Respiratory-Swallow Training and Variable Practice in Parkinson's Disease: A Clinical Trial Pilot Study

Area of Science:

• Neurology
• Speech-Language Pathology
• Rehabilitation Science

Background:

• Dysphagia in Parkinson's disease (PwPD) is linked to impaired respiratory-swallow coordination.
• Respiratory-swallow training (RST) is a promising intervention, but its application in PwPD is under-explored.

Purpose of the Study:

• To explore associations between exhale-swallow-exhale RST and swallowing safety, efficiency, and respiratory patterns in PwPD.
• To investigate the impact of constant versus variable practice on RST motor learning outcomes in PwPD.

Main Methods:

• A pilot clinical trial involving 12 PwPD undergoing pre- and post-RST assessments.
• Randomization to constant or variable practice conditions for RST sessions.
• Outcomes measured via nasal airflow, respiratory inductive plethysmography, surface EMG, and FEES, analyzed with multilevel models.

Main Results:

• Exhale-swallow-exhale usage increased significantly post-RST (p < .05).
• Variable practice showed higher exhale-swallow-exhale usage at 1-month follow-up compared to constant practice (p < .05).
• Pharyngeal residue, laryngeal vestibule residue, vocal fold residue, and Penetration-Aspiration Scale scores decreased post-RST (p < .05).

Conclusions:

• RST shows preliminary evidence of improving exhale-swallow-exhale usage, swallowing safety, and efficiency in PwPD.
• Variable practice may enhance the retention and generalization of RST skills in PwPD.
• Findings will guide refinement of RST protocols and future clinical trials for PwPD.