CTAR vs. Shaker for Treating Pharyngeal Dysphagia

December 12, 2022

The Chin tuck against resistance (CTAR) exercise has been gaining popularity as a therapeutic exercise to improve swallowing function since its introduction in 2013. CTAR has similar effects to the tried-and-true Shaker exercise.  When comparing CTAR with Shaker, the research suggests CTAR may be more effective, less strenuous and improve compliance with the prescribed swallow rehabilitation program.

Clinical Benefits of CTAR1

  • Activates the suprahyoid muscle
  •  Effectively improves the swallowing function
  • Advances oral diet stage in the pharyngeal phase
  • Reduces aspiration in patients with dysphagia after stroke

Clinical Advantages Compared to Shaker

  • More selectively activates the suprahyoid muscle1
  •  Less strenuous than Shaker1
  •  Increased anterior tongue pressure2
  •  Increased compliance, motivation, and enjoyment completing CTAR3
  •  Significantly higher effectiveness4
  •  Significantly lower Self-Rating Depression Scale Scores in CTAR group versus patients with cerebral infarction4
  •  No requirements for the patient to lie flat

Using the Right Tool

AliMed created the SupraBall specifically designed for speech-language pathologists using the CTAR exercise with their patients. The AliMed® SupraBall® offers a consistent level of resistance and makes it easy for the patient to complete the exercise outside of therapy. The SupraBall is a game-changer and will further motivate your patients to work towards meeting their swallowing goals.

Authored by: Jennifer Llado, MS, MS, CCC-SLP


  1. Chin tuck against resistance exercise for dysphagia rehabilitation: A systematic review 
  2. The Effects of Different Exercise Trainings on Suprahyoid Muscle Activation, Tongue Pressure Force and Dysphagia Limit in Healthy Subjects
  3.  Effects of game-based chin tuck against resistance exercise vs head-lift exercise in patients with dysphagia after stroke: An assessor-blind, randomized controlled trial
  4.  Effects of chin tuck against resistance exercise versus Shaker exercise on dysphagia and psychological state after cerebral infarction. 


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