Patients with Parkinson's disease have difficulty swallowing, and this difficulty typically worsens as the disease progresses. When foreign material enters into the airway it is called aspiration and can lead to aspiration pneumonia, the number-one cause of death in patients with Parkinson's disease. Currently, there are few behavioral techniques that treat the swallow dysfunction associated with PD.
Often times the swallow dysfunction is characterized by slowness and reduced movements of the structures that help move the food into the esophagus. This project will study an experimental treatment called expiratory muscle strength training. It uses a device that helps the muscles involved in swallow become active with the intent on combating the bradykinetic, rigid and weak swallow musculature associated with PD. This training technique also strengthens the muscles used in breathing. This technique uses an experimental pressure threshold device to accomplish the strength training. The patient uses the device at home for 5 weeks, 5 days a week.
Four main aims will be studied in this project. The first goal is to test whether the technique works in patients with Parkinson's disease although our preliminary data supports a positive outcome. The second and third goals are to study how the training affects the swallow respiration phase relationships. The fourth goal is to determine the impact of the training on quality of life specific to swallow dysfunction. A randomized treated and control group consisting of 48 patients, Hoehn & Yahr, stage II to III will be included for study.
Dr. Sapienza demonstrated that strength training improved swallowing function in PD patients. Work is ongoing to leverage this finding for a practical treatment approach to benefit patients suffering from dysphagia.