518
|
wileyonlinelibrary.com/journal/joor J Oral Rehabil. 2018;45:518–525.
© 2018 John Wiley & Sons Ltd
1 | BACKGROUND
Swallowing is a sensorimotor activity by which food, liquids and sa-
liva pass from the oral cavity to the stomach and its trigger begins
after inhibition of mastication, oral closure and collection of the
bolus or saliva in the posterior part of the oral cavity on the dorsum
of the tongue.
1-3
On the base of the innervation pattern, swallowing
has been subdivided into 3 phases: oral (voluntary), pharyngeal (re-
flex) and oesophageal (controlled by somatic and autonomic nervous
systems).
2,3
The oral phase begins as soon as the tongue voluntary
Accepted: 24 April 2018
DOI: 10.1111/joor.12641
ORIGINAL ARTICLE
Preliminary approach for the surface electromyographical
evaluation of the oral phase of swallowing
C. Dellavia
1
| R. Rosati
2
| F. Musto
1
| G. Pellegrini
1
| G. Begnoni
1
| V. F. Ferrario
2
1
Department of Biomedical, Surgical and
Dental Sciences, Universita’ degli Studi di
Milano, Milan, Italy
2
Department of Biomedical Sciences for
Health, Università degli Studi di Milano,
Milan, Italy
Correspondence
Riccardo Rosati, Department of Biomedical
Sciences for Health, Universita’ degli Studi di
Milano, Milan, Italy.
Email: riccardo@riccardorosati.eu
Summary
Swallowing is a muscular activity that occurs both after mastication and spontaneously
as a result of saliva accumulation. Spontaneous saliva swallowing occurs about every
2 minutes. Comprehension of its functional mechanisms is relevant to assess their
modification in clinical situations. A standardised surface electromyographical (ssEMG)
protocol for the evaluation of this muscle activity is lacking. Aims of the present study
are: (i) to determine the reproducibility of a ssEMG protocol for the evaluation of the
oral phase of saliva swallowing and (ii) to evaluate the activity of masseter (MM), ante-
rior temporalis (TA), submental muscles (SM) to draw a reference model of swallowing.
Standardised surface electromyographical activity of MM, TA and SM during swallow-
ing of saliva spontaneously accumulated was recorded in 20 healthy participants.
Functional indexes including symmetry (POC), recruitment (Impact), duration of activa-
tion of each couple of muscles and of the whole exercise, position, intensity of the
spike were computed. Inter- and intra- appointment reliabilities were assessed and
method errors calculated. Descriptive statistics, sex- and muscles- related comparisons
were carried out. Standardised surface electromyographical assessment of MM, TA
and SM muscles was reliable. A high inter- individual variability was found. Percentage
overlapping coefficient (POC) values were close to 80% for TA and SM, higher than for
MM (P < .001). Impact values ranged between 16.4% and 30.7%, and differences were
found between muscles (P < .001). The global muscle activity during swallowing lasted
between 1.5 and 1.8 seconds. For each couple of muscles, the duration of activation
ranged between 0.7 and 1.6 seconds and muscles- related differences were found
(P < .001). The spike of activation for each couple of muscle ranged between 35.7%
and 44.2% of the duration. The protocol was reliable and intra- participants repeatable
measures can be carried out. Due to the high inter- participants variability, further anal-
yses are needed to draw a model of muscular activity.
KEYWORDS
submental muscles, surface electromyography, swallowing
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