Análisis del papel de la electromiografía de superficie en las alteraciones de la degluciónuna revisión sistemática

Résumé

Swallowing is a complex process involving the coordination of orofacial and pharyngeal muscles. Alterations in this process can have consequences that affect quality of life. Instrumental assessment includes videoendoscopy and videofluoroscopy, but these are expensive procedures or require experience and skill on the part of the examiner. For this reason, screening tests for dysphagia have emerged, including surface electromyography. In addition, surface electromyography can play an important role in the rehabilitation of these disorders. Method: A systematic review of the literature in four databases (Pubmed, Scopus, Web Of Science and Cochrane) was carried out by means of five searches in each database (combining surface electromyography with swallowing, masticatory musculature, suprahyoid musculature, lingual musculature and facial musculature) with the aim of analyzing the role of surface electromyography both in the assessment and treatment of swallowing disorders. For this purpose, PRISMA methodology is used, and a search algorithm is developed in Phyton language. Results: We applied the search algorithm in the Pubmed database, obtaining 153 results in contrast to the 424 obtained by the traditional method. Studies referring to other muscles or functions were excluded, as well as those studying the musculature involved, but not linked to swallowing. Unpublished studies, those carried out on animals, those written in Asian languages and those in which surface electromyography was not used were not taken into account. After eliminating duplicate studies and applying exclusion criteria, of the 1637 studies found, 116 studies are included in this review. 69 studies use surface electromyography as a way of evaluating the muscular activity involved in swallowing, 9 use it as biofeedback to improve the rehabilitation techniques for swallowing disorders, 27 use the technique to evaluate the improvement of other existing treatments to improve swallowing and 11 study the improvement of the technique or generate advances on it. Conclusions: The proposed search algorithm improves search efficiency and facilitates access to specific information. "Degglutition disorders" as a keyword loses importance to "Dysphagia". There is a growing trend to use surface electromyography in swallowing and Tel Aviv University and the University of Florida are the international reference in the field. Regarding the analysis of the studies, its use to evaluate suprahyoid muscle activity (duration and amplitude), by means of four-channel devices with Ag / AgCl electrodes, stands out. Studies with healthy people followed by people with dysphagia secondary to stroke or neurodegenerative diseases are the most common. When used to investigate the effectiveness of other treatments, it is usually with Shaker or ChinTuck Against Resistance (CTAR) techniques. On the other hand, when used as biofeedback, it is used in visual mode for learning the Forced Swallowing and Mendelsohn maneuver techniques. Surface electromyography is an evolving technique and this research is focused on the development of peripherals that adapt to the submental anatomy and the use of piezoelectric sensors