J Korean Dysphagia Soc.  2021 Jul;11(2):128-136. 10.34160/jkds.2021.11.2.007.

Reliability of Suprahyoid and Infrahyoid Electromyographic Measurements during Swallowing in Healthy Subjects

Affiliations
  • 1Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Korea
  • 2Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea
  • 3Department of Biomedical Engineering, Seoul National University Hospital, Seoul, Korea
  • 4Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, Korea
  • 5Institute of Medical & Biological Engineering, Medical Research Center, Seoul National University, Seoul, Korea
  • 6Interdisciplinary Program in Bioengineering, Graduate School, Seoul National University, Seoul, Korea
  • 7Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Korea
  • 8Institute on Aging, Seoul National University, Seoul, Korea
  • 9National Traffic Injury Rehabilitation Hospital, Yangpyeong, Korea
  • 10Neuroscience Research Institute, Seoul National University College of Medicine, Seoul, Korea

Abstract


Objective
To evaluate the reliability of suprahyoid and infrahyoid electromyography (EMG) measurement during swallowing.
Methods
In all, 10 healthy volunteers were evaluated for the following surface EMG (sEMG) parameters in the suprahyoid and infrahyoid muscles during swallowing: onset latency, offset latency, duration, peak latency, maximal amplitude during swallowing, and the area under curve (AUC) of the rectified EMG signal. The sEMG was recorded while the participants swallowed five times each of the four fluid volumes (saliva, 2 ml, 5 ml, and 20 ml of water), totaling to 20 swallows. Moreover, the intra-participant variability per parameter was evaluated using the coefficient of variation (CV).
Results
Suprahyoid muscles were activated 0.095 s (95% CI, 0.062-0.128) earlier than the infrahyoid muscles. Maximal amplitudes during the 20 ml swallow were 17.484 (−1.543-36.512) and 13.490 (1.254-25.727) μV higher than values obtained during the 2 ml swallow in the suprahyoid and infrahyoid muscles, respectively. Furthermore, the AUC of the rectified EMG signal increased with the volume of swallow in both muscle groups (P=0.003, suprahyoid; P<0.002, infrahyoid). The intra-individual variabilities of offset latency, duration, and maximal amplitude were relatively low (<30% CV) in both muscle groups with respect to other parameters. The assessment of each parameter using EMG was highly reliable, with an intraclass correlation coefficient of >0.8.
Conclusion
Among the variable sEMG parameters assessed, the offset latency, duration, and maximal amplitude were the least variable. Although reliability on the rater side showed good results, the swallow-to-swallow variability of the parameters need to be considered in swallowing studies using sEMG.

Keyword

Electromyography; Deglutition disorders; Reliability of results
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