Swallowing problems are among the major problems that are often experienced by change all word patients with clients who suffer neurological condition (such as stroke, traumatic brain injury), neurodegenerative diseases or head and neck cancer.
There are many techniques that can be taught by Speech-Language Therapist to help individual with swallowing problems to eat by mouth without any visual aid. However, for some patients, biofeedback, which is a technique in which the performance of the individual is known and displayed by a computer, is needed. In the case of swallowing problems, this technique is known as Surface electromyography (sEMG ) biofeedback.
What Is Surface Electromyography (sEMG) Biofeedback?
Surface electromyography (sEMG) Biofeedback is an instrumental technique that measures the timing, duration and amplitude of the muscles involved in swallowing through electrodes attached to the neck.
Function of Surface Electromyography (sEMG) Biofeedback
sEMG Biofeedback is used in the therapy for patients with swallowing problems. sEMG able to measure muscle contraction amplitude and quantify the time and duration of the contraction of muscles while the patient swallows.
Amplitude, time and duration of muscle contractions obtained from the patient will be compared with the amplitude, time and duration of normal muscle contractions. The comparisons will determine whether patients have swallowing problems or not.
sEMG biofeedback is also used in therapy sessions to help patients control the muscle contractions with the help of visual biofeedback display on the computer.
Who Might Benefit from sEMG Biofeedback?
Patients who might benefit from sEMG biofeedback in the swallowing treatment include patients with following diagnosis:
- Cognitive Disorders
- Brain Injury
- Cortical stroke
- Head and neck cancer
sEMG Biofeedback Procedure
Below is a brief sEMG biofeedback therapy procedure:
Step 1: Check the sEMG submental signal to ensure the electrodes are able to read muscle activity at the bottom of the chin or floor of the mouth.
- After the electrodes have been attached to the patient and connected to the biofeedback device, ask the patient to make some movements such as opening and closing of the mouth to achieved the desired amplitude of muscle contractions.
Step 2: Measure the sEMG amplitude levels (baseline) patients during swallowing of saliva.
- Patients are encouraged to swallow saliva every 30 seconds.
Step 3: Train the patient to do regular effort saliva swallows
- For patients who cannot do step 2, train the patient to swallow saliva as usual or as how patients always do.
Step 4: Train the patient to swallow saliva with effortful swallows
- The purpose of this step is to ensure maximum muscle contractions to achieve the highest signal amplitude.
Step 5: Train patient to use Mandelson Maneuver swallowing technique.
- This step is quite difficult for some patients. Patients are trained to use the Mandelson Maneuver only after patient is proficient in step 4. The objective of Mandelshon Maneuver swallowing technique is to elongate the period of muscle contraction associated with swallowing activity.
Food consistencies such as yogurt and pudding can also be used to train patient if patient was able to swallow saliva according to the above procedure.
Picture shown therapist attaching the electrodes to patient’s neck
Picture shown patient receiving treatment
- Campbell, D. (2001) Beyond Compensation. Biofeedback For Dysphagia, 42(11), 10.
- Steele, C.M., Bennett, J.W., Champan-Jay, S., Polacco, R.C., Molfenter, S.M.,Oshalla, M. (2012). Electromyography as a Biofeedback Tool for Rehabilitating Swallowing Muscle Function. DOI: 10.5772/26443
09 October 2016
|Writer / Translator||
|Rozila bt. Sumardi|
|Nadwah bt. Onwi|