Relationship Between Swallowing Dynamics and Suprahyoid Muscle Activity in Sarcopenic Dysphagia

NCT07198568 | Recruiting DMC

• 1 other identifier: 2024-04-012
• Study Type: observational
• Target: 50
• Locations: 1 country
• Sites: 1

Brief Summary

Sarcopenic dysphagia is defined as swallowing difficulty among the elderly due to the loss of whole body skeletal and swallowing muscle mass and function. However, the pathophysiology and dynamics of swallowing in sarcopenic dysphagia have been poorly investigated. Therefore, the present study aims to investigate the characteristics of sarcopenic dysphagia using the Videofluoroscopic study (VFSS) focusing on each phase of dysphagia, and surface Electromyography (surface EMG) to assess suprahyoid muscle activity. In sarcopenic dysphagia, impairments will occur in both the oral and pharyngeal phases, particularly affecting bolus formation, premature bolus spillage and laryngeal elevation during swallowing due to the loss of swallowing muscle mass and function. These changes will be considered to have led to an change of duration and amplitude of suprahyoid muscle activity measured via surface EMG.

Conditions

Sarcopenia in Elderly; Dysphagia

Outcome Measures

Primary Outcomes (4)

• Amplitude of suprahyoid muscle activity: Surface electromyography data

  The measurement parameters included the mean and maximum amplitudes of suprahyoid muscle activation during swallowing. Amplitude values were normalized relative to the amplitude observed during jaw opening contraction (JOC). Both mean and maximum amplitudes were subsequently expressed as percentages of the jaw opening contraction (%JOC).

  Baseline

• Total duration of suprahyoid muscle activity: Surface electromyography data

  The onset of swallowing was defined as the point at which a distinct visual increase in sEMG activity above the background level was observed and the end point of swallowing was determined as the moment when the sEMG trace returned to within +2 standard deviations (SDs) of the baseline amplitude level. The baseline amplitude was calculated as the average amplitude during a 1 second period at rest from the start of the sEMG trace.

  Baseline

• Onset to peak duration of suprahyoid muscle activity: Surface electromyography data

  duration from the swallowing onset to the maximum amplitude point

  Baseline

• Peak to onset duration of suprahyoid muscle activity: Surface electromyography data

  duration from the maximum amplitude point to the end of the swallowing

  Baseline

Secondary Outcomes (4)

• Videofluoroscopic dysphagia scale (VDS) that assessed by Videofluoroscopic swallowing study (VFSS)

  baseline

• Penetration aspiration scale (PAS) that assessed by Videofluoroscopic swallowing study (VFSS)

  Baseline

• Parramatta Hospital's assessment of dysphagia that assessed by Videofluoroscopic swallowing study (VFSS)

  Baseline

• American Speech-Language-Hearing Association National Outcome Measurement System swallowing scale (ASHA NOMS scale) that assessed by Videofluoroscopic swallowing study (VFSS)

  Baseline

Study Arms (2)

Aspiration group

-Dysphagic group: Participants with a Penetration Aspiration score (PAS) of 6 points or higher that observed by Videofluoroscopic swallowing study were considered to have dysphagia

Diagnostic Test: Surface electromyography; Diagnostic Test: Videofluoroscopic swallowing study (VFSS)

Non-aspiration group

Participants with a Penetration Aspiration score (PAS) of 5 points or lower that observed by Videofluoroscopic swallowing study

Diagnostic Test: Surface electromyography; Diagnostic Test: Videofluoroscopic swallowing study (VFSS)

Interventions

Surface electromyography DIAGNOSTIC_TEST

A previous other study has examined the suprahyoid muscle activity patterns in sarcopenic dysphagia patients using surface electromyography (sEMG). However, there was a lack of research analyzing the swallowing dynamics of sarcopenic dysphagia alongside Videofluoroscopic Swallowing Study (VFSS). VFSS enables the observation of swallowing in phases, offering a crucial method for assessing the presence of dysphagia and identifying the specific phases where dysphagia occurs. Therefore, the present study aims to investigate the characteristics of sarcopenic dysphagia across phases using sEMG and VFSS. Additionally, the investigators aim to analyze the relationship between suprahyoid muscle activity patterns and swallowing dynamics utilizing these modalities.

Aspiration group; Non-aspiration group

Videofluoroscopic swallowing study (VFSS) DIAGNOSTIC_TEST

VFSS enables the observation of swallowing in phases, offering a crucial method for assessing the presence of dysphagia and identifying the specific phases where dysphagia occurs. The investigators will utilize Videofluoroscopic Dysphagia Scale (VDS), that composed of fourteen categories, which can be divided into oral and pharyngeal phases to assess scores based on VFSS results. The oral phase composed of 7 items (lip closure, bolus formation, mastication, apraxia, tongue-to-palate contact, premature bolus loss, and oral transit time). The pharyngeal phase also included 7 items (triggering of pharyngeal swallowing, vallecular residues, pyriform sinus residues, laryngeal elevation, coating of pharyngeal wall, pharyngeal transit time, and aspiration). VDS can assess the components of dysphagia in such detail. Therefore, investigators can evaluate the etiology of dysphagia more precisely.

Aspiration group; Non-aspiration group

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients admitted at an Inha University Hospital, tertial general hospital in Republic of Korea and referred to the department of physical and rehabilitation medicine to evaluate for presence of dysphagia and meet the inclusion criteria specified above.

You may qualify if:

• years of age or older who underwent VFSS to evaluate the presence of dysphagia
• Patient who diagnosed with sarcopenia based on the cutoff values of the Asian Working Group for Sarcopenia (AWGS) 2019
• Cognitive ability to follow instructions for Videofluoroscopic swallowing study, surface electromyography.

You may not qualify if:

• History of cerebral hemorrhage or cerebral infarction
• History of neuromuscular diseases that could lead to dysphagia such as Parkinson's disease, amyotrophic lateral sclerosis, Guillain-Barre disease
• History of Tracheostomy
• History of oropharyngeal cancer
• History of esophageal structural disease that could lead to dysphagia
• History of connective tissue disease
• History of cervical surgical procedure
• Cognitive impairment who cannot follow instructions for Videofluoroscopic swallowing study, surface electromyography

Sponsors & Collaborators

• Inha University Hospital: lead

Study Sites (1)

Inha University Hospital

Incheon, Jung-gu, 22332, South Korea

RECRUITING

Related Publications (14)

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  PMID: 33116453 RESULT

MeSH Terms

Conditions

Deglutition Disorders

Interventions

Electromyography

Condition Hierarchy (Ancestors)

Esophageal Diseases; Gastrointestinal Diseases; Digestive System Diseases; Pharyngeal Diseases; Otorhinolaryngologic Diseases

Intervention Hierarchy (Ancestors)

Electrodiagnosis; Diagnostic Techniques and Procedures; Diagnosis; Myography

Central Study Contacts

Moon Jung Kim

CONTACT

+821055605875; rlaanswjd1997@gmail.com

Kyung Lim Joa

CONTACT

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: M.D. PhD.

Study Record Dates

• First Submitted: September 15, 2025
• First Posted: September 30, 2025
• Study Start: June 3, 2024
• Primary Completion: March 1, 2026
• Study Completion: April 1, 2026
• Last Updated: March 6, 2026

Record last verified: 2026-03

Locations

KR (1)