In 2023, a review of how swallowing rehabilitation has evolved (Huckabee et al., 2023) recognised CTAR (Chin Tuck Against Resistance) as one of the exercises that has shaped the field. CTAR was developed in Singapore by speech therapist Yoon Wai Lam as a simple, low-cost way to strengthen the suprahyoid muscles used in swallowing. The very first version used an S$2 inflatable rubber ball bought at a pasar malam (night market).
Huckabee, ML., Mills, M., Flynn, R. et al. The Evolution of Swallowing Rehabilitation and Emergence of Biofeedback Modalities. Curr Otorhinolaryngol Rep 11, 144–153 (2023). https://doi.org/10.1007/s40136-023-00451-8
CTAR was first presented internationally at the Dysphagia Research Society meeting in Seattle, USA, in 2013. It drew strong interest and won first place for Scientific Abstract Poster. The first CTAR paper, published in the journal Dysphagia in 2014, was one of the journal’s top 10 most downloaded articles that year, and a follow-up study in 2016 added further evidence. Together, the two papers have been cited more than 220 times in journal articles and textbooks (Springer, November 2026).
CTAR has since inspired a number of commercial devices around the world. Mr Yoon’s own approach remains low-cost: the exercise can be done with a simple rubber ball, or with the hand providing the resistance, with no special equipment needed.
To make CTAR freely available, Mr Yoon set up the Singapore Swallowing Specialists YouTube channel. It offers CTAR videos in seven languages, which have been viewed more than 150,000 times worldwide (October 2026).
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References:
- Huckabee, ML., Mills, M., Flynn, R. et al. The Evolution of Swallowing Rehabilitation and Emergence of Biofeedback Modalities. Curr Otorhinolaryngol Rep 11, 144–153 (2023). https://doi.org/10.1007/s40136-023-00451-8
- Sze, W. P., Yoon, W. L., Escoffier, N., & Rickard Liow, S. J. (2016). Evaluating the Training Effects of Two Swallowing Rehabilitation Therapies Using Surface Electromyography-Chin Tuck Against Resistance (CTAR) Exercise and the Shaker Exercise. Dysphagia, 31(2), 195–205. http://doi.org/10.1007/s00455-015-9678-2
- Yoon, W.L., Khoo, J., & Liow, S. (2014). Chin tuck against resistance (CTAR): a new method for enhancing suprahyoid muscle activity using a Shaker-type exercise. Dysphagia. Retrieved from http://link.springer.com/article/10.1007/s00455-013-9502-9
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