title: Expiratory muscle strength training evaluated with simultaneous high-resolution manometry and electromyography.
abstract: To examine feasibility of a simultaneous high-resolution pharyngeal manometry (HRM) and electromyography (EMG) experimental paradigm to detect swallowing-related patterns of palatal, laryngeal, and pharyngeal muscle activity during expiratory training.
  
  
  
  Technical report.
  
  
  
  Simultaneous HRM, surface submental, and intramuscular EMG were acquired in two healthy participants during five tasks: 10-cc water swallow, maximum expiratory pressure (MEP) testing, and expiratory muscle strength training (EMST) at three pressure levels (sham, 50%, and 75% MEP).
  
  
  
  Experimental conditions were feasible. Velopharyngeal closing pressure, palate EMG activity, and pharyngeal EMG activity increased as expiratory load increased. In contrast, thyroarytenoid EMG activity was low during the expiratory task, consistent with glottic opening during exhalation. Submental EMG patterns were more variable during expiratory tasks. Intraluminal air pressures recorded with HRM were correlated with measured expiratory pressures and target valve-opening pressures of the EMST device.
  
  
  
  Results suggest that a simultaneous HRM/EMG/EMST paradigm may be used to detect previously unquantified swallowing-related muscle activity during EMST, particularly in the palate and pharynx. Our approach and initial findings will be helpful to guide future hypothesis-driven studies and may enable investigators to evaluate other muscle groups active during these tasks. Defining mechanisms of action is a critical next step toward refining therapeutic algorithms using EMST and other targeted treatments for populations with dysphagia and airway disorders.
  
  
  
  4. Laryngoscope, 127:797-804, 2017.
authors.affiliation: Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, Texas, U.S.A.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Hutcheson
authors.affiliation: Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin-Madison, Madison, Wisconsin, U.S.A.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Hammer
authors.affiliation: Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin-Madison, Madison, Wisconsin, U.S.A.
authors.forename: Sarah P
authors.initials: SP
authors.lastname: Rosen
authors.affiliation: Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin-Madison, Madison, Wisconsin, U.S.A.|Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, Wisconsin, U.S.A.|Neuroscience Training Program, University of Wisconsin-Madison, Madison, Wisconsin, U.S.A.
authors.forename: Corinne A
authors.initials: CA
authors.lastname: Jones
authors.affiliation: Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin-Madison, Madison, Wisconsin, U.S.A.|Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, Wisconsin, U.S.A.
authors.forename: Timothy M
authors.initials: TM
authors.lastname: McCulloch
mesh_terms: D003679:Deglutition / Q000502:physiology; D004576:Electromyography / Q000379:methods*; D005081:Exercise Therapy / Q000379:methods*; D045853:Exhalation / Q000502:physiology; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D008365:Manometry / Q000379:methods*; D053580:Muscle Strength / Q000502:physiology*; D010609:Pharyngeal Muscles / Q000502:physiology; D012016:Reference Values; D012494:Sampling Studies; D055158:Velopharyngeal Sphincter / Q000502:physiology*; D055815:Young Adult
keywords: High-resolution manometry; electromyography; expiratory muscle strength training; swallowing