Measurement Of Voluntary Cough Production And Airway Protection In Parkinson Disease

Keywords

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

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.

Publication Date

3-1-2016

Publication Title

Archives of Physical Medicine and Rehabilitation

Volume

97

Issue

3

Number of Pages

413-420

Document Type

Article

Personal Identifier

scopus

DOI Link

https://doi.org/10.1016/j.apmr.2015.10.098

Socpus ID

84960082128 (Scopus)

Source API URL

https://api.elsevier.com/content/abstract/scopus_id/84960082128

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