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International Journal of Practical Nursing

Volume  6, Issue 2, May - August 2018, Pages 63-68
 

Original Article

A study to assess the effectiveness of Chin Tuck Against Resistance (CTAR) Exercise in Improving Swallowing Ability among Cerebrovascular Accident Patients with Dysphagia at a Selected Hospital, Coimbatore

Santhosh Priya N.1, Tamil Selvi A.2, Malarvizhi G.3

1Post Graduate 2Head of the Department, Subject Guide, Department of Medical surgical Nursing, 3Vice Principal, Research Guide, Department of Child Health Nursing, P.S.G College of Nursing Peelamedu, Coimbatore, Tamil Nadu 641004, India.

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DOI: DOI: http://dx.doi.org/10.21088/ijpn.2347.7083.6218.3

Abstract

Stroke is a life changing event and among them 65% could be presented with dysphagia. Dysphagia means an impairment of the swallowing mechanism due to physiological weakness or deficits of structure or neurological function (Ekberg,1982; park et al., 2012;). It can cause negative impact on the person's ability to maintain adequate hydration and nutrition. (Logemann, Nilsson et al., 1998;). Stroke guidelines of UK, US and Australia also stressing on early detection of dysphagia.So, In order to improve the overall outcome after stroke it is essential that the swallowing and feeding performance need to be improved through Chin Tuck Against Resistance (CTAR) Exercise which is helpful in strengthening the suprahyoid muscles that are responsible for swallowing. Thus the study is focused to evaluate the effectiveness of Chin Tuck Against Resistance (CTAR) exercise in improvement of swallowing ability among CVA patients of intervention group. The study was conducted in tertiary care center, Coimbatore and the research design adopted was Quasi-experimental Time series design with multiple institution of treatment. As per the inclusion criteria, 32 samples were selected by purposive sampling and were divided into intervention and comparison group. Pre test data was collected from both the groups then, from next day onwards Chin Tuck Against Resistance Exercise was administered for 8 consecutive days, 3 times a day to the CVA patients who belonged intervention group and the comparison group received the routine care. Post test assessment of swallowing ability among CVA patients was assessed using GUSS (Gugging Swallowing Screen) & FOIS (Functional Oral Intake scale) in both the groups after the exercise during their next feeding time for 8 consecutive days, 3 times a day. The study finding revealed that in the pre test assessment of swallowing ability among CVA patients showed all 16 (100%) patients in
the intervention group were having severe dysphagia. After administration of CTAR exercises gradually at the end of eight days of observation mostly 9 (56.25%) of them progressed to mild dysphagia and 5 (31.2%) of them progressed to no dysphagia category. In the intervention group, on day 1 the CVA patients were having severe dysphagia with the post test mean score of 4.38, they progressed to moderate dysphagia at the end of 6 days with the mean score of 11.56 and at the end of day 8 they progressed to mild dysphagia with a mean score of 16.36 which is also statistically significant with a ‘t’ value 17.347 at the level of p<0.001. Thus it concludes, in the intervention group CTAR exercise is effective in improving the swallowing ability among CVA patients with dysphagia.

Keywords: Effectiveness; Chin Tuck Against Resistance Exercise; CVA Patients; Dysphagia.

 


Corresponding Author : amil Selvi A, Head of the Department, Subject Guide, Department of Medical surgical Nursing, P.S.G College of Nursing Peelamedu, Coimbatore, Tamil Nadu 641004, India.