Swallowing and Breathing Exercises for Dysphagia in Parkinson Disease

Federal University of Bahia

Status: Completed

Conditions: Dysphagia; Parkinson Disease

Treatments: Other: Swallowing exercise; Other: Swallowing and breathing exercises; Other: Breathing Exercises

Study type: Interventional

Funder types: Other

Identifiers

NCT01420796

96/10

Details and patient eligibility

About

Parkinson's disease (PD) is a chronic, degenerative disease described by motors and non-motors symptoms. Changes in swallowing and respiratory dynamics increase risk of tracheal aspiration largely responsible for increased morbidity and mortality in this population. Thus, interdisciplinary rehabilitation strategies can reduce the complications of dysphagia, with consequent improvement of the prognosis of individuals with PD. Objective: To determine the impact of combined oral motor exercises and breathing exercises on swallowing disorders in individuals with PD. Method: Clinical trial, randomized and blinded for the examinator. For all subjects will be given the stage of PD and applied quality of life questionnaire. The swallowing complaints will be investigated through structured questionnaire and functional aspects of swallowing with videofluoroscopy. The Manovacuometry Spirometry will determine measures of respiratory function. The assessment of vocal and speech disorders will be done with perceptive, acoustic, aerodynamic and electroglottographic measures as well as analysis of intelligibility. Three groups of intervention will be defined: one of them doing oral motor exercises for swallowing, one doing breathing exercises and another must do this two interventions combined. Effect of intervention will be assessed through measures of swallowing, breathing, voice and speech. The groups will be compared, according to the principle of "intention to treat" by appropriate statistical tests, according to the distribution of the dependent variables.

Enrollment: 38 patients

Sex: All

Volunteers: No Healthy Volunteers

Inclusion criteria

• Parkinson's disease diagnosed following UKPDS Criteria
• Complaints and symptoms of dysphagia
• Dopaminergic treatment

Exclusion criteria

• Cranial trauma
• Severe heart disease
• Others neurologic disease
• Psychiatric diseases
• Therapy for swallowing or breathing in the last 3 months

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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38 participants in 3 patient groups

Swallowing and breathing exercises

Experimental group

Description:

This group will perform both swallowing and breathing exercises for five weeks.

Treatment:

Other: Swallowing and breathing exercises

Swallowing exercises

Experimental group

Description:

This exercises aim to increase strength and range of motion of mouth, larynx and pharynx structures. All patients will perform sustained vowel phonation of /a/, pushing plosive phonemes /pa/, /ta/, /ka/ in a forceful manner, suction of wet gauze, swallowing with tongue hold and modified supraglottic maneuver, in ten repetitions, ascending and descending gliding phonation of vowel /a/ and /u/, five repetitions of each vowel, and tongue rotation in oral vestibule, 3 series of 5 repetitions to each side.

Treatment:

Other: Swallowing exercise

Breathing exercises

Experimental group

Description:

Expiratory Muscle Training will be performed with Threshold® (Respironics HealthScan, Inc, Cedar Grove, Nova Iorque, EUA).

Treatment:

Other: Breathing Exercises