# Impact of wearable biofeedback for the rehabilitation and tele-rehabilitation of neurogenic dysphagia

> **NIH NIH R01** · PURDUE UNIVERSITY · 2024 · $549,106

## Abstract

PROJECT SUMMARY/ABSTRACT
Oropharyngeal swallowing disorders (a.k.a. dysphagia) are among the most common and dangerous
manifestations of many neurologic conditions. Critically, dysphagia in neurologic diseases (i.e., neurogenic
dysphagia) is often associated with highly negative health and quality of life outcomes. Despite this, optimal
management for neurogenic dysphagia has yet to be established. Behavioral treatments in the form of head/neck
exercises appear promising in improving swallowing in small-scale studies but typically require the use of
adjunctive biofeedback. Further, two significant clinical-research gaps remain: a) to date biofeedback as adjunct
to swallow therapy has not been systematically examined in the context of neurogenic dysphagia, and b) current
swallowing biofeedback devices are large and/or expensive and thus not widely available. Hence, despite its
promise, biofeedback-facilitated dysphagia treatment remains underused and understudied, limiting access to
important swallowing rehabilitation services with potentially detrimental effects. To address these gaps, we
developed and validated a cost-effective wearable surface electromyography (sEMG) biofeedback sensor
technology (i-Phagia), optimized to record muscle activity from the head/neck and provide biofeedback to
patients and adherence data to clinicians. In this proposal the objective is to conduct a large-scale randomized
clinical trial (RCT) to determine the efficacy of sEMG biofeedback (using i-Phagia) as adjunct to a standardized
swallow therapy protocol delivered both in-person and via telehealth compared to a standard of care (SOC)
approach on swallow outcomes in patients with chronic stroke or Parkinson’s disease (PD), i.e., two common
neurogenic dysphagia populations. Our long-term goal is to improve neurogenic dysphagia management through
the development of evidence-based and accessible treatments. The aims of this study are to: 1) compare the
safety, satisfaction, and efficacy of sEMG biofeedback as adjunct to in-person swallow treatment and a standard-
of-care approach in improving swallow outcomes for patients with chronic stroke or PD and dysphagia; 2)
compare the safety, satisfaction, and efficacy of sEMG biofeedback as adjunct to in-person vs. telehealth
swallow treatment in improving swallow outcomes for patients with chronic stroke or PD and dysphagia, and 3)
examine the role of clinical data (such as diagnosis, disease severity, age, stimulability, and neuromuscular
activity at baseline) on treatment responsiveness. We will achieve the aims by conducting an RCT of 180 people
with stroke or PD and dysphagia randomly assigned to one of three treatment groups (in-person i-Phagia, remote
i-Phagia, and SOC). Upon study completion, we will have established the efficacy of sEMG biofeedback-
facilitated swallow therapy for both in-person and telehealth service delivery in two neurogenic dysphagia
populations, and we will have started to identify variables de...

## Key facts

- **NIH application ID:** 10858369
- **Project number:** 1R01AG086371-01
- **Recipient organization:** PURDUE UNIVERSITY
- **Principal Investigator:** Georgia Malandraki
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $549,106
- **Award type:** 1
- **Project period:** 2024-08-15 → 2029-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10858369

## Citation

> US National Institutes of Health, RePORTER application 10858369, Impact of wearable biofeedback for the rehabilitation and tele-rehabilitation of neurogenic dysphagia (1R01AG086371-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10858369. Licensed CC0.

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