A Study on the Parameters of Submental Muscle Surface Electromyography and Their Correlation with Aspiration Risk in Post-Stroke Dysphagia Patients Based on Videofluoroscopic Swallowing Study

ObjectiveTo investigate the parameters of submental muscle surface electromyography （sEMG） in patients with post-stroke dysphagia based on videofluoroscopic swallowing study （VFSS），and to explore their correlation with aspiration risk.MethodsA total of 47 patients with post-stroke dysphagia who were hospitalized in the Department of Rehabilitation Medicine，Shijiazhuang People's Hospital from July 2023 to July 2024 and met the above inclusion criteria were selected. Patients were evaluated using the Rosenbek Penetration-Aspiration Scale （PAS）. Those with PAS grades 1–4 were included in the non-aspiration group （n=15），and those with PAS grades 5–8 were included in the aspiration group （n=32）. VFSS was used to dynamically observe the swallowing process of different food consistencies （e. g. ，thin liquid，paste），and PAS was employed to assess aspiration risk. sEMG was used to record the myoelectric activity of the bilateral submental muscles during swallowing of 5 mL of warm water to obtain surface myoelectric signals. The root mean square （RMS），average electromyographic amplitude （AEMG），and swallowing duration were compared between the unaffected and affected sides in both groups. Spearman correlation analysis was performed to evaluate the correlations between PAS grade and RMS，AEMG，and swallowing duration of the bilateral submental muscles.ResultsA total of 15 patients （31. 91%） had PAS grades 1–4，and 32 patients （68. 09%） had PAS grades 5–8. Compared with the affected submental muscle，both groups showed significantly higher RMS and AEMG on the unaffected side（P0. 05）. There was no statistically significant difference in swallowing duration on the unaffected side between the two groups （P0. 05）. Compared with the non-aspiration group，the aspiration group exhibited significantly higher RMS and AEMG on the unaffected submental muscle（P0. 05），as well as significantly longer swallowing duration on both the affected and unaffected sides（P0. 05）. PAS grade was negatively correlated with RMS on the affected submental muscle （rs = -0. 303，P=0. 039），and positively correlated with swallowing duration on both the affected and unaffected submental muscles （rs = 0. 661，P0. 001; rs=0. 625，P0. 001）.ConclusionThere are certain differences in sEMG parameters of the submental muscles between the affected and unaffected sides in patients with post-stroke dysphagia. Among them，the compensatory effect on the unaffected submental muscle is more pronounced in the aspiration group. Aspiration risk is negatively correlated with RMS on the affected submental muscle，and positively correlated with swallowing duration on both the affected and unaffected submental muscles.