sEMG Biofeedback Research Articles

McNeill Dysphagia Therapy Program: A Case-Control Study

Carnaby-Mann GD, Crary MA. McNeill Dysphagia Therapy Program: a case-control study. Objective To compare the effectiveness of the McNeill Dysphagia Therapy Program, a systematic exercise-based rehabilitation framework for swallowing remediation, with traditional swallowing therapy techniques paired with surface electromyography (sEMG) biofeedback. Design Matched case-control study. Setting University medical center. Participants Dysphagic patients referred to an outpatient swallowing therapy service. Interventions Cases were individually matched to 2 separate controls for age, sex, and primary medical diagnosis (N=24). Cases were patients with dysphagia who entered the McNeill Dysphagia Therapy Program from September 2006 to October 2008. Controls entered a traditional swallowing therapy program augmented with sEMG biofeedback (traditional therapy with biofeedback group) from February 1994 to June 1999. Main Outcome Measures The primary outcome was the proportion of patients who improved clinical swallowing ability and functional oral intake. The secondary outcomes were the presence (or not) of tube feeding, physiologic change on instrumental swallowing studies, and occurrence of aspiration on posttreatment assessment. Results Case patients were more likely to demonstrate dysphagia recovery at posttreatment re-evaluation (adjusted odds ratio for dysphagia recovery=13.0 [95% CI, 1.27–63.89]; Mantel-Haenszel χ 2=6.7; P=.009; relative risk reduction=.69). Dysphagia was reduced by 69% in the McNeill Dysphagia Therapy Program treatment group compared with the traditional therapy with biofeedback group. Conclusions Both approaches facilitated improved swallowing function. The McNeill Dysphagia Therapy Program resulted in superior outcomes compared with traditional dysphagia therapy supplemented with sEMG biofeedback.

Neck and face surface electromyography for prosthetic voice control after total laryngectomy.

The electrolarynx (EL) is a common rehabilitative speech aid for individuals who have undergone total laryngectomy, but they typically lack pitch control and require the exclusive use of one hand. The viability of using neck and face surface electromyography (sEMG) to control the onset, offset, and pitch of an EMG-controlled EL (EMG-EL) was studied. Eight individuals who had undergone total laryngectomy produced serial and running speech using a typical handheld EL and the EMG-EL while attending to real-time visual sEMG biofeedback. Running speech tokens produced with the EMG-EL were examined for naturalness by 10 listeners relative to those produced with a typical EL using a visual analog scale. Serial speech performance was assessed as the percentage of words that were fully voiced and pauses that were successfully produced. Results of the visual analog scale assessment indicated that individuals were able to use the EMG-EL without training to produce running speech perceived as natural as that produced with a typical handheld EL. All participants were able to produce running and serial speech with the EMG-EL controlled by sEMG from multiple recording locations, with the superior ventral neck or submental surface locations providing at least one of the two best control locations.

Pelvic floor muscle functioning in women with vulvar vestibulitis syndrome

Vaginal sEMG biofeedback and pelvic floor physical therapists' manual techniques are being increasingly included in the treatment of vulvar vestibulitis syndrome (VVS). Successful treatment outcomes have generated hypotheses concerning the role of pelvic floor pathology in the etiology of VVS. However, no data on pelvic floor functioning in women with VVS compared to controls are available. Twenty-nine women with VVS were matched to 29 women with no pain with intercourse. Two independent, structured pelvic floor examinations were carried out by physical therapists blind to the diagnostic status of the participants. Results indicated that therapists reached almost perfect agreement in their diagnosis of pelvic floor pathology. A series of significant correlations demonstrated the reliability of assessment results across muscle palpation sites. Women with VVS demonstrated significantly more vaginal hypertonicity, lack of vaginal muscle strength, and restriction of the vaginal opening, compared to women with no pain with intercourse. Anal palpation could not confirm generalized hypertonicity of the pelvic floor. We suggest that pelvic floor pathology in women with VVS is reactive in nature and elicited with palpations that result in VVS-type pain. Treatment interventions need to recognize the critical importance of addressing the conditioned, protective muscle guarding response in women with VVS.