Effect of Expiratory Muscle Strength Training in Patients With Parkinson's Disease and Forward Trunk Flexion: A Pilot Study
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- 入组人数
- 28
- 试验地点
- 2
- 主要终点
- Voluntary peak cough flow
研究概览
简要总结
Postural abnormalities (PA) negatively affecting the axial system are part of the symptoms of Parkinson's disease (PD). They occur in more than 20% of patients with PD especially in more advanced stages of the disease, contribute significantly to patient disability, affect respiratory functions, and reduce quality of life. Eighty-five percent of patients with forward trunk flexion (FTF) reported difficulties with swallowing (dysphagia), shortness of breath, and drooling. Previous studies in patients with PD also identified cough disorders (dystussia). Since cough and properly functioning swallowing are key mechanisms for airway protection, impairments in these functions lead to a higher risk of aspiration. The seriousness of this problem is clearly confirmed by the fact that aspiration pneumonia is the leading cause of death in patients with PD.
Among non-pharmacological interventions for airway protection, expiratory muscle strength training (EMST) has been shown to be beneficial in patients with PD. Recent randomized controlled studies demonstrated a significant effect of EMST on dysphagia, dystussia, drooling, and dysarthria in patients with PD.
However, the literature lacks data on the effect of EMST on dystussia in patients with PD and FTF, who, according to previous research, are also affected by restrictive ventilatory impairment, which negatively affects respiratory capacity and, in particular, cough strength.
The aim of this study is to evaluate the effect of EMST on cough, swallowing, respiratory muscle strength, and drooling in patients with PD and forward trunk flexion.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Diagnosis of Parkinson' s disease
- •Age ≥ 18 years
- •MoCA score (Montreal Cognitive Assessment) ≥ 19
- •Score II-IV during the "ON" phase under regular antiparkinsonian medication according to the Modified Hoehn and Yahr Scale
- •Pathological forward trunk flexion defined as thoracic (≥ 25°) or lumbar flexion (> 15°) during standing and walking, which completely disappears in the supine position (for the experimental group only)
排除标准
- •Change in antiparkinsonian medication within the last 3 months prior to study enrollment
- •Other neurological, orthopedic, cardiovascular, or respiratory comorbidities
- •Inability to cooperate due to neuropsychological dysfunction
- •Current smoking history
- •Inadequate lip seal
结局指标
主要结局
Voluntary peak cough flow
时间窗: Week -1, week 0, week 4, week 8
Assessments will be performed in accordance with American Thoracic Society/European Thoracic Society guidelines.
次要结局
- Assessment of Drooling(Week -1, week 4, week 8)
- Maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP)(Week -1, week 0, week 4, week 8)
- Forced expiratory volume (FEV1)(Week -1, week 0, week 4, week 8)
- Forced vital capacity (FVC)(Week -1, week 0, week 4, week 8)
- Peak expiratory flow (PEF)(Week -1, week 0, week 4, week 8)
- Assessment of Swallowing(Week -1, week 4, week 8)
研究者
Kateřina Dvořáková
Physiotherapist
General University Hospital, Prague