Galek, K.E., Bice, E.M., Allen, K. (2023). The Influence of Three Feedback Conditions on Performing a Swallow Motor Pattern in Healthy Adults. Folia Phoniatrica et Logopaedica (Karger). doi.org/10.1159/000525634  

Research Focus:
Studies suggest the principles of motor learning have the potential to optimize
outcomes in the rehabilitation of swallowing. Successful motor learning relies on accurate feedback and literature investigating the therapeutic benefit of adjunctive sEMG (surface electromyography) in swallowing therapy has reported rapid progress, even in those with chronic dysphagia. Furthermore, research supports the efficacy of interventions designed to modify the motor pattern of the swallow, including the Mendelsohn maneuver (MM).

Intervention:
The authors randomized 120 healthy adults into 3 groups: visual and verbal feedback (VVF), verbal feedback only (VF), and intrinsic feedback (IF). Participants were asked to perform the MM with saliva swallows. Data was collected utilizing OmnisEMG™ part of Synchrony Dysphagia Solutions by ACP^®. Participants were provided standardized verbal instructions and an image of the desired sEMG trace for the MM.

• VVF group: The therapist and patient both had access to visual feedback via sEMG.
• VF group: The investigator viewed sEMG feedback but the participant did not.
• IF group: Participants received neither verbal nor visual feedback concerning accuracy and the investigator did not have visual feedback.

Results:
The MM performance accuracy in the VVF group was 100%, followed by 74% in the VF group, and only 18% for IF group. Additionally, of the participants who accurately performed 3 consecutive MM patterns, the mean session time for accomplishment in the VVF group was 3 minutes 31 seconds, VF condition 8 minutes 25 seconds, and the IF condition 13 minutes 46 seconds.

Clinical Impact:
At a minimum, clinicians must have visual feedback to shape swallowing behavior
and improve accurate performance. Otherwise, the clinician may reinforce incorrect
swallow movements, which is not beneficial for motor learning purposes. Additionally,
the session length for accurate performance is an important factor to maximize often limited therapy time.

ACP Value:
ACP’s Dysphagia program incorporates virtual reality biofeedback using OmnisEMG to help improve motor learning in swallowing rehabilitation including movements such as MM for improved patient outcomes.