JMIR Publications

ABSTRACT

Background:

Dysphagia is common in intensive care (ICU) patients. Using surface electromyography (sEMG) signals as biofeedback training exercises might offer a promising path to improving swallowing function. The Rephagia® biofeedback system uses sEMG to assess muscle strength, stamina and timing of the swallowing action.

Objective:

The aim of this study was to evaluate the feasibility of the Rephaghia system in ICU patients with dysphagia.

Methods:

This feasibility study included patients admitted to a 14-bed mixed medical-surgical ICU. All patients underwent a new tracheostomy placement during ICU stay due to persistent aspiration and ICU acquired weakness, accompanied by verified dysphagia. Following Rephagia training, patients completed a questionnaire assessing comprehension, satisfaction, and motivation. Swallowing characteristics were assessed via mean sEMG peak values during exercise.

Results:

Twenty patients with a mean age of 69.4±8.2 were included. The means of sEMG values at the beginning of a measurement were not significantly different at baseline versus everyone’s last measurement (52 µV±23 µV vs.57 µV±22 µV; P= 0.503). The means of sEMG values obtained at the end of a measurement were not significantly different at baseline versus everyone’s last measurement (56 µV ± 18 µV vs 59 µV±23 µV; P=0.622). However, in all patients dysphagia improved. Patients understood the importance of the game in relation to their swallowing problems (89%), which kept them motivated to participate in the training sessions (>50%).

Conclusions:

The Rephagia biofeedback system for stimulating swallowing actions in dysphagic tracheotomized ICU patients is feasible. No relation was found between clinical improvement in swallowing function and sEMG signals.