Effects of CTAR and PNF Exercises on Swallowing in Multiple Sclerosis

This study compares two exercise programs for people with multiple sclerosis (MS) who have trouble swallowing. One group did chin exercises against resistance (CTAR), and the other group did neck exercises based on a technique called proprioceptive neuromuscular facilitation (PNF). Both groups also received a sensory technique to help trigger swallowing. The study tested whether these exercises could improve swallowing ability, swallowing speed, and quality of life related to eating and drinking. Participants were randomly assigned to one of the two exercise groups and were treated for 8 weeks, three times per week. Swallowing was assessed before and after treatment using validated questionnaires and a water-swallow test.

Inclusion Criteria: * \- Confirmed diagnosis of multiple sclerosis according to the 2017 McDonald criteria * DYMUS (Dysphagia in Multiple Sclerosis) questionnaire score ≥1 * Age between 18 and 65 years * No relapse within the preceding 6 months Exclusion Criteria: * \- Pregnancy or breastfeeding * Presence of another neurological disease that could cause dysphagia * Presence of pneumonia * History of head-neck surgery or head-neck cancer * Persistent neck pain and/or radiculopathy * Inadequate head control * Inability to understand or follow verbal commands