Refining Cough Skill Training in Parkinson's Disease and Dysphagia

Teachers College, Columbia University23 enrolled

Overview

Airway protection deficits (cough and swallowing) are prevalent and pervasive in Parkinson's disease (PD), contributing to adverse health outcomes like pneumonia. This study aims to refine cough skill training by examining whether variable versus constant practice conditions improve cough outcomes in people with PD. In addition, this study will provide insight into optimal respiratory adaptations that occur during training to support cough effectiveness, resulting in immediately translatable treatments to improve airway protection-related health outcomes in people with neurodegenerative disease.

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Parkinson Disease Dysphagia

Interventions

Eligibility

Sex: ALLMin age: 40 YearsMax age: 90 Years

Medical Language ↔ Plain English

Inclusion criteria: * 40 years of age or older * have dysphagia as documented by a penetration-aspiration score \> 2 on a flexible endoscopic evaluation of swallowing * have cough disorder as defined as a maximal voluntary cough peak flow \< 5 L/s * have no history of other neurological disorders, head and neck cancer, respiratory disease, smoking within 5 years, uncontrolled hypertension, or allergy to capsaicin (reflex cough stimulus) Exclusion criteria: * unable to participate due to neuropsychological dysfunction (i.e., dementia with a score of \< 19 on the Montreal Cognitive Assessment) * actively participating in other cough or swallowing treatments

Outcomes

Primary Outcomes

Change in Peak Expiratory Flow Rate

Cough Strength

Time frame: Before to after two sessions of cough variable practice training over two weeks

Secondary Outcomes

Change in Respiratory Kinematics, specifically lung volume excursion