Effects of Surface Electromyography Biofeedback to Conventional Swallowing Therapy in Post-Stroke Dysphagia: A Systematic Review

Abstract

Dysphagia is common in post-stroke patients. Various rehabilitation techniques can aid the swallowing disorder in post-stroke dysphagia. Surface electromyography (sEMG) biofeedback is thought to improve clinical outcomes in patients with post-stroke dysphagia. This systematic review aims to determine the effect of providing sEMG intervention on swallowing disorders in post-stroke dysphagia patients. Systematic review, which used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach, included patients aged 18 and older with post-stroke dysphagia who received sEMG biofeedback intervention compared to a control group or no control group (comparing before and after intervention only). The risk of bias was assessed using the Cochrane Risk of Bias Tool (RoB 1) for RCTs and the Agency for Healthcare Research and Quality (AHRQ) evaluation for non-RCTs. Three articles demonstrated clinical improvement after sEMG biofeedback compared to a control group. One article demonstrated clinical improvement after sEMG biofeedback compared to before the intervention. However, two articles demonstrated no significant difference in the severity and clinical outcomes of post-stroke dysphagia patients after sEMG biofeedback compared to a control group. Four studies showed that sEMG biofeedback can improved several parameters of post-stroke dysphagia; however, two studies did not show any significant difference in improvement effects between the intervention and control groups.