Electromyography and Mechanomyography Signals During Swallowing in Healthy Adults and Head and Neck Cancer Survivors

Abstract

Surface electromyography (sEMG) is used as an adjuvant to dysphagia therapy to demonstrate the activity of submental muscles during swallowing exercises. Mechanomyography (MMG) has been suggested as a potential superior alternative to sEMG; however, this advantage is not confirmed for signal acquired from submental muscles. This study compared the signal-to-noise ratio (SNR) obtained from sEMG and MMG sensors during swallowing tasks, in healthy participants and those with a history of head and neck cancer (HNC), a population with altered anatomy and a high incidence of dysphagia. Twenty-two healthy adults and 10 adults with a history of HNC participated in this study. sEMG and MMG signals were acquired during dry, thin liquid, effortful, and Mendelsohn maneuver swallows. SNR was compared between the two sensors using repeated measures ANOVAs and subsequent planned pairwise comparisons. Test-retest measures were collected on 20 % of participants. In healthy participants, MMG SNR was higher than that of sEMG for dry [t(21) = -3.02, p = 0.007] and thin liquid swallows [t(21) = -4.24, p < 0.001]. Although a significant difference for sensor was found in HNC participants F(1,9) = 5.54, p = 0.043, planned pairwise comparisons by task revealed no statistically significant difference between the two sensors. sEMG also showed much better test-retest reliability than MMG. Biofeedback provided as an adjuvant to dysphagia therapy in patients with HNC should employ sEMG technology, as this sensor type yielded better SNR and overall test-retest reliability. Poor MMG test-retest reliability was noted in both healthy and HNC participants and may have been related to differences in sensor application.

Effectiveness of Therapy on Post-Extubation Dysphagia: Clinical and Electromyographic Findings

“…This technique has been used as an aid in differential diagnosis and monitoring of possible muscular disorders 13 and contributed to the assessment of swallowing dysfunction. It also assists therapy techniques aimed at treating dysphagia as it can demonstrate the activity of suprahyoid muscles during swallowing exercises 14 and also provide visual biofeedback to physicians and patients, which can be used to better understand muscle activity that takes place when exercising is carried out during therapy. 15,16…”

“…This technique has been used as an aid in differential diagnosis and monitoring of possible muscular disorders 13 and contributed to the assessment of swallowing dysfunction. It also assists therapy techniques aimed at treating dysphagia as it can demonstrate the activity of suprahyoid muscles during swallowing exercises 14 and also provide visual biofeedback to physicians and patients, which can be used to better understand muscle activity that takes place when exercising is carried out during therapy. 15,16 The hypothesis of this research is that rehabilitation exercises aimed at hyolaryngeal muscles may facilitate functional adaptation by means of strength training principles, resulting in improvement of muscle activity and recruitment in patients presented with oropharyngeal dysphagia following intubation, showing a meaningful impact on the swallowing physiology of patients, providing greater safety in oral feeding.…”

Correlation between cervical auscultation and electromyography in the pharyngeal phase of swallowing

“…Distúrb Comun, São Paulo, 2022;34(2): e52916 tempo e na amplitude da atividade muscular entre os gêneros. 9,10,11 Em pesquisas realizadas com adultos sem queixas de transtornos, observou-se que a amplitude da musculatura supra-hioidea varia de 23 µV a 40,76 µV durante a deglutição. A duração da atividade muscular, durante a deglutição, varia de 1,0 s a 2,05 s. O valor sofre interferência do volume e da consistência do alimento.…”

“…12 Na avaliação eletromiográfica, ainda não há consenso quanto à diferença no tempo e na amplitude da atividade muscular entre diferentes gêneros. 10,11 Autores sustentam que um dos sinais acústicos mais importantes do som da deglutição corresponde à movimentação da musculatura supra e infra-hióidea, além do deslocamento da laringe, e através do músculo cricofaríngeo, de forma que os sinais acústicos da deglutição possam estar correlacionados com a superfície da eletromiografia. 5,7,8 É necessário estudar a correlação entre a EMGs e a ausculta cervical, pois esses dados inferem sobre a biomecânica da deglutição, auxiliando assim na clínica fonoaudiológica.…”

“…A posição exata dos eletrodos para cada um dos músculos previamente conhecidos e foram esclarecidas após correlação anatômica. [10][11][12] Em seguida, o participante foi orientado quanto aos procedimentos a serem realizados: sentar apoiando os pés no chão paralelamente; posicionar a cabeça medialmente ao tronco; deglutir 90 ml de líquido (água) ininterruptamente para registro da auscultação cervical e da eletromiografia de superfície. A água teve sua medida realizada em seringa esterilizada e ofertada em copo plástico.…”