Effects of Age and Stimulus on Submental Mechanomyography Signals During Swallowing

Abstract

Mechanomyography (MMG) is the measurement of the vibrations associated with muscle contraction. As an indicator of muscle activity in swallowing, MMG has several potential advantages over conventional electromyography (EMG), including robustness to variations in sensor placement, perspiration, and food spillage. The objective of this study was to investigate the effects of participant age and stimulus on submental muscle activity as measured by MMG. Nasal airflow was utilized as a reference signal. Four liquid stimuli were investigated: water, nectar-thick and honey-thick apple juices, and a thin-liquid barium suspension. Each of 15 healthy adults completed nine swallowing sequences, each consisting of four discrete swallows via a self-administered cup-drinking task, with an MMG sensor at a midline submental location and a nasal cannula at the nares. Muscle activity and swallowing apneas in the signals were identified with pseudo-automatic segmentation algorithms. Various timing and amplitude features were extracted from each segmented swallow. Muscle activity onset preceded the onset of swallow apnea. Significant main effects of stimulus were found for the duration of muscle activity and for the time difference between the offsets of muscle activity and swallow apnea. No other main or interaction effects were significant. In general, the timing and amplitude variations of submental muscle activity revealed by MMG seem to agree with previously reported findings using EMG. The minor discrepancies between the results of this study and those of previous EMG studies are likely due to differences in experimental tasks. MMG may serve as an alternative measure of muscle activity during swallowing and further investigation is warranted.

Alimentos na consistência líquida e deglutição: uma revisão crítica da literatura

“…Regarding EMGs, which is a complementary test that has been widely used in speech-language pathology practices that favor the objective measurement of performance in this field and the use of evidence-based practices, a significant correlation was found between the biomechanical events of swallowing and the electromyographic signals (21,25,36) , especially when determining the hyoid bone elevation (36) . Studies indicate that expiration was the breathing event during pre-and post-swallowing apnea that was noted by most studies on this matter (9,21,29) .…”

“…Studies indicate that expiration was the breathing event during pre-and post-swallowing apnea that was noted by most studies on this matter (9,21,29) . Post-swallowing apnea inspiration was an important parameter for the characterization of patients with and without a risk of laryngotracheal penetration/ aspiration (30) .…”

“…Post-swallowing apnea inspiration was an important parameter for the characterization of patients with and without a risk of laryngotracheal penetration/ aspiration (30) . The study linking the breathing events to EMGs showed that the onset of muscle activity occurred prior to the onset of swallowing apnea (21) .…”

“…The objective swallowing test that was most often used to assess the laryngotracheal penetration and/or aspiration was videofluoroscopy (6,9,11,14,15,20,22,30,31,(34)(35)(36) . However, the variety of complementary tests used by current studies, including accelerometry (13) , EMGs (12,20,21,25,36) , tongue use (16,17) , and airway (9) pressure gauges, among others, should not be overlooked.…”

“…Another study (21) assessed the effects of age and swallowing-related muscle activity based on stimuli detected by equipment combining the analysis of the displacement of swallowing-related structures and the electromyographic activity of muscles. The participants in the study were 15 adults (seven women and eight men) with a history of dysphagia and neurological changes.…”