Reliable Dysphagia monitoring

Swallowing disorders are common after stroke and screening is recommended to identify patients at risk of aspiration and infection. Screening aims to identify those at risk for further endoscopic or videofluoroscopic investigation but it is not easy to carry out this screening with accuracy or indeed monitor the effectiveness of management.

Whilst qualitative measures are sometimes relied upon, quantitative measurement of swallowing represents a step forward and this is the aim of RehaIngest. RehaIngest is a new medical device that complements qualitative measures without adding lengthy processes or extra hazard. Basically, the Speech and Language therapist can do what they always do but enjoy richer and more reliable data.

Reliability of RehaIngest

RehaIngest uses inexpensive disposable electrodes

For any technique to have value in diagnosis, therapy and monitoring it must be reliable. RehaIngest uses two types of signals to identify swallowing status

  • EMG of the suprahyoid muscle

  • Bioimpedance - the electrical resistance of tissue

The EMG determines the activity of the suprahyoid muscle whilst the larynx lifts during a swallow.

Bioimpedance measurement is unique to the RehaIngest and this technique is able to indirectly capture the changing structural anatomy of the deep structures of the tongue base and thyroid cartilage during a swallow.

EMG alone is unreliable - Adding bioimpedence allows better than 90% accuracy in swallow detection and classification

A very small electrical current (too small for the patient to notice) flows between two electrodes placed on the throat. This varies during swallowing as the tissues move during swallowing. The developers have analysed the data from thousands of examples of normal swallowing and complex algorithms now in the RehaIngest software can classify the quality of a swallowing example in real-time.

The problem with EMG

Some systems on the market have attempted to use EMG to identify swallowing but unfortunately it is impossible to have reliable assessment with EMG alone. Lots of artefacts and technical issues prevent EMG alone being useful.

RehaIngest uses two biological signals to classify the act of swallowing

By adding Bioimpedence measurement, the developers have been able to achieve better than 90% accuracy in reliably detecting a swallow. The change in bio impedance correlates with movement of the hyoid bone and larynx during the pharyngeal swallowing phase. During swallowing a typical curve pattern is generated. The bioimpedance changes depending on the elevation of the larynx.

The measurement signal shows a typical curve of a saliva swallow of a healthy subject.

During the swallow, the bioimpedance falls and then rises again after swallowing

With reliable measurement as a starting point, RehaIngest allows real-time or longer term (up to 8 hour) recording of swallowing. In addition, the clinician can view an accurate animation of exactly what is happening to the deep tissues. This clarifies screening and can provide a way of informing patients and improving their understanding of the issue.

In 2019, RehaIngest will incorporate novel Biofeedback games that can help the therapist to reinforce training strategies.

 RehaIngest software incorporates visualisation of the deep structures

RehaIngest software incorporates visualisation of the deep structures

If you would like to learn more about RehaIngest please check out our main product page or request detailed information and a quote below.

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