This study aims to investigate the effectiveness of resistance swallowing rehabilitation using Chin Tuck Against Resistance (CTAR) exercises combined with an innovative swallowing pressure ball in improving swallowing function and swallowing-related quality of life among home-based older stroke patients with dysphagia.

Participants will receive a 12-week swallowing rehabilitation program conducted in the home-care setting. Outcome measures include swallowing function assessments, swallowing-related quality of life, and rehabilitation adherence. The study is designed as a randomized controlled trial to explore the feasibility and clinical benefits of resistance-based swallowing rehabilitation in community and home-care environments.

Inclusion Criteria:

• Age between 65 and 90 years.
• Diagnosed with ischemic or hemorrhagic stroke more than 6 months prior to enrollment.
• Receiving home care services from participating home care agencies.
• Able to follow instructions and participate in swallowing training.
• MMSE score ≥24, or adjusted according to education level.
• Passed the second stage of the 3-step swallowing screening test.
• Presence of post-stroke dysphagia symptoms.

Exclusion Criteria:

• History of head and neck cancer or head and neck radiotherapy.
• History of cervical spine surgery or tracheostomy.
• Severe neurological or neuromuscular diseases affecting swallowing function.
• Severe unstable medical conditions.
• Current use of medications significantly affecting swallowing function or muscle tone.
• Unable to complete the intervention or follow-up assessments.
• Receiving tube feeding without oral intake ability.