{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T15:28:17Z","timestamp":1778858897594,"version":"3.51.4"},"reference-count":32,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Oral Rehabilitation"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The chin tuck against resistance (CTAR) exercise is a rehabilitative technique for stroke patients with dysphagia. However, related clinical evidence remains unclear, and methodological improvements in this therapy are required.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to investigate the effects of the modified CTAR exercise on swallowing\u2010related muscles and swallowing function in stroke patients with dysphagia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Stroke patients with dysphagia (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200930) were randomly assigned to a multidirectional CTAR exercise group (md\u2010CTAR exercise group) and a vertical\u2010directional (vd\u2010CTAR exercise group) (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200915 per group). The md\u2010CTAR exercise group performed exercises in the left and right diagonal and vertical directions using a prototype device. The vd\u2010CTAR group performed only vertical exercises. Both groups performed the exercises for 5\u2009days each week over a period of 6\u2009weeks. Primary outcome measures included tongue strength, thickness and suprahyoid muscle activation. Secondary outcome measures included the Videofluoroscopic Dysphagia Scale (VDS) and Penetration\u2013Aspiration Scale (PAS) based on videofluoroscopic study.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The md\u2010CTAR group exhibited significantly higher maximal tongue strength, thickness and suprahyoid muscle activity than the vd\u2010CTAR group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05, all), as well as a significant decrease in the oral and pharyngeal phase of the VDS score (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.048 and 0.041) and PAS compared to the vd\u2010CTAR group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.047).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>md\u2010CTAR exercise is more effective than vd\u2010CTAR exercise in improving the oropharyngeal muscles and swallowing function in stroke patients with dysphagia. Therefore, the md\u2010CTAR exercise is recommended as a modified therapeutic exercise for dysphagia rehabilitation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/joor.13972","type":"journal-article","created":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T23:34:09Z","timestamp":1746142449000},"page":"1050-1058","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Effect of Multidirectional Chin Tuck Against Resistance Exercise on Oropharyngeal Muscles and Swallowing Function in Subacute Stroke Patients With Dysphagia: A Randomised Controlled Trial"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7113-4792","authenticated-orcid":false,"given":"Ji\u2010Su","family":"Park","sequence":"first","affiliation":[{"name":"Research Institute for Korean Medicine Pusan National University  Yangsan Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4294-5714","authenticated-orcid":false,"given":"Young\u2010Seok","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Occupational Therapy Osan University  Osan\u2010si Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5993-309X","authenticated-orcid":false,"given":"Motoyoshi","family":"Morishita","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Faculty of Rehabilitation Reiwa Health Sciences University  Fukuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3651-9755","authenticated-orcid":false,"given":"Na\u2010Mi","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine Busan Paik Hospital  Busan Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1130-8636","authenticated-orcid":false,"given":"Tae\u2010Hyung","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Occupational Therapy Dongseo University  Busan Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,5,1]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.5535\/arm.2014.38.2.153"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-011-9336-2"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-013-9502-9"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-019-10079-w"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.3233\/NRE-172250"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-015-9678-2"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40814-022-01060-w"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-011-9392-7"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1044\/2017_JSLHR-S-16-0277"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-019-05772-3"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-81993-9"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/PHM.0000000000000230"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000017304"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-019-10071-4"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-007-9097-0"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00417897"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2012.07.2370"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-642-34988-1"},{"key":"e_1_2_10_20_1","volume-title":"Proprioseptif noromuskuler fasilitasyon teknigi","author":"Livanelio\u011flu A.","year":"2014"},{"issue":"3","key":"e_1_2_10_21_1","first-page":"343","article-title":"Heterogeneity in Vertical Positioning of the Hyoid Bone in Relation to Genioglossal Activity in Men","volume":"74","author":"Pae E. 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