Dysphagia Therapy, Uncategorized

(Korean) Dysphagia Swallowing Therapy – Chin Tuck Against Resistance with Rubber Ball. 삼킴 장애 요법 – 고무공 사용하는 저항성 턱 당기기 (한국어)

GDM would like to thank Ms Sandy Lim (SLP from USA) for her help in translation and presentation of the Korean Version of the CTAR video.

This Korean translated CTAR video and blog post are initiative of the Global Dysphagia Movement (GDM).

The Chin Tuck Againt Resistance (CTAR) exercise works on strengthening the suprahyoid muscles, necessary for opening your upper food pipe sphincter (or known as the upper esophageal sphincter) to allow food to enter the stomach.

저항성 턱 당기기 운동은 목뿔의근을 강화시켜 상부 식도 괄약근을 열어 음식이 위장에 들어갈수있게 해줍니다.

Since CTAR was introduced in 2013, Mr Yoon (The CTAR inventor) has been receiving enquiries from clinicians from around the world. We hope that this video will provide the details to facilitate the carrying out of the exercise. We plan to translate this and all our upcoming videos into different languages.

2013년 저항성 턱 당기기 운동이 소개 된 이후 운동 발명가 윤선생님께서는 전 세계에서 문의를 받고 있습니다. 이 동영상이 연습수행을 용이하게 하는데에 도움이 되길를 바랍니다. 이 동영상과 앞으로 나올 모든영상들은 여러 언어로 번역될  예정입니다.

The following is the CTAR exercise instructions. You may download a PDF copy of this instructions at the bottom of this page.

다음은 저항성 턱 당기기 운동 지침입니다. 이 페이지 하단에서 이 지침의 PDF사본을 다운로드 할 수 있습니다.

For clinicians, you may download the above QR code and print it on your exercise handouts to facilitate clients’ search for the above YouTube Video.

치료사일 경우, 위 QR 코드를 다운로드 받은 후 유인물에 인쇄하면  환자가 위의 YouTube 동영상을 쉽게 검색 할수있습니다.

저항성 턱 당기기 고무공 사용법

목적: 삼키는데 사용되는 목뿔위근육을 강화시키기 위함. 상부 식도 괄약근을 열어 음식이 위장에 들어갈수 있도록 하려면 목뿔위근이 중요하다.

준비물: 1. 고무공  2. 공기 펌프, 공 펌프 니들 밸브 (추가 필요물) – 공의 직경과 압력을 높이기 위해


1부: 지속적인 저항성 턱 당기기 (등척성)

  1. 바로 앉거나 서서 어깨를 뒤로 폅니다. 이 자세를 유지 하십시오.
  2. 손으로 공을턱 아래에 고정시키고 이 자세를 유지하십시오.
  3. 턱을 세게 당겨주세요; _____초 동안 유지하십시오.
  4. 언어 치료사가 권장하는대로 ____세트를 반복하십시오.
  5. 세트 사이 일분동안 휴식을 취하십시오.

2부: 반복적인 저항성 턱 당기기 (등장성)

  1. 바로 앉거나 서서 어깨를 뒤로 폅니다. 이 자세를 유지 하십시오.
  2. 손으로 공을턱 아래에 고정시키고 이 자세를 유지하십시오.
  3. 턱을 세게 당긴다음 턱을 드세요.
  4. 언어 치료사가 권장한 대로 위의 단계를 ____회 ____세트를 반복하십시오.
  5. 세트 사이 일분동안 휴식을 취하십시오.

YouTube 동영상을 보시려면

-다음 링크를 https://youtu.be/CExiSYvpcSo 클릭하면 YouTube 동영상으로 바로 연결됩니다.

To download a PDF copy of the CTAR exercise instructions, please click on:

저항성 턱 당기기 운동 지침의 PDF 사본을 다운로드 하시려면 ?? 눌러주십시오.

CTAR with Rubber Ball Exercise videos are available in the following languages:

* Click to view CTAR videos in the following languages.

** Chin Tuck Against Resistance or CTAR is suitable for:

  • dysphagia or swallowing difficulties following strokes,
  • dysphagia following head and neck cancer,
  • dysphagia following Parkinson’s disease,
  • dysphagia due to late effect of radiotherapy i.e. Nasopharyngeal cancer
  • etc.


How COVID-19 Swab Test is done? A Singapore Speech Therapist’s experience

In this video, I will show you how a COVID-19 swab test is done and I will explain how it feels like.

Is it necessary for Speech Therapist to go through COVID-19 swab test?

We feel that it is very important for speech therapists / pathologists in Singapore to go through the COVID-19 swab test. As this will not just boost clients’ confidence but also to ensure safety especially when it comes to physical visits such as home or clinic speech or swallowing therapy sessions.

All our speech therapists at Singapore Swallowing Specialists and Speech Therapy Works, Singapore have undergone COVID-19 swab testing, and we have all tested negative.

Cost effective treatment, dysphagia research, Dysphagia Therapy, Singapore, speech therapy singapore, speech-language therapy, Swallowing Problem, Teaching, Uncategorized

Second Publication on Chin Tuck Against Resistance (CTAR)

We are happy to announce that the follow up study on CTAR has been published online (online first version) in Dysphagia Journal.

Original Paper


pp 1-11

First online: 02 February 2016

Evaluating the Training Effects of Two Swallowing Rehabilitation Therapies Using Surface Electromyography—Chin Tuck Against Resistance (CTAR) Exercise and the Shaker Exercise

  • Wei Ping Sze 
  • , Wai Lam Yoon
  • , Nicolas Escoffier
  • , Susan J. Rickard Liow


In this study, the efficacy of two dysphagia interventions, the Chin Tuck against Resistance (CTAR) and Shaker exercises, were evaluated based on two principles in exercise science—muscle-specificity and training intensity. Both exercises were developed to strengthen the suprahyoid muscles, whose contractions facilitate the opening of the upper esophageal sphincter, thereby improving bolus transfer. Thirty-nine healthy adults performed two trials of both exercises in counter-balanced order. Surface electromyography (sEMG) recordings were simultaneously collected from suprahyoid muscle group and sternocleidomastoid muscle during the exercises. Converging results using sEMG amplitude analyses suggested that the CTAR was more specific in targeting the suprahyoid muscles than the Shaker exercise. Fatigue analyses on sEMG signals further indicated that the suprahyoid muscle group were equally or significantly fatigued (depending on metric), when participants carried out CTAR compared to the Shaker exercise. Importantly, unlike during Shaker exercise, the sternocleidomastoid muscles were significantly less activated and fatigued during CTAR. Lowering the chin against resistance is therefore sufficiently specific and intense to fatigue the suprahyoid muscles.

Details of the journal can be found at http://link.springer.com/article/10.1007%2Fs00455-015-9678-2

We are happy to announce that we are starting our third CTAR research at the National University of Singapore.

CTAR research 3
CTAR research 3 in progress

materials for CTAR 3
Materials used in CTAR 3

Dysphagia Therapy, Featured clinicians, Singapore, Swallowing Problem, Teaching, Uncategorized

Workshop on ‘Best Practices in the Management of Oropharyngeal Dysphagia’

Dear all,

JurongHealth Speech Therapy department will be organising a 2 day workshop next year entitled ‘Best Practices in the Management of Oropharyngeal Dysphagia’. The workshop will be conducted by Dr. Catriona Steele and will be held on 20 – 21 May, 2016 at Ng Teng Fong General Hospital, Singapore.



About the speaker:

Dr. Catriona M. Steele is a clinician scientist working in the area of swallowing and swallowing disorders. She has a background as a medical speech-language pathologist, and is Director of the Swallowing Rehabilitation Research Laboratory at the Toronto Rehabilitation Institute – University Health Network. Dr. Steele is a Professor in the Department of Speech-Language Pathology at the University of Toronto and is in demand as a teacher and workshop instructor around the world. Dr. Steele holds research funding from the National Institutes of Health (USA) and has more than 100 peer-reviewed publications.


Brief outline of workshop

> Best Practices in the Identification and Assessment of Oropharyngeal Dysphagia

–   Sensitivity and specificity of different dysphagia screening tools

–   Purpose, protocols and important technical considerations of videofluoroscopy

– Using information from research to quantify observations during a clinical bedside swallowing assessment

> Management and Rehabilitation of Oropharyngeal Dysphagia

–  Evidence behind texture modification and postural approaches

–  Direct and indirect swallowing/exercise approaches including the use of IOPI and sEMG biofeedback

–  Other approaches in the literature: respiratory interventions, electrical stimulation, vibratory stimulation


Estimated cost:  $400 – $500 per participant for the full workshop.



Registration Correspondent: Ms Wong Wan Xin

Wong Wan Xin| Speech Therapist, Rehabilitation | Ng Teng Fong General Hospital & Jurong Community Hospital | Jurong Health Services
1 Jurong East Street 21, Singapore 609606 | T: (65) 67161674 | E: Wan_Xin_Wong@juronghealth.com.sg