Research Article| Volume 26, ISSUE 6, P813.e1-813.e7, November 2012

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Incomplete Swallowing and Retracted Tongue Maneuvers for Electromyographic Signal Normalization of the Extrinsic Muscles of the Larynx

Published:October 08, 2012DOI:



      To investigate which muscular maneuvers provide larger electric activity (EA) of the suprahyoid (SH) and infrahyoid (IH) muscles to be used as surface electromyography (SEMG) signal normalization reference.


      The electrical potentials of the SH and IH muscles of 12 subjects were evaluated using six muscular maneuvers, involving the position of the tongue and effort. It was selected as maximum voluntary sustained activity maneuver, the one having the minor coefficient of variation and the smallest value for each muscle group. The EA signal was converted using the root mean square in microvolts. It was considered then the maximum signal of each maneuver as the difference between the mean of three measures and the resting potential.


      The maneuvers that provided higher mean potentials with minor coefficient of variation and smallest P value were incomplete swallowing (IS) with effort (mean potential equal to 56.73±8.68 with coefficient of variation of 15.30%) in SH group, and tongue retracted with mouth open (TROM, mean potential equal to 46.57±7.83 with coefficient of variation of 16.81%) in IH group.


      The IS with effort and TROM maneuvers should be considered for signal normalization in these muscles, respectively, and may provide conditions for using the SEMG in voice clinic.


      The use of normalization standards in researches of SH and IH muscles in the voice area will allow comparisons among future works.

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        • Hermens H.
        • Freriks B.
        European Recommendations for Surface Electromyography. Results of the SENIAM Project.
        ([CD-ROM]) Roessingh Research and Development, Enschede, The Netherlands1999 (ISBN 90-75452-14)
        • Redenbaugh M.A.
        • Reich A.R.
        Surface EMG and related measures in normal and vocally hyperfunctional speakers.
        J Speech Hear Disord. 1989; 54: 68-73
        • Hocevar-Boltezar I.
        • Janko M.
        • Zargi M.
        Role of surface EMG in diagnostics and treatment of muscle tension dysphonia.
        Acta Otolaryngol. 1998; 118: 739-743
        • Pettersen V.
        • Westgaard R.
        The activity patterns of neck muscles in professional classical singing.
        J Voice. 2004; 19: 238-251
        • Guirro R.R.J.
        • Bigaton D.R.
        • Silvério K.C.A.
        • Berni K.C.S.
        • Distéfano G.
        • Santos F.L.
        • et al.
        Transcutaneous electric nerve stimulation in dysphonic women.
        Pro fono. 2008; 20: 189-194
        • Andrade C.R.F.
        • Sassi F.C.
        • Juste F.S.
        • Ercolin B.
        Modeling of the fluency with the use of the surface electromyograph: pilot study.
        Pro fono. 2008; 20: 129-132
        • Stepp C.E.
        • Heaton J.T.
        • Braden M.N.
        • Jette M.E.
        • Stadelman-Cohen T.K.
        • Hillman R.E.
        Comparison of neck tension palpation rating systems with surface electromyographic and acoustic measures in vocal hyperfunction.
        J Voice. 2011; 25: 67-75
        • Burden A.
        How should we normalize electromyograms obtained from healthy participants? What we have learned from over 25 years of research?.
        J Electromyogr Kinesiol. 2010; 20: 1023-1035
      1. Moraes KJR, Cunha RA, Bezerra LA, Cunha DA, Silva HJ. Surface electromyography: proposal of a protocol for cervical muscles. Rev CEFAC 2011. [Epub ahead of print].

        • Masuda K.
        • Masuda T.
        • Sadoyama T.
        • Inaki M.
        • Katsuta S.
        Changes in surface EMG parameters during static and dynamic fatiguing contractions.
        J Electromyogr Kinesiol. 1999; 9: 39-46
        • Stager S.
        • Bielamowicz S.A.
        • Regnell J.R.
        • Gupta A.
        • Barkmeier J.M.
        Supraglottic activity: evidence of vocal hyperfunction or laryngeal articulation?.
        J Speech Lang Hear Res. 2000; 43: 229-238
        • Vaiman M.
        • Shoval G.
        • Gavriel H.
        The electrodiagnostic psychogenic swallowing disorders.
        Eur Arch Otorhinolaryngol. 2008; 265: 663-668
        • Behlau M.
        • Madazio G.
        • Feijó D.
        • Azevedo R.
        • Gielow I.
        • Rehder M.I.
        Vocal improvement and speech therapy of disphonia.
        in: Voice. The Expertise Book. 2. Revinter, São Paulo, Brazil2001: 410-564
        • Palmer P.M.
        • Jaffe D.M.
        • McCulloch T.M.
        • Finnegan E.M.
        • van Daele D.J.
        • Luschei E.S.
        Quantitative contributions of the muscles of the tongue, floor-of-mouth, jaw, and velum to tongue-to-palate pressure generation.
        J Speech Lang Hear Res. 2008; 51: 828-835
        • Vaiman M.
        • Segal S.
        • Eviatar E.
        Surface electromyographic studies of swallowing in normal children, age 4-12 years.
        Int J Pediatr Otorhinolaryngol. 2004; 68: 65-73
        • McKeown M.J.
        • Torpey D.C.
        • Gehm W.C.
        Non-invasive monitoring of functionally distinct muscle activations during swallowing.
        Clin Neurophysiol. 2002; 113: 354-366
        • Netto K.J.
        • Burnett A.F.
        Reliability of normalization methods for EMG analysis of neck muscles.
        Work. 2006; 26: 123-130
        • Balata P.M.M.
        • Nascimento G.K.B.O.
        • Andrade G.M.
        • Moraes S.R.A.
        • Cunha R.A.
        • Silva H.J.
        Proposal of protocol for electromyographic evaluation of larynx extrinsic muscles in voice clinic.
        Braz J Oral Sci. 2010; 9: 277