By Todd Taylor
As Parkinson’s disease progresses, swallowing problems that can lead to food and drinks “going down the wrong pipe” become more common. Parkinson’s disease can also weaken cough, which is instrumental in clearing these aspirated materials from the airway to prevent lung infections such as pneumonia.
“These types of lung infections are a leading cause of death in Parkinson’s disease,” said Michelle Troche, Ph.D., CCC-SLP, an associate professor of communication sciences and disorders at Teachers College, Columbia University and a former assistant professor at UF.
To help Parkinson’s patients strengthen their cough, expiratory muscle strength training (EMST) is commonly used by clinicians. But a new study in the journal Movement Disorders found that sensorimotor training for airway protection (smTAP) improved cough-related outcomes in people with Parkinson’s more than EMST did. The study was co-authored by Karen Hegland, Ph.D., CCC-SLP, an associate professor of speech, language and hearing sciences at UF’s College of Public Health and Health Professions, and Troche, director of the Laboratory for the Study of Upper Airway Dysfunction at Teachers College.
“We found that both interventions lead to increases in cough airflows for voluntary cough — the kind you produce if someone tells you to cough, not in response to any stimulus,” Hegland said. “However, reflex cough airflows — the kind of cough you produce when a stimulus causes you to cough — only improved for the smTAP treatment group.
The clinical trial included 65 participants split into two treatment groups to compare EMST and smTAP. Participants’ cough sensitivity and strength were measured before and after treatment. EMST focuses on strengthening the muscles used to breathe out forcefully, while smTAP uses a low-dose, inhaled cough stimulus called capsaicin, an active component of chili peppers, to cause and improve reflex cough.
“Our next steps will focus on how these results will translate to real-world clinical settings to see if we can achieve similar results outside of the controlled clinical trial,” Hegland said. “We are also interested in whether a training program combining EMST and smTAP may yield even greater improvements to cough function than either training alone.”