%0 Journal Article
%@ 2291-9279
%I JMIR Publications
%V 13
%N 
%P e60685
%T Kangaroo Stimulation Game in Tracheostomized Intensive Care–Related Dysphagia: Interventional Feasibility Study
%A Jansen,Marjolein
%A van Iperen,Ingrid D
%A Kroner,Anke
%A Hemler,Raphael
%A Dekker-Holverda,Esther
%A Spronk,Peter E
%K dysphagia
%K swallowing
%K intensive care
%K ICU
%K swallowing disturbance
%K kangaroo stimulation
%K game
%K feasibility study
%K surface electromyography
%K training
%K exercise
%K Rephagia biofeedback
%K muscle strength
%K stamina
%K timing
%K tracheostomy
%K clinical
%K feasibility
%D 2025
%7 5.3.2025
%9 
%J JMIR Serious Games
%G English
%X Background: Dysphagia is common in intensive care unit (ICU) patients. Using surface electromyography (sEMG) signals as biofeedback training exercises might offer a promising path to improving swallowing function. The Rephagia biofeedback system uses sEMG to assess muscle strength, stamina, and timing of the swallowing action. Objectives: The aim of this study was to evaluate the feasibility of the Rephagia system in ICU patients with dysphagia. Methods: This feasibility study included patients admitted to a 14-bed mixed medical-surgical ICU. All patients underwent a new tracheostomy placement during ICU stay due to persistent aspiration and ICU-acquired weakness, accompanied by verified dysphagia. Following Rephagia training, patients completed a questionnaire assessing comprehension, satisfaction, and motivation. Swallowing characteristics were assessed via mean sEMG peak values during exercise. Results: Twenty patients with a mean age of 69.4 (SD 8.2) years were included. The means of sEMG values at the beginning of a measurement were not significantly different at baseline versus everyone’s last measurement (52 µV [23 µV] vs 57 µV [22 µV]; P=.50). The means of sEMG values obtained at the end of a measurement were not significantly different at baseline versus everyone’s last measurement (56 µV [18 µV] vs 59 µV [23 µV]; P=.62). However, dysphagia improved in all patients. Patients understood the importance of the game in relation to their swallowing problems (16/80, 89%), which kept them motivated to participate in the training sessions (9/18, 50%). Conclusions: The Rephagia biofeedback system for stimulating swallowing actions in tracheotomized ICU patients with dysphagia is feasible. No relation was found between clinical improvement in swallowing function and sEMG signals. 
%R 10.2196/60685
%U https://games.jmir.org/2025/1/e60685
%U https://doi.org/10.2196/60685