Surface Electromyographic Biofeedback and the Effortful Swallow Exercise for Stroke-Related Dysphagia and in Healthy Ageing.
Sally K Archer, Christina H Smith, Di J Newham
PMID 32445060WHAT IT FOUND
Acute stroke participants could raise swallowing muscle activity during effortful swallows, and a screen showing muscle activity raised it further.
Most said the screen helped and would use it regularly. This measured muscle activity, not whether swallowing improved.
Key findings
01Stroke participants and healthy controls were able to raise muscle activity under the chin during the effortful swallow above their normal swallow.
02Stroke participants and healthy controls produced higher median effortful-swallow signals with feedback than without; for stroke participants this was 147.53% of normal swallow versus 141.39%.
0386% of stroke participants reported that sEMG feedback helped them, and 100% said they would be happy to use it regularly.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The stroke group was small: 14 participants were analysed, and one did not complete both feedback conditions. This was a Phase I study, not a therapy trial, and it did not measure swallowing outcomes or recovery. Stroke participants received different consistencies because only three could tolerate water, so comparisons with healthy participants were not identical. Questionnaire views came after only two short sessions, so they may not reflect long-term acceptability. One healthy participant's data were removed as an outlier after equipment concerns, and two stroke participants declined FEES. The study did not do full thematic analysis of participant comments.
Declared interests
The paper names the funder as National Institute For Health Research Guy's and St Thomas' Comprehensive Biomedical Research Centre.
The easy way to misread this
Do not read the larger muscle-activity signal as evidence that swallowing became safer or that the exercise improved clinical dysphagia. This was a Phase I study, and it did not measure patient swallowing outcomes after treatment.