European Archives of Oto-Rhino-Laryngology

, Volume 274, Issue 2, pp 989–995 | Cite as

Identification of the most significant electrode positions in electromyographic evaluation of swallowing-related movements in humans

  • E. Zaretsky
  • P. Pluschinski
  • R. Sader
  • P. Birkholz
  • C. Neuschaefer-Rube
  • Christiane Hey
Head and Neck


Surface electromyography (sEMG) is a well-established procedure for recording swallowing-related muscle activities. Because the use of a large number of sEMG channels is time consuming and technically sophisticated, the aim of this study was to identify the most significant electrode positions associated with oropharyngeal swallowing activities. Healthy subjects (N = 16) were tested with a total of 42 channels placed in M. masseter, M. orbicularis oris, submental and paralaryngeal regions. Each test subject swallowed 10 ml of water five times. After having identified 16 optimal electrode positions, that is, positions with the strongest signals quantified by the highest integral values, differences to 26 other ones were determined by a Mann–Whitney U test. Kruskal–Wallis H test was utilized for the analysis of differences between single subjects, subject subgroups, and single electrode positions. Factors associated with sEMG signals were examined in a linear regression. Sixteen electrode positions were chosen by a simple ranking of integral values. These positions delivered significantly higher signals than the other 26 positions. Differences between single electrode positions and between test subjects were also significant. Sixteen most significant positions were identified which represent swallowing-related muscle potentials in healthy subjects.


sEMG Surface electromyography Swallowing Oropharyngeal Dysphagia 


Compliance with ethical standards

Financial disclosure information


Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Doty RW, Bosma JF (1956) An electromyographic analysis of reflex deglutition. J Neurophysiol 19(1):44–60PubMedGoogle Scholar
  2. 2.
    Palmer PM, Luschei ES, Jaffe D, McCulloch TM (1999) Contributions of individual muscles to the submental surface electromyogram during swallowing. J Speech Lang Hear Res 42(6):1378–1391CrossRefPubMedGoogle Scholar
  3. 3.
    Palmer JB, Rudin NJ, Lara G, Crompton AW (1992) Coordination of mastication and swallowing. Dysphagia 7(4):187–200CrossRefPubMedGoogle Scholar
  4. 4.
    Crary MA, Carnaby Mann GD, Groher ME (2006) Biomechanical correlates of surface electromyography signals obtained during swallowing by healthy adults. J Speech Lang Hear Res 49(1):186–193CrossRefPubMedGoogle Scholar
  5. 5.
    Koole P, de Jongh HJ, Boering G (1991) A comparative study of electromyograms of the masseter, temporalis, and anterior digastric muscles obtained by surface and intramuscular electrodes: raw-EMG. Cranio 9(3):228–240CrossRefPubMedGoogle Scholar
  6. 6.
    Suvinen TI, Malmberg J, Forster C, Kemppainen P (2009) Postural and dynamic masseter and anterior temporalis muscle EMG repeatability in serial assessments. J Oral Rehabil 36(11):814–820CrossRefPubMedGoogle Scholar
  7. 7.
    Vaiman M, Eviatar E, Segal S (2004) Evaluation of normal deglutition with the help of rectified surface electromyography records. Dysphagia 19(2):125–132CrossRefPubMedGoogle Scholar
  8. 8.
    Vaiman M, Eviatar E, Segal S (2004) Surface electromyographic studies of swallowing in normal subjects: a review of 440 adults. Report 1. Quantitative data: timing measures. Otolaryngol Head Neck Surg 131(4):548–555CrossRefPubMedGoogle Scholar
  9. 9.
    Vaiman M, Eviatar E, Segal S (2004) Surface electromyographic studies of swallowing in normal subjects: a review of 440 adults. Report 2. Quantitative data: amplitude measures. Otolaryngol Head Neck Surg 131(5):773–780CrossRefPubMedGoogle Scholar
  10. 10.
    Vaiman M, Eviatar E, Segal S (2004) Surface electromyographic studies of swallowing in normal subjects: a review of 440 adults. Report 3. Qualitative data. Otolaryngol Head Neck Surg 131(6):977–985CrossRefPubMedGoogle Scholar
  11. 11.
    McKeown MJ, Torpey DC, Gehm WC (2002) Non-invasive monitoring of functionally distinct muscle activations during swallowing. Clin Neurophysiol 113(3):354–366CrossRefPubMedGoogle Scholar
  12. 12.
    Steele CM, Bennett JW, Chapman-Jay S, Cliffe Polacco R, Molfenter SM, Oshalla M (2011) Electromyography as a biofeedback tool for rehabilitating swallowing muscle function. In: Steele CM (ed) Applications of EMG in clinical and sports medicine. InTech, Rijeka, pp 311–328Google Scholar
  13. 13.
    Huckabee ML, Steele CM (2006) An analysis of lingual contribution to submental surface electromyographic measures and pharyngeal pressure during effortful swallow. Arch Phys Med Rehabil 87(8):1067–1072CrossRefPubMedGoogle Scholar
  14. 14.
    Steele CM, Huckabee ML (2007) The influence of orolingual pressure on the timing of pharyngeal pressure events. Dysphagia 22(1):30–36CrossRefPubMedGoogle Scholar
  15. 15.
    Huckabee ML, Butler SG, Barclay M, Jit S (2005) Submental surface electromyographic measurement and pharyngeal pressures during normal and effortful swallowing. Arch Phys Med Rehabil 86(11):2144–2149CrossRefPubMedGoogle Scholar
  16. 16.
    Wheeler-Hegland KM, Rosenbek JC, Sapienza CM (2008) Submental sEMG and hyoid movement during Mendelsohn maneuver, effortful swallow, and expiratory muscle strength training. J Speech Lang Hear Res 51(5):1072–1087CrossRefPubMedGoogle Scholar
  17. 17.
    Stepp CE (2012) Surface electromyography for speech and swallowing systems: measurement, analysis, and interpretation. J Speech Lang Hear Res 55(4):1232–1246CrossRefPubMedGoogle Scholar
  18. 18.
    De Luca CJ (1997) The use of surface electromyography in biomechanics. J of Appl Biomech 13:135–163CrossRefGoogle Scholar
  19. 19.
    Hermens HJ, Freriks B, Merletti R, Hägg GG, Stegeman D, Blok J, Rau G, Disselhorst-Klug C, Hägg G (1999) European recommendations for surface electromyography. Results of the SENIAM project. Roessingh Research and Development, Enschede. CD-ROMGoogle Scholar
  20. 20.
    Hermens HJ, Freriks B, Disselhorst-Klug C, Rau G (2000) Development of recommendations for SEMG sensors and sensor placement procedures. J Electromyogr Kinesiol 10(5):361–374CrossRefPubMedGoogle Scholar
  21. 21.
    De Luca CJ, Gilmore LD, Kuznetsov M, Roy SH (2010) Filtering the surface EMG signal: movement artifact and baseline noise contamination. J Biomech 43(8):1573–1579CrossRefPubMedGoogle Scholar
  22. 22.
    Hugger S, Schindler HJ, Kordass B, Hugger A (2012) Clinical relevance of surface EMG of the masticatory muscles. (Part 1): resting activity, maximal and submaximal voluntary contraction, symmetry of EMG activity. Int J Comput Dent 15(4):297–314PubMedGoogle Scholar
  23. 23.
    Ko EW, Teng TT, Huang CS, Chen YR (2015) The effect of early physiotherapy on the recovery of mandibular function after orthognathic surgery for class III correction. Part II: electromyographic activity of masticatory muscles. J Craniomaxillofac Surg 43(1):138–143CrossRefPubMedGoogle Scholar
  24. 24.
    van den Engel-Hoek L, de Groot IJ, Esser E, Gorissen B, Hendriks JC, de Swart BJ, Geurts AC (2012) Biomechanical events of swallowing are determined more by bolus consistency than by age or gender. Physiol Behav 106(2):285–290CrossRefPubMedGoogle Scholar
  25. 25.
    Reyes A, Cruickshank T, Thompson J, Ziman M, Nosaka K (2014) Surface electromyograph activity of submental muscles during swallowing and expiratory muscle training tasks in Huntington’s disease patients. J Electromyogr Kinesiol 24(1):153–158CrossRefPubMedGoogle Scholar
  26. 26.
    Watts CR (2013) Measurement of hyolaryngeal muscle activation using surface electromyography for comparison of two rehabilitative dysphagia exercises. Arch Phys Med Rehabil 94(12):2542–2548CrossRefPubMedGoogle Scholar
  27. 27.
    Crary MA (1995) A direct intervention program for chronic neurogenic dysphagia secondary to brainstem stroke. Dysphagia 10(1):6–18CrossRefPubMedGoogle Scholar
  28. 28.
    Monaco A, Cattaneo R, Spadaro A, Giannoni M (2008) Surface electromyography pattern of human swallowing. BMC Oral Health 26(8):6CrossRefGoogle Scholar
  29. 29.
    Nagy A, Steele CM, Pelletier CA (2014) Barium versus nonbarium stimuli: differences in taste intensity, chemesthesis, and swallowing behavior in healthy adult women. J Speech Lang Hear Res 57(3):758–767CrossRefPubMedGoogle Scholar
  30. 30.
    Vaiman M, Nahlieli O (2009) Oral vs. pharyngeal dysphagia: surface electromyography randomized study. BMC Ear Nose Throat Disord 9:3CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Maria das Coriolano WS, Belo LR, Carneiro D, Asano AG, Al Oliveira PJ, da Silva DM, Lins OG (2012) Swallowing in patients with Parkinson’s disease: a surface electromyography study. Dysphagia 27(4):550–555CrossRefGoogle Scholar
  32. 32.
    Crary MA, Carnaby Mann GD, Groher ME, Helseth E (2004) Functional benefits of dysphagia therapy using adjunctive sEMG biofeedback. Dysphagia 19(3):160–164CrossRefPubMedGoogle Scholar
  33. 33.
    Van Houtte E, Claeys S, D’haeseleer E, Wuyts F, Van Lierde K (2013) An examination of surface EMG for the assessment of muscle tension dysphonia. J Voice 27(2):177–186CrossRefPubMedGoogle Scholar
  34. 34.
    Lapatki BG, Van Dijk JP, Jonas IE, Zwarts MJ, Stegeman DF (2004) A thin, flexible multielectrode grid for high-density surface EMG. J Appl Physiol 96(1):327–336CrossRefPubMedGoogle Scholar
  35. 35.
    Lapatki BG, Oostenveld R, Van Dijk JP, Jonas IE, Zwarts MJ, Stegeman DF (2006) Topographical characteristics of motor units of the lower facial musculature revealed by means of high-density surface EMG. J Neurophysiol 95(1):342–354CrossRefPubMedGoogle Scholar
  36. 36.
    Lapatki BG, Oostenveld R, Van Dijk JP, Jonas IE, Zwarts MJ, Stegeman DF (2010) Optimal placement of bipolar surface EMG electrodes in the face based on single motor unit analysis. Psychophysiology 47(2):299–314CrossRefPubMedGoogle Scholar
  37. 37.
    Loeb GE, Gans C (1986) Electromyography for experimentalists, 1st edn. The University of Chicago Press, ChicagoGoogle Scholar
  38. 38.
    Macrae PR, Myall DJ, Jones RD, Huckabee ML (2011) Pharyngeal pressures during swallowing within and across three sessions: within-subject variance and order effects. Dysphagia 26(4):385–391CrossRefPubMedGoogle Scholar
  39. 39.
    Hof AL (1984) EMG and muscle force: an introduction. Hum Mov Sci 3(1):119–153CrossRefGoogle Scholar
  40. 40.
    Ertekin C, Pehlivan M, Aydoğdu I, Ertaş M, Uludağ B, Celebi G, Colakoğlu Z, Sağduyu A, Yüceyar N (1995) An electrophysiological investigation of deglutition in man. Muscle Nerve 18(10):1177–1186CrossRefPubMedGoogle Scholar
  41. 41.
    Ding R, Larson CR, Logemann JA, Rademaker AW (2002) Surface electromyographic and electroglottographic studies in normal subjects under two swallow conditions: normal and during the Mendelsohn maneuver. Dysphagia 17(1):1–12CrossRefPubMedGoogle Scholar
  42. 42.
    Tallgren A, Tryde G (1992) Swallowing activity of lip muscles in patients with a complete upper and a partial lower denture. J Oral Rehabil 19(4):329–341CrossRefPubMedGoogle Scholar
  43. 43.
    Gay T, Rendell JK, Spiro J (1994) Oral and laryngeal muscle coordination during swallowing. Laryngoscope 104(3 Pt 1):341–349PubMedGoogle Scholar
  44. 44.
    Spiro J, Rendell JK, Gay T (1994) Activation and coordination patterns of the suprahyoid muscles during swallowing. Laryngoscope 104(11 Pt 1):1376–1382PubMedGoogle Scholar
  45. 45.
    Perlman AL, Palmer PM, McCulloch TM, Vandaele DJ (1999) Electromyographic activity from human laryngeal, pharyngeal, and submental muscles during swallowing. J Appl Physiol 86(5):1663–1669PubMedGoogle Scholar
  46. 46.
    Kendall K (2002) Oropharyngeal swallowing variability. Laryngoscope 112(3):547–551CrossRefPubMedGoogle Scholar
  47. 47.
    Molfenter SM, Leigh C, Steele CM (2014) Event sequence variability in healthy swallowing: building on previous findings. Dysphagia 29(2):234–242CrossRefPubMedPubMedCentralGoogle Scholar
  48. 48.
    Dodds WJ, Taylor AJ, Stewart ET, Kern MK, Logemann J, Cook IJ (1989) Tipper and dipper types of oral swallows. AJR Am J Roentgenol 153(6):1197–1199CrossRefPubMedGoogle Scholar
  49. 49.
    Vaiman M, Segal S, Eviatar E (2004) Surface electromyographic studies of swallowing in normal children, age 4–12 years. Int J Pediatr Otorhinolaryngol 68(1):65–73CrossRefPubMedGoogle Scholar
  50. 50.
    Wang CM, Chen JY, Chuang CC, Tseng WC, Wong AM, Pei YC (2015) Aging-related changes in swallowing, and in the coordination of swallowing and respiration determined by novel non-invasive measurement techniques. Geriatr Gerontol Int 15(6):736–744CrossRefPubMedGoogle Scholar
  51. 51.
    Sella O, Jones RD, Huckabee ML (2014) Age and gender effects on submental motor-evoked potentials. Age (Dordr) 36(6):9735CrossRefGoogle Scholar
  52. 52.
    Vaiman M, Gabriel C, Eviatar E, Segal S (2005) Surface electromyography of continuous drinking in healthy adults. Laryngoscope 115(1):68–73CrossRefPubMedGoogle Scholar
  53. 53.
    Moreno I, Sánchez T, Ardizone I, Aneiros F, Celemin A (2008) Electromyographic comparisons between clenching, swallowing and chewing in jaw muscles with varying occlusal parameters. Med Oral Patol Oral Cir Bucal 13(3):E207–E213PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • E. Zaretsky
    • 1
  • P. Pluschinski
    • 1
  • R. Sader
    • 2
  • P. Birkholz
    • 3
  • C. Neuschaefer-Rube
    • 4
  • Christiane Hey
    • 1
  1. 1.Department of Phoniatrics and Pediatric AudiologyUniversity Hospital of MarburgMarburgGermany
  2. 2.Center of Surgery, Clinic for Oral, Dental and Cosmetic Facial SurgeryUniversity Hospital of Frankfurt/MainFrankfurt/MainGermany
  3. 3.Institute for Acoustics and Speech Communication, Faculty for Electrical Engineering and Information TechnologyTechnische Universität DresdenDresdenGermany
  4. 4.Department of Phoniatrics and Pediatric AudiologyUniversity Hospital of AachenAachenGermany

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