Aulia Salsabilla
Faculty of Health Sciences UPN Veteran Jakarta

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Application of The Chin Tuck Against Resistance (CTAR) Exercise to Improve Swallowing Function as Clinical Observation in Stroke Patients With Dysphagia: Case Report Aulia Salsabilla
Critical Medical and Surgical Nursing Journal Vol. 15 No. 2 (2026): JUNE 2026
Publisher : Universitas Airlangga

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Abstract

Introduction: Dysphagia (difficulty swallowing) is a common condition after a stroke due to the impairment of swallowing muscles. Managing dysphagia plays a crucial role in helping patients meet their nutritional needs through oral intake. Therapeutic exercises that stimulate and strengthen the muscles involved in swallowing are highly recommended for dysphagia rehabilitation, one of which is the Chin Tuck Against Resistance (CTAR) exercise. This case study aims to provide an analysis of nursing care for post-stroke patients with the application of CTAR intervention to improve swallowing ability as clinical observation. Method: The CTAR therapy was carried out over five consecutive days, with two sessions per day, each lasting 15 to 30 minutes. Improvement in swallowing ability was observed in patients with dysphagia after five days of Chin Tuck Against Resistance (CTAR) therapy, with GUSS scores increasing from 12 to 15 in one patient and from 15 to 17 in another and FOIS levels improving from level 3 to 5 in one patient and 5 to 6 in another. Results: Both patients demonstrated improvement in swallowing function following CTAR therapy; however, the timing of improvement differed between cases. Patient 2 showed earlier improvement in GUSS and FOIS scores beginning on Day 4, whereas Patient 1 demonstrated more gradual improvement, with notable increases observed on Day 5. Conclusions: Therefore, this therapy can be considered effective as part of nursing interventions for dysphagia in stroke patients. Further research with larger sample sizes and comparative designs is needed to strengthen the evidence of CTAR’s effectiveness.