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Arch Phys Med Rehabil. 2016 Mar;97(3):413-20. doi: 10.1016/j.apmr.2015.10.098. Epub 2015 Nov 6.

Measurement of Voluntary Cough Production and Airway Protection in Parkinson Disease.

Author information

1
Department of Physiological Sciences, University of Florida, Gainesville, FL. Electronic address: epearson@ufl.edu.
2
Department of Communication Sciences and Disorders, University of Central Florida, Orlando, FL.
3
Brooks Rehabilitation, Jacksonville, FL; Department of Communication Sciences and Disorders, Jacksonville University, Jacksonville, FL.
4
Eastman Chemical Company, Kingsport, TN.

Abstract

OBJECTIVE:

To examine relations between peak expiratory (cough) airflow rate and swallowing symptom severity in participants with Parkinson disease (PD).

DESIGN:

Cross-sectional study.

SETTING:

Outpatient radiology clinic at an acute care hospital.

PARTICIPANTS:

Men and women with PD (N=68).

INTERVENTIONS:

Participants were cued to cough into an analog peak flow meter then swallowed three 20-mL thin liquid barium boluses. Analyses were directed at detecting potential relations among disease severity, swallowing symptom severity, and peak expiratory (cough) airflow rate.

MAIN OUTCOME MEASURES:

Peak expiratory (cough) airflow rate and swallow symptom severity.

RESULTS:

Peak expiratory (cough) airflow rate varied significantly across swallowing severity classifications. Participants with more severe disease displayed a significant, linear decrease in peak expiratory (cough) airflow rate than those participants with earlier stage, less severe disease. Swallowing symptom severity varied significantly across groups when comparing participants with less severe PD with those with more severe PD. Participants with early stage PD demonstrated little to no swallowing symptoms and had the highest measures of peak expiratory (cough) airflow rate. In contrast, participants with the most severe swallowing symptoms also displayed the lowest measures of peak expiratory (cough) airflow rate.

CONCLUSIONS:

Relations existed among PD severity, swallowing symptom severity, and peak expiratory (cough) airflow rate in participants with PD. Peak expiratory (cough) airflow rate may eventually stand as a noninvasive predictor of aspiration risk in those with PD, particularly those with later stage disease. Inclusion of peak expiratory (cough) airflow rates into existing clinical swallowing assessments may increase the sensitivity and predictive validity of these assessments.

KEYWORDS:

Airway management; Cough; Parkinson disease; Rehabilitation; Respiratory aspiration

PMID:
26551228
PMCID:
PMC4769912
[Available on 2017-03-01]
DOI:
10.1016/j.apmr.2015.10.098
[Indexed for MEDLINE]
Free PMC Article

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