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J Speech Lang Hear Res ; 63(10): 3293-3310, 2020 10 16.
Article in English | MEDLINE | ID: covidwho-982521


Purpose Surface electromyography (sEMG) is often used for biofeedback during swallowing rehabilitation. However, commercially available sEMG electrodes are not optimized for the head and neck area, have rigid form, and are mostly available in large medical centers. We developed an ultrathin, soft, and flexible sEMG patch, specifically designed to conform to the submental anatomy and which will be ultimately incorporated into a telehealth system. To validate this first-generation sEMG patch, we compared its safety, efficiency, and signal quality in monitoring submental muscle activity with that of widely used conventional sEMG electrodes. Method A randomized crossover design was used to compare the experimental sEMG patch with conventional (snap-on) sEMG electrodes. Participants completed the same experimental protocol with both electrodes in counterbalanced order. Swallow trials included five trials of 5- and 10-ml water. Comparisons were made on (a) signal-related factors: signal-to-noise ratio (SNR), baseline amplitude, normalized mean amplitude, and sEMG burst duration and (b) safety/preclinical factors: safety/adverse effects, efficiency of electrode placement, and satisfaction/comfort. Noninferiority and equivalence tests were used to examine signal-related factors. Paired t tests and descriptive statistics were used to examine safety/preclinical factors. Results Forty healthy adults participated (24 women, M age = 67.5 years). Signal-related factors: SNR of the experimental patch was not inferior to the SNR of the conventional electrodes (p < .0056). Similarly, baseline amplitude obtained with the experimental patch was not inferior to that obtained with conventional electrodes (p < .0001). Finally, normalized amplitude values were equivalent across swallows (5 ml: p < .025; 10 ml: p < .0012), and sEMG burst duration was also equivalent (5 ml: p < .0001; 10 ml: p < .0001). Safety/preclinical factors: The experimental patch resulted in fewer mild adverse effects. Participant satisfaction was higher with the experimental patch (p = .0476, d = 0.226). Conclusions Our new wearable sEMG patch is equivalent with widely used conventional sEMG electrodes in terms of technical performance. In addition, our patch is safe, and healthy older adults are satisfied with it. With lessons learned from the current COVID-19 pandemic, efforts to develop optimal swallowing telerehabilitation devices are more urgent than ever. Upon further validation, this new technology has the potential to improve rehabilitation and telerehabilitation efforts for patients with dysphagia. Supplemental Material

Deglutition Disorders/rehabilitation , Electrodes , Electromyography/instrumentation , Telerehabilitation/instrumentation , Wearable Electronic Devices , Aged , Betacoronavirus , COVID-19 , Coronavirus Infections , Cross-Over Studies , Deglutition/physiology , Electromyography/methods , Equipment Design , Female , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral , SARS-CoV-2
Non-conventional in English | WHO COVID | ID: covidwho-714269


Tackling poverty and injustices, protecting the environment and ensuring equality, all underpin ideas of being a responsible business. There are many arbitrators of what constitutes a responsible business and rethinking the United Kingdom?s farm business, post BREXIT, post COVID-19 and in relation to the entrepreneurial orientation (EO) of farmers is timely and essential to tackle crisis, uncertainty and sustain a healthy rural ecosystem. This is an ethnographic study into contextual dualities. Data from one case farm are presented, and findings are triangulated through a grounded thematic data analysis of five in-depth interviews with other farms from the same community. An empirically informed framework is constructed explaining how, through duality, EO is moderated across six themes. The contributions to policy and practice are intertwined. Through identification of moderators of (and for) duality, the rural ecosystem can be better managed through effective policy design and responsible practice at grass roots. Accelerated professionalisation in the agricultural industry involves combining the rich, irreplaceable knowledge of older generations with shaping the values and behaviours of new generations. By synthesising EO with farmer mentality, we theorise and inform how to re-educate future generations in responsible and sustainable farm businesses.