Refining Cough Skill Training in Parkinson's Disease and Dysphagia
Trial Snapshot
- Phase
- Phase 1
- Status
- Completed
- Enrollment
- 23
- Locations
- 1
- Primary Endpoint
- Change in Peak Expiratory Flow Rate
Study Overview
Brief Summary
Airway protection deficits (cough and swallowing) are prevalent and pervasive in Parkinson's disease (PD), contributing to adverse health outcomes like pneumonia. This study aims to refine cough skill training by examining whether variable versus constant practice conditions improve cough outcomes in people with PD. In addition, this study will provide insight into optimal respiratory adaptations that occur during training to support cough effectiveness, resulting in immediately translatable treatments to improve airway protection-related health outcomes in people with neurodegenerative disease.
Study Design
- Study Type
- Interventional
- Allocation
- Na
- Intervention Model
- Single Group
- Primary Purpose
- Treatment
- Masking
- None
Eligibility Criteria
- Ages
- 40 Years to 90 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •40 years of age or older
- •have dysphagia as documented by a penetration-aspiration score > 2 on a flexible endoscopic evaluation of swallowing
- •have cough disorder as defined as a maximal voluntary cough peak flow < 5 L/s
- •have no history of other neurological disorders, head and neck cancer, respiratory disease, smoking within 5 years, uncontrolled hypertension, or allergy to capsaicin (reflex cough stimulus)
Exclusion Criteria
- •unable to participate due to neuropsychological dysfunction (i.e., dementia with a score of < 19 on the Montreal Cognitive Assessment)
- •actively participating in other cough or swallowing treatments
Arms & Interventions
Cough Skill Training
During cough skill training, participants will be seated in front of a computer with real-time visualization of their cough waveform. A target line will be provided, and participants will be instructed to perform a single voluntary cough so that their peak flow is within the target's range. Participants will be instructed to continue the cough training regardless of initial accuracy.
Intervention: Cough Skill Training - with Variable Practice (Behavioral)
Outcomes
Primary Outcomes
Change in Peak Expiratory Flow Rate
Time Frame: Before to after two sessions of cough variable practice training over two weeks
Cough Strength
Secondary Outcomes
- Change in Respiratory Kinematics, specifically lung volume excursion(Before to after two sessions of cough variable practice training over two weeks)
Investigators
Michelle Troche
Associate Professor, Lab Director
Teachers College, Columbia University