Expiratory Muscle Strength Training for Therapy of Pharyngeal Dysphagia in Parkinson's Disease

Background Pharyngeal dysphagia in Parkinson's disease (PD) is a common and clinically relevant symptom associated with poor nutrition intake, reduced quality of life, aspiration pneumonia. Despite this, effective behavioral treatment approaches are rare. Objective The objective this study was to verify if 4 week expiratory muscle strength training can improve pharyngeal the short long term able induce neuroplastic changes cortical swallowing processing. Methods In double-blind, randomized, controlled trial, 50 patients hypokinetic dysphagia, as confirmed by flexible endoscopic evaluation swallowing, performed 4-week training. Twenty-five participants used calibrated (“active”) device, 25 sham handheld device. Swallowing function evaluated directly before after period, well period 3 month using swallowing. Swallowing-related activation measured 22 (active:sham; 11:11) whole-head magnetencephalography. Results active group showed significant improvement swallowing–based score weeks months, whereas no from baseline were observed. Especially, clear reduction residues found. Regarding network training, statistically differences found magnetencephalography examination. Conclusions Four-week significantly reduces overall severity PD patients, sustained effect months compared This mainly achieved improving efficiency. probably caused peripheral mechanisms, identified. © 2021 Authors. Movement Disorders published Wiley Periodicals LLC on behalf International Parkinson Disorder Society