Voluntary Cough Effectiveness and Airway Clearance in Neurodegenerative Disease

Autor/inn/en	Borders, James C.; Troche, Michelle S.
Titel	Voluntary Cough Effectiveness and Airway Clearance in Neurodegenerative Disease
Quelle	In: Journal of Speech, Language, and Hearing Research, 65 (2022) 2, S.431-449 (19 Seiten) PDF als Volltext Verfügbarkeit
Zusatzinformation	ORCID (Borders, James C.) ORCID (Troche, Michelle S.)
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	1092-4388
Schlagwörter	Motor Reactions; Human Body; Neurological Impairments; Eating Disorders; Physiology; Older Adults + Suchen Sie Ihr Suchwort? Menschlicher Körper; Neurodegenerative Erkrankung; Appetite disorder; Essstörung; Physiologie; Älterer Erwachsener
Abstract	Purpose: Voluntary cough dysfunction is highly prevalent across multiple patient populations. Voluntary cough has been utilized as a screening tool for swallowing safety deficits and as a target for compensatory and exercise-based dysphagia management. However, it remains unclear whether voluntary cough dysfunction is associated with the ability to effectively clear the airway. Method: Individuals with neurodegenerative disorders performed same-day voluntary cough testing and flexible endoscopic evaluations of swallowing (FEES). Participants who were cued to cough after exhibiting penetration to the vocal folds and/or aspiration with thin liquids during FEES met inclusion criteria. One-hundred and twenty-three trials were blinded, and the amount of residue before and after a cued cough on FEES was measured with a visual analog scale. Linear and binomial mixed-effects models examined the relationship between cough airflow during voluntary cough testing and the proportion of residue expelled. Results: Peak expiratory flow rate (p = 0.004) and cough expired volume from the entire epoch (p = 0.029) were significantly associated with the proportion of aspiration expelled from the subglottis. Peak expiratory flow rate values of 3.00 L/s, 3.50 L/s, and 5.30 L/s provided high predicted probabilities that [greater than or equal to] 25%, [greater than or equal to] 50%, and [greater than or equal to] 80% aspirate was expelled. Accounting for depth of aspiration significantly improved model fit (p < 0.001). Conclusions: These findings suggest that voluntary cough airflow is associated with cough effectiveness to clear aspiration from the subglottis, although aspiration amount and depth may play an important role in this relationship. These findings provide further support for the clinical utility of voluntary cough in the management of dysphagia. (As Provided).
Anmerkungen	American Speech-Language-Hearing Association. 2200 Research Blvd #250, Rockville, MD 20850. Tel: 301-296-5700; Fax: 301-296-8580; e-mail: slhr@asha.org; Web site: http://jslhr.pubs.asha.org
Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2024/1/01