Handheld Cough Testing: A Novel Tool for Cough Assessment and Dysphagia Screening

Aspiration pneumonia is a leading cause of death in Parkinson's disease (PD), occurring as a result of impaired cough and swallowing function. However, portable diagnostic tools for cough assessment and dysphagia screening are limited. Therefore, the aims of this study were to determine if: (1) 'Handheld Cough Testing' (HCT), a novel tool developed for cough assessments, could detect differences in cough airflow and sensation during reflex and voluntary cough tasks; and (2) HCT could screen for dysphagia in PD with high sensitivity. Twenty-two people with PD underwent HCT and swallowing assessments. Cough airflow ('PEFR') and sensation ('UTC') was recorded during reflex and voluntary cough tasks. Flexible endoscopy was used to identify people with and without dysphagia. Within-subject statistical analyses were used to detect differences in PEFR and UTC across cough tasks and between-subject statistical analyses were used to detect differences in cough function between people with and without dysphagia. Results revealed significant differences in PEFR (p < 0.0005) and UTC (p < 0.0005) across cough tasks using HCT. Additionally, reflex cough PEFR was significantly different between people with and without dysphagia (p < 0.05). A cut-off of 42.5 L/min exhibited an excellent ability to predict dysphagia in people with PD (90.9% sensitivity; 80.0% specificity). This study revealed that HCT was a valid tool for cough assessment and dysphagia screening. It identified differences in cough airflow and sensation during reflex and voluntary cough tasks and screened for people with dysphagia in PD with high sensitivity.