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

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

Arch Phys Med Rehabil. 2015 Nov 6;

Authors: Silverman EP, Carnaby-Mann G, Singletary F, Hoffman-Ruddy B, Yeager J, Sapienza C

Abstract
OBJECTIVE: To examine relationships between Peak expiratory (cough) airflow rate and swallowing symptom severity in participants with Parkinson Disease DESIGN: 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 relationships among disease severity, swallowing symptom severity and PEFR.
PARTICIPANTS: Sixty eight male and females with PD.
INTERVENTIONS: Not applicable MAIN OUTCOME MEASURES: PEFR and swallow symptom severity RESULTS: PEFR varied significantly across swallowing severity classifications. Participants with more severe disease displayed a significant, linear decrease in PEFR compared to those participants with earlier stage, less severe disease. Swallowing symptom severity varied significantly across groups when comparing participants with less severe PD to those with more severe PD. Participants with early-stage PD demonstrated little to no swallowing symptoms and had the highest measures of PEFR. In contrast, participants with the most severe swallowing symptoms also displayed the lowest measures of PEFR.
CONCLUSIONS: Relationships existed among PD severity, swallowing symptom severity and PEFR in participants with PD. PEFR may eventually stand as a non-invasive predictor of aspiration risk in those with PD, particularly later-stage disease. Inclusion of PEFRs into existing clinical swallowing assessments may increase the sensitivity and predictive validity of these assessments.

PMID: 26551228 [PubMed - as supplied by publisher]

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