Expiratory Muscle Strength Training for Drooling in Adults with Parkinson's Disease.
Naomi Cocks, Jonathan Rafols, Elizabeth Embley and 1 others
PMID 35171321WHAT IT FOUND
Sixteen adults with Parkinson's disease completed a single-group pilot of expiratory muscle strength training.
Self-reported drooling, swallow function, and cough flow all improved significantly after training. No control group was used, so these changes cannot be separated from natural fluctuation or other factors.
Key findings
01Self-reported drooling severity significantly decreased after the training period.
02Bedside swallow function scores and swallowing-related quality of life scores significantly improved post-training.
03Peak cough flow significantly increased compared to all four pre-training baseline measures.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
There was no control group or sham training, so improvements cannot be distinguished from natural variation, placebo effects, or other concurrent therapies. The sample size was small (n=16), limiting the generalisability of the findings. The primary measure of drooling was self-reported, which may be less accurate in people with Parkinson's due to reduced awareness of motor symptoms. Swallow function was assessed using a bedside clinical tool (MASA) rather than an instrumental assessment like videofluoroscopy, which is more objective. Five of the twenty-one consented participants dropped out (24% attrition), which may introduce bias if those who dropped out differed from those who completed the study.
Declared interests
The study was funded by Parkinson's Western Australia and Curtin University. The authors declared no conflicts of interest.
The easy way to misread this
Do not interpret the improvements in drooling, swallow, and cough flow as proven efficacy of EMST. Because this was a single-group pilot with no control or sham condition, these changes could result from natural fluctuation, placebo effects, or other factors. The study demonstrates feasibility and tolerance, not effectiveness.