Feasibility of game-based electromyographic biofeedback for dysphagia rehabilitation

Dysphagia (abnormal swallowing) is widely prevalent in the neurologically impaired and can result from both motor weakness and degraded sensory feedback. We present a system to pair augmentative sensory feedback through surface electromyography biofeedback with video game play for dysphagia rehabilitation. This system was employed with an individual with dysphagia as a result of brainstem stroke and compared against 6 unimpaired individuals. Initial results indicate high usability of the system and identify two objective measures with potential for differentiating control participants from the individual with dysphagia. Both gaming performance and the neck intermuscular beta coherence were decreased for the individual with dysphagia relative to control participants. Performance during gameplay is an estimate of the ability to voluntarily modulate neck muscle activity, whereas intermuscular coherence in the beta band may be representative of transmission from the primary motor cortex to muscle.