Electromyographic Biofeedback for Rehabilitation of Oropharyngeal Dysphagia in Stroke Patients: A Narrative Review

Abstract

Background: Oropharyngeal dysphagia is a swallowing impairment that frequently occurs as a consequence of stroke, affecting a significant portion of survivors and leading to severe clinical complications like aspiration pneumonia, malnutrition, and dehydration. Stroke-induced neurogenic disorders typically result in weakness and reduced endurance of the oral and pharyngeal musculature, disrupting the precisely coordinated stages of normal swallowing. Early and accurate management is vital to mitigate these risks. Purpose: This narrative review aimed to explore the physiological mechanisms of normal swallowing, examine current clinical and instrumental assessment methods, and evaluate the efficacy of surface electromyography (sEMG) as a quantitative tool and biofeedback mechanism in the rehabilitation of post-stroke oropharyngeal dysphagia. Methods: By searching for papers published between 2004 and 2024 that were relevant, a thorough literature search was performed using PubMed, Cochrane Library, Web of Science, Scopus, and Google Scholar. We only considered observational studies, systematic reviews, meta-analyses, and randomized controlled trials (RCTs) that were published in English.Results: Literature demonstrates that sEMG provides objective, real-time data on the timing and amplitude of suprahyoid muscle contractions during deglutition, enhancing motor learning and patient engagement. Quantitative outcomes show that intensive rehabilitation utilizing sEMG biofeedback significantly increases baseline suprahyoid muscle amplitude in subacute stroke patients. Conclusion: Surface EMG serves as a highly effective, non-invasive tool in dysphagia rehabilitation. By targeting the suprahyoid muscle, sEMG biofeedback significantly enhances volitional muscle recruitment and improves swallowing.