Comparison of Neck Tension Palpation Rating Systems With Surface Electromyographic and Acoustic Measures in Vocal Hyperfunction

Abstract

Objectives/Hypothesis The purpose of this study was to evaluate current neck tension palpation rating systems to determine inter-rater reliability and possible correlation with neck surface electromyography (sEMG, collected from three electrode recording locations) and measures of the third formant for /a/ during various vocal behaviors. Study Design This prospective study examined the neck muscle tension of 16 participants before and after a single session of voice therapy. Methods Inter-rater reliability and relationships between palpation ratings and objective measures of sEMG (anterior neck) and the third formant for /a/ were assessed using Pearson’s correlations (r). Results Inter-rater reliability was relatively low as measured by Pearson’s correlations, although Wilcoxon Signed Rank Test results were similar as those in a previous study. Correlations between palpation ratings and sEMG, and between ratings of laryngeal height and the third formant for /a/ were generally low. Correlations increased between anterior neck sEMG and ratings of suprahyoid muscle tension when examined in a reduced set of individuals with higher inter-rater reliability. Conclusions Palpation rating scales do not reliably capture changes that may occur in neck muscle tension of typical voice therapy patients over one session. Consequently, little can be concluded from correlations between sEMG and palpation ratings.

Non-invasive ambulatory monitoring of complex sEMG patterns and its potential application in the detection of vocal dysfunctions

“…Recently, the interest in many areas of human-computer interfacing [6], prosthesis [7] and even voice pathology [8], [9] has shifted towards the use of devices that can monitor muscle activity 1 . However, when it comes to recognizing patterns of muscle activity in a reliable, accurate and robust manner, much remains to be done.…”

Incomplete Swallowing and Retracted Tongue Maneuvers for Electromyographic Signal Normalization of the Extrinsic Muscles of the Larynx

“…Still, on the lateral region of the neck are mainly the sternocleidomastoid (SCM) and the scalenes that also have been object of investigation in the study of voice disorders. 5,7 This muscular architecture of head and neck can limit the trustworthiness of the investigation of SH and IH muscles because, in the captured SEMG signal, cross talk can occur, which would be the interference by a signal of the adjacent muscles. 10 As SEMG evaluates a pool of motor units and the human body works in a synergic manner, some measures are important as, for instance, the distance between the electrodes and the The interelectrodes distance, from pole to pole (silver area) recommended by SENIAM, is up to 2 cm.…”

“…[2][3][4] Suprahyoid (SH) and infrahyoid (IH) extrinsic muscles, as in normal phonation as in dysphonia cases, may be investigated using this procedure, but researches are few and hard to compare because the technique, size sample, and muscle groups used are different among papers. 2,3,[5][6][7][8] In EA evaluation by SEMG, a reference pattern of muscular contraction is used, entitled normalization signal, used to reduce inter-and intrasubject variability. There are several possibilities of normalization signal, by the maximum peak of the EA as well as by the maximum voluntary isometric contraction (MVIC), referential demanding the measurement of determined applied load, such as resistance of the studied muscle.…”

“…There are several possibilities of normalization signal, by the maximum peak of the EA as well as by the maximum voluntary isometric contraction (MVIC), referential demanding the measurement of determined applied load, such as resistance of the studied muscle. [7][8][9] Electromyography (EMG) normalization signal by MVIC has been vastly discussed and referred as the most adequate one, taking the value of referred sustained contraction as the EA maximum percentage of the muscle or muscular group to be studied on each subject. It allows the comparison between the value found in the MVIC and the percentages acquired with performed tasks.…”

“…It allows the comparison between the value found in the MVIC and the percentages acquired with performed tasks. 7 MVIC is an isometric task, which serves as reference for the normalization of EA of most muscles. It should be performed with a known static load, in which the muscle must not vary in length.…”