About this trial
Airway protective disorders are a prevalent and progressive consequence of Parkinson's Disease (PD), and often result in aspiration pneumonia which is the leading cause of death in PD. Despite this, a large number of patients with PD do not access specialized services to address these critical deficits. The investigators will examine the comparative effectiveness of a novel treatment paradigm delivered in-person versus via telehealth in persons with PD, as well as the role of patient burden and treatment adherence on outcomes; thus, the proposed research is relevant to public health and in line with NIH's mission to identify novel, efficacious, and accessible rehabilitation strategies for short- and long-term improvement of dysfunctional airway protection in PD.
Eligibility criteria
Qualifiers
Diagnosed with PD (Hoehn and Yahr Stages II-IV)126,127 confirmed by a Movement Disorders fellowship trained neurologist having reviewed the video recorded Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) assessment for each participant and using strict UK brain bank criteria
airway protective deficits as defined as a minimum of penetration of thin liquids (penetration-aspiration score>3) as determined by instrumental swallowing assessment and/or dystussia as determined by voluntary cough assessment (PEFR ≤4.1 L/s)
not actively receiving exercise-based swallowing therapy
between the ages of 50 and 90.
Disqualifiers
Other neurological disorders (e.g., multiple sclerosis, stroke, brain tumor, etc.)
history of head and neck cancer
history of breathing disorders or diseases (e.g., COPD)
history of smoking in the last five years
Trial design
Treatments tested in this trial
- Expiratory Muscle Strength Training + Cough Skill Training
Treatment groups
Sponsors and collaborators
Teachers College, Columbia University
Lead sponsor
National Institute of Neurological Disorders and Stroke (NINDS)
Collaborator
Purdue University
Collaborator