Brief Article
Copyright ©2013 Baishideng. All rights reserved.
World J Otorhinolaryngol. May 28, 2013; 3(2): 35-41
Published online May 28, 2013. doi: 10.5319/wjo.v3.i2.35
Surface electromyography for diagnosing dysphagia in patients with cerebral palsy
Fan-Fei Tseng, Shu-Fen Tseng, Yu-Hui Huang, Chun-Ching Liu, Tung-Hua Chiang
Fan-Fei Tseng, Shu-Fen Tseng, Chun-Ching Liu, Maria Social Welfare Foundation, Taichung City 40346, Taiwan
Yu-Hui Huang, Department of Physical Medicine and Rehabilitation, Chung Shan Medical University Hospital, Taichung City 40201, Taiwan
Yu-Hui Huang, Department of Rehabilitation Medicine, Chung Shan Medical University, Taichung City 40201, Taiwan
Tung-Hua Chiang, Department of Neurology, Cheng Ching Hospital, Taichung City 40045, Taiwan
Author contributions: Tseng FF designed the study, wrote the protocol and the first draft of the manuscript; Tseng SF performed the research; Huang YH performed the research; Liu CC performed the research; Chiang TH undertook the statistical analysis, managed the literature searches and analyses.
Supported by Maria Social Welfare Foundation
Correspondence to: Tung-Hua Chiang, MD, Department of Neurology, Cheng Ching Hospital, No. 139, Pingdeng St., Taichung City 40045, Taiwan.
Telephone: +886-4-24754039 Fax: +886-4-24754039
Received: January 6, 2013
Revised: May 27, 2013
Accepted: May 27, 2013
Published online: May 28, 2013

AIM: To determine the accuracy of 2-channel surface electromyography (sEMG) for diagnosing oropharyngeal dysphagia (OPD) in patients with cerebral palsy.

METHODS: Participants with cerebral palsy and OPD between 5 and 30 years of age and age- and sex-matched healthy individuals received sEMG testing during swallowing. Electrodes were placed over the submental and infrahyoid muscles, and sEMG recordings were made during stepwise (starting at 3 mL) determination of maximum swallowing volume. Outcome measures included submental muscle group maximum amplitude, infrahyoid muscle group maximum amplitude (IMGMA), time lag between the peak amplitudes of 2 muscle groups, and amplitude difference between the 2 muscle groups.

RESULTS: A total of 20 participants with cerebral palsy and OPD (OPD group) and 60 age- and sex-matched healthy volunteers (control group) were recruited. Among 20 patients with OPD, 19 had Dysphagia Outcome and Severity Scale records. Of them, 8 were classified as severe dysphagia (level 1), 1 was moderate dysphagia (level 3), 4 were mild to moderate dysphagia (level 4), 3 were mild dysphagia (level 5), and 3 were within functional limits (level 6). Although the groups were matched for age and sex, participants in the OPD group were significantly shorter, weighed less and had lower body mass index than their counterparts in the control group (both, P < 0.001). All sEMG parameter values were significantly higher in the OPD group compared with the control group (P < 0.05). Differences were most pronounced at the 3 mL swallowing volume. IMGMA at the 3 mL volume was the best predictor of OPD with a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 85.0%, 90.0%, 73.9%, 94.7% and 88.8%, respectively.

CONCLUSION: Two-channel sEMG may be useful in the diagnosis of OPD in patients with cerebral palsy.

Keywords: Cerebral palsy, Dysphagia, Surface electromyography, Maximum swallowing volume

Core tip: Surface electromyography (sEMG) parameters obtained using 2-channel recordings of submental and infrahyoid muscle activity differ significantly during swallowing between patients with oropharyngeal dysphagia (OPD) and cerebral palsy and healthy control individuals. These findings suggest that with further optimization and testing, 2-channel sEMG may be useful for the diagnosis of OPD in patients with cerebral palsy, as well as patients with other disorders.