Sains Malaysiana 50(12)(2021): 3523-3535

http://doi.org/10.17576/jsm-2021-5012-05

Surface Electromyography Quantification Methods for Evaluating Muscle Activity in Dysphagia

(Kaedah Kuantifikasi Elektromiografi Permukaan untuk Penilaian Aktiviti Otot pada Disfagia)

SUPRIJANTO¹*, AZIZAH S. NOOR¹, MIRANTI I. MANDASARI² & HESTY SUSANTI¹

¹Medical Instrumentation Laboratory, Instrumentation and Control Research Group, Faculty of Industrial Technology, Institut Teknologi Bandung, Indonesia

²Department of Engineering Physics, Faculty of Industrial Technology, Institut Teknologi Bandung, Indonesia

Received: 21 November 2020/Accepted: 19 April 2021

ABSTRACT

Quantitative evaluation of stroke patients with the risk of swallowing disorder or dysphagia is required to support diagnosis and further rehabilitation planning. Fluoroscopy X-ray imaging usually is used for swallowing diagnosis, though it gives radiation exposure to patients. Therefore, quantification of muscle coordination patterns involved in swallowing based on surface electromyography (sEMG) was introduced. However, an adequate quantification of sEMG for dysphagia diagnosis still lacks standardization. In this work, potential sEMG signal features, namely the contraction duration (DUR), the time to peak of maximum contraction (TTP), and the total RMS power (TP), were further investigated to evaluate the swallowing processes in healthy subjects and post-stroke patients. The experimental scheme instructed the participant, i.e. 20 healthy subjects and 20 patients, to swallow 3 mL of water in normal swallowing mode and swallow saliva in dry swallowing mode. The proposed signal processing procedure helps to establish the feature extraction of the three features mentioned earlier. For dysphagia assessment, with the support of our proposed signal processing procedure, DUR and TTP can be used together to improve diagnosis reliability. The characteristic of both features in healthy subjects was shorter than in post-stroke patients. Also, the TP feature is useful as additional information to evaluate the role of suprahyoid (SUP) and infrahyoid (INF) muscle groups which are very important in the swallowing process. These results are promising to provide a reliable set of features in the time domain for swallowing analysis. Notably, this can also be utilized as a feature for supporting the automatic classification of dysphagia diagnosis. 

Keywords: Dysphagia; signals processing; surface electromyography (sEMG); swallowing disorder

ABSTRAK

Penilaian kuantitatif pesakit strok dengan risiko gangguan menelan atau disfagia diperlukan untuk menyokong diagnosis dan perencanaan rehabilitasi selanjutnya. Pengimejan sinar-X dengan kaedah fluoroskopi saat ini sering digunakan untuk diagnosis disfagia, walaupun ia menyebabkan pendedahan radiasi kepada pesakit. Oleh itu, kuantifikasi pola koordinasi daripada otot yang terkait pada proses menelan berdasarkan elektromiografi permukaan (sEMG) diusulkan. Walaupun demikian, standard kuantifikasi sEMG untuk diagnosis disfagia masih lemah. Dalam kajian ini, potensi ciri sEMG, antara lain durasi kontraksi (DUR), waktu ke puncak kontraksi maksimum (TTP) dan daya RMS total (TP) perlu dilakukan penilaian lebih lanjut untuk mengenal pasti proses menelan pada subjek yang sihat dan pasca penyakit strok. Skema uji kaji mengarahkan peserta  yang terdiri daripada 20 subjek sihat dan 20 pesakit, untuk menelan 3 mL air dalam mod menelan normal dan menelan air liur dalam mod menelan kering. Prosedur pemprosesan isyarat yang diusulkan untuk menentukan ciri pengekstrakan daripada ketiga ciri yang disebutkan. Untuk penilaian disfagia, dengan prosedur pemprosesan isyarat yang diusulkan, DUR dan TTP dapat digunakan bersama untuk meningkatkan keberkesanan diagnosis. Kedua ciri pada subjek yang sihat adalah lebih pendek daripada pesakit pasca strok. Selain itu, ciri TP berguna sebagai maklumat tambahan untuk menilai peranan kelompok otot suprahoid (SUP) dan infrahoid (INF) yang sangat penting dalam proses menelan. Hasil daripada penelitian ini memberikan ciri untuk pengkelasan diagnosis automatik disfagia.

Kata kunci: Disfagia; elektromiografi permukaan (sEMG); gangguan menelan; pemprosesan isyarat

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*Corresponding author; email: supri@tf.itb.ac.id