Reliability of clinical office-based laryngeal electromyography in vocally healthy adults

Daniel J. Croake, Joseph C. Stemple, Timothy Uhl, Sanford Archer, Richard D. Andreatta

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Objective: This study aimed to conduct a 3-session reliability assessment of the laryngeal electromyography (LEMG) signal in healthy participants during intensity controlled vocalization tasks. We hypothesized that vocal intensity level and testing session would affect LEMG measures. Methods: This prospective study used a 2-factor repeated measures design. Seven participants underwent bipolar needle LEMG of the right thyroarytenoid muscle. Data were collected over 3 testing sessions using vocalization tasks performed with visually guided intensity feedback targets (65 and 75 dB SPL). Root mean square amplitudes in microvolts were analyzed for within-session and between-session reliability. Results: The main effect for intensity was found to approach significance (F = 5.71, P = .054). However, intraclass correlation coefficients (ICCs) using a 2-factor mixed random effect model indicated poor to fair signal reliability between testing sessions (ICC = 0.56 at 65 dB, 0.40 at 70 dB). Intraclass correlation coefficients for within-session data indicated excellent reliability for all testing conditions (0.84-0.98). Conclusion: Using a quantitative analysis protocol to inform an essentially qualitative technique, our results indicated that there was generally poor to fair reliability in the LEMG signal over testing sessions. Vocal intensity was an important variable that affected LEMG signal reliability. Standardization of LEMG protocols using vocal control parameters and quantitative analyses may help improve LEMG reliability in clinical settings.

Original languageEnglish
Pages (from-to)271-278
Number of pages8
JournalAnnals of Otology, Rhinology and Laryngology
Issue number4
StatePublished - Apr 2014

Bibliographical note

Funding Information:
The authors would like to thank the participants for undergoing multiple LEMG procedures for this study, and the University of Kentucky College of Health Sciences Office of Research for supporting this project through pilot funding.


  • LEMG
  • Motor units
  • Neuromuscular
  • Thyroarytenoid

ASJC Scopus subject areas

  • Otorhinolaryngology


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