Effects of Expiratory Muscle Training and Air Stacking on Peak Cough Flow in Individuals with Parkinson’s Disease
- 50 Downloads
Abstract
The purpose of this study was to investigate the effects of air stacking (AS) and an expiratory muscle training (EMT) program to increase voluntary and reflex peak cough flow (PCF) in individuals with Parkinson’s disease. Participants were allocated to the control (n = 11), EMT (n = 11), or EMT + AS group (n = 11). All groups performed EMT (5 sets of 5 repetitions), 6 times a week for 2 months. The control group used a fixed resistance, EMT plus AS and EMT groups used a progressively increased resistance. The EMT plus AS group additionally performed 10 series of three to four lung insufflations using a manual resuscitator bag. Voluntary and reflex PCF, maximum expiratory pressure, and slow vital capacity were assessed before and after training. EMT plus AS was more beneficial than EMT alone for improving reflex and voluntary PCF. The effect of the EMT plus AS was greater for reflex PCF than for voluntary PCF.
Keywords
Respiratory muscle training Pulmonary function Parkinson’s diseaseNotes
Acknowledgment
This work was supported by Fondo Nacional de Desarrollo Científico y Tecnologico FONDECYT (Grant No. 11160419)
Compliance with Ethical Standards
Conflict of interest
The authors declare no conflict of interest.
References
- 1.Wheeler-Hegland K et al (2014) Comparison of voluntary and reflex cough effectiveness in Parkinson's disease. Parkinsonism Relat Disord 20(11):1226–1230CrossRefGoogle Scholar
- 2.Polatli M et al (2001) Pulmonary function tests in Parkinson's disease. Eur J Neurol 8(4):341–345CrossRefGoogle Scholar
- 3.Hegland KW, Okun MS, Troche MS (2014) Sequential voluntary cough and aspiration or aspiration risk in Parkinson’s disease. Lung 192(4):601–608CrossRefGoogle Scholar
- 4.Magni C et al (2011) Voluntary and reflex cough: similarities and differences. Pulm Pharmacol Ther 24(3):308–311CrossRefGoogle Scholar
- 5.Mccool FDMJ (2006) Rosen, Nonpharmacologic airway clearance therapies: ACCP evidence-based clinical practice guidelines. Chest 129(1 Suppl):250s–259sCrossRefGoogle Scholar
- 6.Gauld LM (2009) Airway clearance in neuromuscular weakness. Dev Med Child Neurol 51(5):350–355CrossRefGoogle Scholar
- 7.Boitano LJ (2006) Management of airway clearance in neuromuscular disease. Respir Care 51(8):913–922 (Discussion 922–924) PubMedGoogle Scholar
- 8.Janssens T et al (2015) The impact of harmfulness information on citric acid induced cough and urge-to-cough. Pulm Pharmacol Ther 31:9–14CrossRefGoogle Scholar
- 9.Brandimore AE et al (2015) Respiratory kinematic and airflow differences between reflex and voluntary cough in healthy young adults. Front Physiol 6:284CrossRefGoogle Scholar
- 10.Kuo Y-C et al (2017) Effect of expiratory muscle strength training intervention on the maximum expiratory pressure and quality of life of patients with Parkinson disease. Neurorehabilitation 41:219–226CrossRefGoogle Scholar
- 11.Pitts T et al (2009) Impact of expiratory muscle strength training on voluntary cough and swallow function in Parkinson disease. Chest 135(5):1301–1308CrossRefGoogle Scholar
- 12.Sapienza C et al (2011) Respiratory strength training: concept and intervention outcomes. Semin Speech Lang 32(1):21–30CrossRefGoogle Scholar
- 13.Reyes A et al (2018) The effects of respiratory muscle training on peak cough flow in patients with Parkinson's disease: a randomized controlled study. Clin Rehabil 32(10):1317–1327CrossRefGoogle Scholar
- 14.Mills C, Jones R, Huckabee M-L (2017) Measuring voluntary and reflexive cough strength in healthy individuals. Respir Med 132:95–101CrossRefGoogle Scholar
- 15.Sohn D et al (2018) Determining peak cough flow cutoff values to predict aspiration pneumonia among patients with dysphagia using the citric acid reflexive cough test. Arch Phys Med Rehabil 99(12):2532–2539CrossRefGoogle Scholar
- 16.Bach JR et al (2008) Lung insufflation capacity in neuromuscular disease. Am J Phys Med Rehabil 87(9):720–725CrossRefGoogle Scholar
- 17.Brito MF et al (2009) Air stacking and chest compression increase peak cough flow in patients with duchenne muscular dystrophy. J Bras Pneumol 35(10):973–979CrossRefGoogle Scholar
- 18.Toussaint M et al (2016) Cough augmentation in subjects with duchenne muscular dystrophy: comparison of air stacking via a resuscitator bag versus mechanical ventilation. Respir Care 61(1):61–67CrossRefGoogle Scholar
- 19.Marques TB et al (2014) Air stacking: effects on pulmonary function in patients with spinal muscular atrophy and in patients with congenital muscular dystrophy. J Bras Pneumol 40(5):528–534CrossRefGoogle Scholar
- 20.Smith JA et al (2012) Chest wall dynamics during voluntary and induced cough in healthy volunteers. J Physiol 590(3):563–574CrossRefGoogle Scholar
- 21.Sarmento A et al (2017) Air stacking: a detailed look into physiological acute effects on cough peak flow and chest wall volumes of healthy subjects. Respir Care 62(4):432–443CrossRefGoogle Scholar
- 22.Evans JA, Whitelaw WA (2009) The assessment of maximal respiratory mouth pressures in adults. Respir Care 54(10):1348–1359PubMedGoogle Scholar