Refining Cough Skill Training in Parkinson's Disease and Dysphagia

Teachers College, Columbia University

Status and phase: Completed; Phase 1

Conditions: Dysphagia; Parkinson Disease

Treatments: Behavioral: Cough Skill Training - with Variable Practice

Study type: Interventional

Funder types: Other

Identifiers

NCT05700838

23-016

Details and patient eligibility

About

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.

Enrollment: 23 patients

Sex: All

Ages: 40 to 90 years old

Volunteers: No Healthy Volunteers

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

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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23 participants in 1 patient group

Cough Skill Training

Experimental group

Description:

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.

Treatment:

Behavioral: Cough Skill Training - with Variable Practice