0
Original Research: COUGH AND ASPIRATION |

Impact of Expiratory Muscle Strength Training on Voluntary Cough and Swallow Function in Parkinson Disease

Teresa Pitts, MA; Donald Bolser, PhD; John Rosenbek, PhD; Michelle Troche, MA; Michael S. Okun, PhD; Christine Sapienza, PhD
Author and Funding Information

*From the Departments of Communication Sciences and Disorders (Ms. Pitts, Ms. Troche, and Dr. Sapienza), Physiological Sciences (Dr. Bolser), Communicative Disorders (Dr. Rosenbek), and Neurology (Dr. Okun), University of Florida, Gainesville, FL; and the Brain Rehabilitation Research Center (Ms. Pitts, Ms. Troche, and Dr. Sapienza), Malcom Randall Veterans Affairs Medical Center, Gainesville, FL.

Correspondence to: Teresa Pitts, MA, University of Florida, Communication Sciences and Disorders, 336 Dauer Hall, PO Box 117420, Gainesville, FL 32611; e-mail: tepitts@csd.ufl.edu


Ms. Pitts, Dr. Bolser, Dr. Rosenbek, Ms. Troche, and Dr. Okun have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article. Dr. Sapienza, is a cofounder of and has financial interest in Aspire, the company that makes the device used in this study. She is also a member of the Scientific Advisory Board of the company.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/site/misc/reprints.xhtml).


© 2009 American College of Chest Physicians


Chest. 2009;135(5):1301-1308. doi:10.1378/chest.08-1389
Text Size: A A A
Published online

Background:  Cough provides high expiratory airflows to aerosolize and remove material that cannot be adequately removed by ciliary action. Cough is particularly important for clearing foreign particles from the airway in those with dysphagia who may be at risk for penetration/aspiration (P/A). Expiratory muscle strength training (EMST) was tested to improve cough and swallow function.

Methods:  Ten male participants, diagnosed with Parkinson disease (PD), with videofluorographic evidence of penetration or with evidence for aspiration of material during swallow of a thin 30-mL bolus, completed 4 weeks of an EMST program to test the hypothesis that EMST would improve cough and/or swallow function. Measured parameters from an airflow waveform produced during voluntary cough, pre-EMST and post-EMST, included inspiration phase duration, compression phase duration (CPD), expiratory phase peak flow (EPPF), expiratory phase rise time (EPRT), and cough volume acceleration (VA) [ie, the EPPF/EPRT ratio]. The swallow outcome measure was the degree of P/A during the swallow task.

Results:  There was a significant decrease in the duration of the CPD and EPRT; the decrease in EPRT resulted in a significant increase in cough VA. Significant decreases in the P/A scores were found posttraining.

Conclusions:  The results demonstrate that EMST is a viable treatment modality for a population of participants with PD at risk of aspiration.

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543