A new handheld tongue-strengthening device may be beneficial for Parkinson’s patients, who often suffer from swallowing difficulties, according to a new University of Florida study. In fact, the leading cause of death related to Parkinson’s is pneumonia, caused by inhaling foreign material.
“The many muscles involved in swallowing progressively weaken in patients with Parkinson’s disease and become uncoordinated in the same way that patients lose coordination and strength in their arms and legs,” said lead researcher Michelle Troche of the UF College of Public Health and Health Professions.
Furthermore, it is difficult for sufferers of Parkinson’s to sense an object in their airway and to cough forcefully enough to expel it, she said.
For the study, Parkinson’s volunteers were taught to exhale into an Expiratory Muscle Strength Training (EMST) device. In prior studies, EMST has been proven to strengthen swallowing and cough function in individuals with multiple sclerosis and in elderly, sedentary adults.
“EMST uses the basic exercise theory behind any strength training program,” said co-researcher Christine Sapienza, Ph.D., chairwoman of the UF department of speech, language and hearing sciences.
“The greater the pressure you need, the stronger the muscles have to be. It acts much like a pin on a weight machine and uses the same concept to strengthen the muscles involved in swallowing and breathing.”
Sapienza developed the EMST along with UF researchers Paul Davenport, Ph.D., and A. Daniel Martin, Ph.D.
“Their efforts are pioneering, and it is likely that this study will stand the test of time as a landmark in Parkinson’s disease swallowing research,” said Dr. Michael Okun, an associate professor of neurology with the College of Medicine and UF’s McKnight Brain Institute.
For the study, 60 volunteers with Parkinson’s were divided into two equal groups. In the first group, individuals were given a properly working EMST device. The other group was given a pseudo-device that looked exactly like the original but did not actually strengthen muscles. Neither the volunteers nor the study therapists knew who was given the real device.
For four weeks, participants used the device at home for 20 minutes a day, five days a week. They also received a visit from a therapist once a week to make sure the device was being used correctly.
The participants’ swallowing abilities were measured before and after treatment with a swallow safety scale, called the Penetration-Aspiration scale. Researchers used videofluoroscopy to take motion X-ray images of the volunteers’ muscles while they swallowed liquid.
The results show that one-third of Parkinson’s participants who used the real device showed great improvement in their swallow safety scores; 14 percent of the participants in the sham group showed improvement.
For those using the real device, significant improvement was found in movements involving the muscles that raise the voice box out of the way while swallowing.
“The fact that EMST is a home-based treatment is of particular importance as many individuals with Parkinson’s disease cannot travel the long distance to attend clinic or hospital therapy sessions,” said Stephanie Daniels, Ph.D., an assistant professor at Baylor College of Medicine who was not involved in the study.
“Very few swallowing treatment studies have incorporated the rigorous research design used in this study. We need more studies such as this to support the different treatment approaches used in swallowing rehabilitation.”
Once the study was over, participants in the pseudo group received the real EMST treatment. The results can be found in the Nov. 23 issue of the journal Neurology.
Source: University of Florida