Surface Electromyography (sEMG) may sound a bit like something out of a sci-fi movie, but it’s actually one of the most established tools in dysphagia therapy. In fact, sEMG has been called one of the oldest treatments used for swallowing disorders—and with a strong research base to back it up.

Let’s break it down.

What Is sEMG?

At its core, sEMG is a form of visual biofeedback. Electrodes are placed on the submental muscles (those key players in hyolaryngeal elevation), and they measure muscle activation during the swallow—not the swallow itself, but the strength of the muscle contraction while it’s happening.

This gives patients the chance to see their effort in real time, rather than relying on vague internal cues like, “Did that feel strong enough?”

It’s like a mirror for the swallow.

Why Use sEMG?

It’s an ideal match for exercises like the:

• Effortful Swallow
• Mendelsohn Maneuver
• Tongue Press
• EMST training

When paired with these, sEMG allows you (and the patient) to visually monitor muscle activation, endurance, and coordination—providing both motivation and measurable data.

Who Makes These Devices?

The Prometheus Group

One of the long-standing names in sEMG equipment, Prometheus offers software and hardware to bring biofeedback to life in your sessions.

ACP (Accelerated Care Plus)

If you work in a Skilled Nursing Facility or rehab center, you’ve likely seen ACP devices floating around. Known for their contributions to PT and OT rehab (think OmniCycle or OmniVR), ACP joined the dysphagia world with Synchrony, a comprehensive sEMG platform.

True Angle

True Angle offers the Mobili-T  that allows for visual biofeedback from anywhere.   This device offers a more affordable and portable option that can be used in the clinic and sent home for the patient to continue use.

Introducing Synchrony by ACP

Unveiled at the 2014 ASHA Convention, Synchrony combines visual biofeedback and electrical stimulation in a single system. The goal? A user-friendly, motivating therapy experience for both clinician and patient.

What’s Included?

Synchrony includes:

• OmnisEMG – the sEMG biofeedback component
• Omnistim FX2 PENS – Patterned Electrical Neuromuscular Stimulation
• Multiple visual training modes:
  • Bar Graph
  • Line Graph
  • Kangaroo (yep, a hopping kangaroo for motivation!)
  • Work-Rest Cycle Mode

You can toggle between assessment and exercise modes, depending on whether you’re collecting baseline data or progressing through a therapy plan.

Bonus: The screen is large and easy to see—even for patients with visual impairments. 👓

Training and Support

ACP offers extensive training and CEU-approved education:

• A 5-hour on-site training for OmnisEMG
• A 7-hour seminar-style training (great for teams!)
• A 2.5-hour on-site course focused on Omnistim FX2
• Initial system installation and orientation
• Ongoing support for clinical integration

And yes—ACP is an ASHA Approved Continuing Education Provider.

So if your facility already partners with ACP for therapy equipment, this may be a very natural fit.

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Bottom Line

sEMG doesn’t replace our clinical judgment—but it can support more focused, engaging, and measurable therapy sessions. It gives patients a goal. It gives clinicians data. And it brings another layer of evidence to the table.

If you’re looking to level up your dysphagia therapy, particularly with patients who struggle to perceive effort or benefit from visual feedback, sEMG is worth exploring.

Are you ready for a deeper dive with even more resources available? Join the Dysphagia Skills Accelerator today. You will get so many great tools with new tools being added all the time! Click here to join now!

Have you ever wanted a way to create a more standardized protocol for your Clinical Swallow Evaluation?   Do you often forget or leave out parts of the CSE, you know, the parts that are important for your Plan of Care?  You probably need the Clinical Dysphagia Assessment Toolkit if you answered yes.   You can get your copy here.  

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📚 Want to Read More?

Check out these key references supporting sEMG in dysphagia therapy:

Crary, M. A., Carnaby, G. D., Groher, M. E., & Helseth, E. (2004). Functional benefits of dysphagia therapy using adjunctive sEMG biofeedback. Dysphagia, 19(3), 160-164.

Yoshida, M., Groher, M. E., Crary, M. A., Mann, G. C., & Akagawa, Y. (2007). Comparison of surface electromyographic (sEMG) activity of submental muscles between the head lift and tongue press exercises as a therapeutic exercise for pharyngeal dysphagia. Gerodontology, 24(2), 111-116.

Steele, C. (2004). Treating dysphagia with sEMG biofeedback. The ASHA Leader, 9(13), 2-23.

Vaiman, M. (2007). Standardization of surface electromyography utilized to evaluate patients with dysphagia. Head & face medicine, 3(1), 1-7.

Crary, M. A., Carnaby, G. D., & Groher, M. E. (2007). Identification of swallowing events from sEMG signals obtained from healthy adults. Dysphagia, 22(2), 94-99.

Vaiman, M., & Eviatar, E. (2009). Surface electromyography as a screening method for evaluation of dysphagia and odynophagia. Head & face medicine, 5(1), 1-11.

Bogaardt, H. C. A., Grolman, W., & Fokkens, W. J. (2009). The use of biofeedback in the treatment of chronic dysphagia in stroke patients. Folia Phoniatrica et Logopaedica, 61(4), 200-205.

Crary, M. A., & Baldwin, B. O. (1997). Surface electromyographic characteristics of swallowing in dysphagia secondary to brainstem stroke. Dysphagia, 12(4), 180-187.

Watts, C. R. (2013). Measurement of hyolaryngeal muscle activation using surface electromyography for comparison of two rehabilitative dysphagia exercises. Archives of physical medicine and rehabilitation, 94(12), 2542-2548.

Crary, M. A., & Groher, M. E. (2000). Basic concepts of surface electromyographic biofeedback in the treatment of dysphagia: a tutorial. American Journal of Speech-Language Pathology, 9(2), 116-125.

Benfield, J. K., Everton, L. F., Bath, P. M., & England, T. J. (2019). Does therapy with biofeedback improve swallowing in adults with dysphagia? A systematic review and meta-analysis. Archives of physical medicine and rehabilitation, 100(3), 551-561.

Stepp, C. E., Britton, D., Chang, C., Merati, A. L., & Matsuoka, Y. (2011, April). Feasibility of game-based electromyographic biofeedback for dysphagia rehabilitation. In 2011 5th International IEEE/EMBS Conference on Neural Engineering (pp. 233-236). IEEE.

Wheeler-Hegland, K. M., Rosenbek, J. C., & Sapienza, C. M. (2008). Submental sEMG and hyoid movement during Mendelsohn maneuver, effortful swallow, and expiratory muscle strength training.

Archer, S. K., Smith, C. H., & Newham, D. J. (2020). Surface electromyographic biofeedback and the effortful swallow exercise for stroke-related dysphagia and in healthy ageing. Dysphagia, 1-12.

Yoon, T. L. (2018). Surface Electromyography Evaluation Method for Dysphagia: A Literature Review. Swallowing Rehabilitation, 1(2), 35-40.

Crary, M. A., Carnaby, G. D., & Groher, M. E. (2006). Biomechanical correlates of surface electromyography signals obtained during swallowing by healthy adults. Journal of Speech, Language, and Hearing Research.