Small device may be a big help

UF-developed device may reduce swallowing health risk in patients with Parkinson’s disease

By Jill Pease

Photo by Jesse S. Jones

A hand-held device that strengthens the muscles involved in swallowing can address a serious symptom of Parkinson’s disease, according to a University of Florida study. 

In what researchers believe is the largest randomized trial of a behavioral swallowing treatment in patients with Parkinson’s disease, scientists found that about one-third of the volunteers who used the device improved their ability to swallow. The findings appeared in the journal Neurology, the medical journal of the American Academy of Neurology.

Nearly 1 million Americans have Parkinson’s disease, according to the Parkinson’s Disease Foundation. Finding solutions to their swallowing problems is important because pneumonia caused by inhaling foreign material, like food, into the lungs during swallowing is their most common cause of death.

Dr. Michelle Troche

“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 Michelle Troche, Ph.D., the study’s lead investigator and a clinical lecturer and speech pathologist in the College of Public Health and Health Professions’ department of speech, language and hearing sciences.

Cough function also worsens, making it harder for patients to sense material in their airways and cough hard enough to expel it, she said.

For the study, researchers trained participants with Parkinson’s disease to exhale into an Expiratory Muscle Strength Training, or EMST, device. In previous studies, EMST has improved swallowing and cough function in patients with multiple sclerosis and in elderly, sedentary adults.

“EMST uses the basic exercise theory behind any strength training program,” said co-investigator Christine Sapienza, Ph.D., a professor and chair of the department of speech, language and hearing sciences. “This small device capitalizes on that concept of overload with a calibrated, pressure release valve that won’t open until you generate a great enough lung pressure. The patient or clinician can vary how much pressure is needed to open the valve on the device. The greater the pressure you need, the stronger the muscles have to be.”

Dr. Christine Sapienza

Sapienza developed the device along with Paul Davenport, Ph.D., a professor in the College of Veterinary Medicine, and A. Daniel Martin, Ph.D., P.T., a professor in PHHP’s department of physical therapy.

“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 research collaborator Michael Okun, M.D., a co-director of UF’s Center for Movement Disorders Neurorestoration.

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