title: Automated detection and evaluation of swallowing using a combined EMG/bioimpedance measurement system.
abstract: BACKGROUND
  Developing an automated diagnostic and therapeutic instrument for treating swallowing disorders requires procedures able to reliably detect and evaluate a swallow. We tested a two-stage detection procedure based on a combined electromyography/bioimpedance (EMBI) measurement system. EMBI is able to detect swallows and distinguish them from similar movements in healthy test subjects.
  
  
  METHODS
  The study was planned and conducted as a case-control study (EA 1/019/10, and EA1/160/09, EA1/161/09).
  
  
  METHODS
  The study looked at differences in swallowing parameters in general and in the event of penetration during swallows in healthy subjects and in patients with an oropharyngeal swallowing disorder. A two-stage automated swallow detection procedure which used electromyography (EMG) and bioimpedance (BI) to reliably detect swallows was developed.
  
  
  RESULTS
  Statistically significant differences between healthy subjects and patients with a swallowing disorder were found in swallowing parameters previously used to distinguish between swallowing and head movements. Our two-stage algorithm was able to reliably detect swallows (sensitivity = 96.1%, specificity = 97.1%) on the basis of these differences.
  
  
  CONCLUSIONS
  Using a two-stage detection procedure, the EMBI measurement procedure is able to detect and evaluate swallows automatically and reliably. The two procedures (EMBI + swallow detection) could in future form the basis for automated diagnosis and treatment (stimulation) of swallowing disorders.
authors.affiliation: Ear, Nose and Throat Unit, Unfallkrankenhaus Berlin, Warener Straße 7, 12683 Berlin, Germany.
authors.forename: Corinna
authors.identifier: 0000-0003-4274-2339
authors.initials: C
authors.lastname: Schultheiss
authors.affiliation: Control Systems Group, Technische Universität Berlin, Germany.
authors.forename: Thomas
authors.identifier: 0000-0002-0865-4418
authors.initials: T
authors.lastname: Schauer
authors.affiliation: Control Systems Group, Technische Universität Berlin, Germany.
authors.forename: Holger
authors.identifier: 0000-0002-4796-1082
authors.initials: H
authors.lastname: Nahrstaedt
authors.affiliation: Ear, Nose and Throat Unit, Unfallkrankenhaus Berlin, Warener Straße 7, 12683 Berlin, Germany.
authors.forename: Rainer O
authors.initials: RO
authors.lastname: Seidl
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000628:therapy; D017097:Electric Impedance; D004576:Electromyography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged