌骨上肌肉活动，分别使用爱荷华州口腔表现仪，超声波和表面肌电图进行评估。

As a results, group 1 exhibited significantly higher maximal tongue pressure, tongue thickness, and suprahyoid muscle activity during swallowing than group 2 (p < .05). In conclusion, This study demonstrated that the md-CTAR exercise was more effective than the vd-CTAR exercise in activating the suprahyoid muscles while promoting greater maximal tongue pressure and thickness in older adults..

因此，第1组在吞咽过程中表现出比第2组显着更高的最大舌压，舌厚和舌骨上肌活动（p<0.05）。总之，本研究表明md CTAR运动比vd CTAR运动更有效地激活舌骨上肌，同时促进老年人更大的最大舌压和厚度。。

IntroductionThe chin tuck against resistance (CTAR) exercise is a therapeutic method developed to activate and strengthen the oropharyngeal muscles related to swallowing in patients experiencing dysphagia1. The CTAR exercise is a resistance exercise that provides loading to the specific muscles related to swallowing using objects, such as elastic rubber balls and bars, and a custom-made device for research1,2,3.According to previous studies, the CTAR exercise induces high levels of suprahyoid muscle activity1,4,5.

引言下巴抵抗运动（CTAR）是一种治疗方法，用于激活和加强吞咽困难患者吞咽相关的口咽肌1。CTAR运动是一种阻力运动，它使用弹性橡胶球和橡皮棒等物体为吞咽相关的特定肌肉提供负荷，并且是一种定制的研究装置1,2,3。根据以前的研究，CTAR运动诱导高水平的舌骨上肌肉活动1,4,5。

Notably, the CTAR exercise is easier to perform and more efficient than the head lift exercise (HLE) with regards to inducing high levels of suprahyoid muscle activity and physiological changes in muscles, such as increased tongue pressure6. Consequently, the CTAR exercise is considered as a therapeutic exercise technique that can replace the HLE as it can improve overall swallowing function, including reduced airway aspiration7.

值得注意的是，在诱导高水平的舌骨上肌肉活动和肌肉生理变化（如舌压增加）方面，CTAR运动比抬头运动（HLE）更容易进行且更有效6。因此，CTAR运动被认为是一种治疗性运动技术，可以替代HLE，因为它可以改善整体吞咽功能，包括减少气道吸气7。

Over time, the CTAR exercise has become commonly used clinically and at home since it requires less physical effort than the HLE, is easy to perform, and represents a safe form of exercise for older adults.Nevertheless, considering the anatomy of the specific structures that comprise the suprahyoid muscles, such as the arrangement and direction of individual muscles, there is still a need to improve the existing vertical-directional (vd-) CTAR exercise methods and protocols.

随着时间的推移，CTAR运动已经成为临床和家庭中常用的运动，因为它比HLE需要更少的体力，易于执行，并且代表了老年人的安全运动形式。然而，考虑到构成舌骨上肌的特定结构的解剖结构，例如单个肌肉的排列和方向，仍然需要改进现有的垂直方向（vd-）CTAR运动方法和方案。

This is because the suprahyoid muscles (e.g., geniohyoid, mylohyoid, digastric, and stylohyoid muscles), located between the mandible and the hyoid bone, exhibit specific anatomical characteristics and are arranged in different directions from the hyoid bone8. Taking the specific anatomical structure of the suprahyoid muscles into account, we hypothesized that mul.

这是因为位于下颌骨和舌骨之间的舌骨上肌（例如颏舌骨，舌骨，二腹肌和茎突舌骨肌）表现出特定的解剖学特征，并且与舌骨的方向不同8。考虑到舌骨上肌的特定解剖结构，我们假设mul。

Data availability

数据可用性

The data that support the findings of this study are available from the corresponding author, upon reasonable request.

根据合理的要求，通讯作者可以提供支持本研究结果的数据。

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Download referencesAcknowledgementsThis work was supported by the 2023 Inje University research grant.Author informationAuthors and AffiliationsResearch Institute for Korean Medicine, Pusan National University, Yangsan, Republic of KoreaJi-Su ParkDepartment of Occupational Therapy, Seoul Metropolitan Bukbu Hospital, Seoul, Republic of KoreaNa-Kyoung HwangDepartment of Occupational Therapy, Dongseo University, Busan, Republic of KoreaTae-Hyung YoonDepartment of Occupational Therapy, Inje University, 197 Inje-ro, 50834, Gimhae, Gyeongsangnam-do, Republic of KoreaMoon-Young ChangAuthorsJi-Su ParkView author publicationsYou can also search for this author in.

下载参考文献致谢这项工作得到了2023年Inje大学研究资助的支持。作者信息作者和附属机构韩国釜山国立大学韩国医学研究所，韩国阳山市，韩国首尔都会布克布医院，韩国首尔市，韩国共和国，韩国釜山市，韩国釜山市，东塞大学，韩国京广职业治疗系，韩国仁济大学，职业治疗系，197 Inje ro，50834，Gimhae，Gyeongsang Nam do，韩国共和国，年轻的常春藤，苏公园视图作者出版物你也可以在中搜索这位作者。

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PubMed Google ScholarContributionsConception and design of the study (JSP, NKH and MYC), data collection and analysis (JSP and NKH), initial drafting of the manuscript (JSP and NKH), critical review of the manuscript (THY and MYC). All the authors provided final approval of the submitted manuscript.Corresponding authorCorrespondence to.

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Reprints and permissionsAbout this articleCite this articlePark, JS., Hwang, NK., Yoon, TH. et al. Effects of multi directional chin tuck against resistance exercise on tongue pressure and thickness and suprahyoid muscle activity.

转载和许可本文引用本文Park，JS。，北卡罗来纳州黄。，Yoon，TH。等人。多向下巴收拢对抗阻力运动对舌压力和厚度以及舌骨上肌活动的影响。

Sci Rep 14, 30040 (2024). https://doi.org/10.1038/s41598-024-81993-9Download citationReceived: 11 April 2024Accepted: 02 December 2024Published: 03 December 2024DOI: https://doi.org/10.1038/s41598-024-81993-9Share this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

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KeywordsExerciseOlder adultsChin tuck against resistance exerciseTongueSuprahyoid muscleRehabilitation

关键词老年人抵抗力锻炼舌骨舌骨上肌肉康复