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Surface electromyography (sEMG) that monitors muscle activity during swallowing, offers a promising alternative. However, existing sEMG electrode arrays for dysphagia assessment remain challenging in combining the advantages of a large coverage area and strong compliance to the entire swallowing muscles. Here, we report a stretchable, breathable, large\u2010area high\u2010density sEMG (HD\u2010sEMG) electrode array, which enables intimate contact to complex surface of the submental and infrahyoid muscles to detect high\u2010fidelity HD\u2010sEMG signals during swallowing. The electrode array features a 64\u2010channel soft on\u2010skin sensing array for comprehensive data capture, and a stiff connector for simple and reliable connection to an external acquisition setup. Systemically experimental studies revealed the easy operability of the soft HD\u2010sEMG electrode array for effortless integration with the skin, as well as the excellent mechanical and electrical characteristics even subject to substantial skin deformations. By comparing HD\u2010sEMG signals collected from 38 participants, three objective indicators for quantitative dysphagia evaluation were discussed. Finally, a machine learning model was developed to accurately and automatically classify the severity of dysphagia, and the factors affecting the recognition accuracy of the model were discussed in depth.<\/jats:p>","DOI":"10.1002\/advs.202500472","type":"journal-article","created":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T22:31:57Z","timestamp":1742855517000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Accurate and Noninvasive Dysphagia Assessment via a Soft High\u2010Density sEMG Electrode Array Conformal to the Submental and Infrahyoid Muscles"],"prefix":"10.1002","volume":"12","author":[{"given":"Weijie","family":"Hong","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine The First Affiliated Hospital School of Medicine Zhejiang University  Hangzhou 310003 China"},{"name":"Key Laboratory of Soft Machines and Smart Devices of Zhejiang Province State Key Laboratory of Brain\u2010Machine Intelligence Department of Engineering Mechanics Zhejiang University  Hangzhou 310027 China"},{"name":"Huanjiang Laboratory  Zhuji 311899 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Mao","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine The First Affiliated Hospital School of Medicine Zhejiang University  Hangzhou 310003 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Lin","sequence":"additional","affiliation":[{"name":"Key Laboratory of Soft Machines and Smart Devices of Zhejiang Province State Key Laboratory of Brain\u2010Machine Intelligence Department of Engineering Mechanics Zhejiang University  Hangzhou 310027 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chongyuan","family":"Huang","sequence":"additional","affiliation":[{"name":"Key Laboratory of Soft Machines and Smart Devices of Zhejiang Province State Key Laboratory of Brain\u2010Machine Intelligence Department of Engineering Mechanics Zhejiang University  Hangzhou 310027 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanyan","family":"Su","sequence":"additional","affiliation":[{"name":"Key Laboratory of Soft Machines and Smart Devices of Zhejiang Province State Key Laboratory of Brain\u2010Machine Intelligence Department of Engineering Mechanics Zhejiang University  Hangzhou 310027 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine The First Affiliated Hospital School of Medicine Zhejiang University  Hangzhou 310003 China"},{"name":"Key Laboratory of Soft Machines and Smart Devices of Zhejiang Province State Key Laboratory of Brain\u2010Machine Intelligence Department of Engineering Mechanics Zhejiang University  Hangzhou 310027 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengjun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine The First Affiliated Hospital School of Medicine Zhejiang University  Hangzhou 310003 China"},{"name":"Key Laboratory of Soft Machines and Smart Devices of Zhejiang Province State Key Laboratory of Brain\u2010Machine Intelligence Department of Engineering Mechanics Zhejiang University  Hangzhou 310027 China"},{"name":"Huanjiang Laboratory  Zhuji 311899 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daming","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine The First Affiliated Hospital School of Medicine Zhejiang University  Hangzhou 310003 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2821-9429","authenticated-orcid":false,"given":"Jizhou","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine The First Affiliated Hospital School of Medicine Zhejiang University  Hangzhou 310003 China"},{"name":"Key Laboratory of Soft Machines and Smart Devices of Zhejiang Province State Key Laboratory of Brain\u2010Machine Intelligence Department of Engineering Mechanics Zhejiang University  Hangzhou 310027 China"},{"name":"Huanjiang Laboratory  Zhuji 311899 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zuobing","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine The First Affiliated Hospital School of Medicine Zhejiang University  Hangzhou 310003 China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,24]]},"reference":[{"key":"e_1_2_9_1_1","first-page":"939","volume":"105","author":"McCarty E. 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