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Background and aim: Swallowing disorder is one of the most important complaints of patients with upper motor neuron lesions.The rate of disphagia increases due to elderly subjects and brain injuries in our society Majority of these patients have hidden aspiration. Electromyographic assessment of swallowing can produce indicators of recovery and treatment effectiveness. This study tries to indicate pattern and recruitment of muscle activity in swallowing by surface electromyography.
Methods and Materials: Twenty healthy subjects (20-50) and ten subjects with swallowing dysfunction contribute at this study. Activities of bilateral orbicularis oris, buccinator, sternocleidomastoid and anterior region of throat muscles recorded during three stage of liquid swallowing include water, juice and honey by surface electrodes. Value of activity (RMS), duration of activity (Dur) , median (Mdf) and band (Banf) frequency of above muscles were measured.
Results: Healthy subjects indicated increase of RMS, Dur, Mdf and Banf of muscles, following increase of sweeten and viscose of liquid (P<0.05). Patients had more increase of this findings at oral muscles markedly, whereas Dur of throat muscle showed more increase in time (P<0.05). Comparison of between two groups indicated patients have more Dur time especially at throat muscles (P<0.05) and in contras reduce of activities and frequency parameters than healthy subjects (P<0.05).
Conclusion: Patients lean to keep liquid in oral phase and during throat swallow have more limitation. Patients may catch early fatigue and dysfunction for maintenance and keep of liquid particularly in throat region and it redound to change of trajectory of liquid to the respiratory tube. Therefore, rehabilitation protocols must enforce on coordination of oropharengeal muscles and recovery by movement therapy patterns.

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Background and Aim: Providing rehabilitation care of deglutition disorders or dysphagia is a challenging issue for speech and language pathologists. Comprehensive assessment of dysphagia includes early screening, clinical tests and finally instrumental tests to be assured. In spite of the importance and the advantages of clinical tests; accurate diagnosis and decision in dysphagia management largely depend on instrumental ones. These tests provide dynamic assessment and information about structures and physiology of normal and affected swallow for clinician. The aim of this review article was to find instrumental tests of swallowing with their application, limitation and advantages.

Materials and Methods: An electronic search was done via the PubMed, Google scholar, Science direct, Medline, Scopus, Iranian web of knowledge data bases and web of knowledge data bases from 1956 to 2012. Based on the used keywords, 150 papers were found of which 90 papers were selected in accordance with the selection criteria.

Results: Fourteen related instrumental tests were found. Only one of the tests is usable for screening and others for diagnosis and treatment of dysphagia. Three tests are used only in adults and others in children too.

Conclusion: The literature review showed that among the instrumental tests, (Video fluoroscopy swallowing study; VFSS), (Fiberoptic Endoscopic evaluation of swallowing; FEES) are golden standards for dysphagia assessment and treatment. Therefore, they are widely accepted among clinicians and researches in despite of their limitations, our study offers the possibility to professionals for selecting the appropriate instrumental test in dysphagia.

Keywords: Assessment, Dysphagia, Screening, Instrumental tests.