Expiratory muscle strength training evaluated with simultaneous high-resolution manometry and electromyography

Area of Science:

• Physiology
• Biomedical Engineering
• Clinical Research

Background:

• Swallowing disorders (dysphagia) and airway issues often require targeted therapeutic interventions.
• Expiratory muscle strength training (EMST) is a common treatment, but its precise mechanisms of action on muscle activity are not fully understood.
• Simultaneous physiological measurements can provide deeper insights into muscle function during therapeutic tasks.

Purpose of the Study:

• To assess the feasibility of a combined high-resolution pharyngeal manometry (HRM) and electromyography (EMG) setup.
• To investigate swallowing-related muscle activity patterns in the palate, larynx, and pharynx during expiratory training.
• To establish a novel experimental paradigm for evaluating muscle engagement during EMST.

Main Methods:

• A technical report detailing a simultaneous HRM, surface submental EMG, and intramuscular EMG acquisition protocol.
• Data collected from two healthy participants performing water swallows, maximum expiratory pressure (MEP) tests, and EMST at varying pressure levels.
• Correlation analysis between HRM pressure readings and EMST device parameters.

Main Results:

• The simultaneous HRM/EMG experimental paradigm was found to be feasible.
• Increased expiratory load during EMST correlated with elevated velopharyngeal closing pressure and EMG activity in the palate and pharynx.
• Thyroarytenoid EMG activity remained low during exhalation, and submental EMG patterns showed variability.

Conclusions:

• The developed HRM/EMG/EMST paradigm can detect and quantify previously unmeasured muscle activity during expiratory training, especially in the palate and pharynx.
• This approach offers a foundation for future hypothesis-driven research into muscle function during swallowing and respiratory tasks.
• Understanding these mechanisms is crucial for refining therapeutic strategies for dysphagia and airway disorders using EMST.