OBJECTIVES Parkinson's disease (PD) causes dysfunction both to swallowing and to the cough mechanism. Oropharyngeal dysphagia is the main cause of pneumonia, due to silent aspiration of food and saliva. Pneumonia is the leading cause of death in PD. Different strategies exist to reduce the risk of inhalation and associated lung infections, but evidence of their efficacy is still unclear. The aim of this preliminary study was to investigate if adding an expiratory flow acceleration (EFA®) technique to standard therapy (ST) for dysphagia can reduce the incidence of bronchopulmonary infections and improve quality of life, respiratory function parameters, cough, and airways encumbrance perception. MATERIALS AND METHODS Twenty-five patients with PD were randomized to two groups: ST vs. ST + EFA. Patients were re-assessed at 30, 180 and 360 days from start of treatment. The primary outcome was the incidence of respiratory exacerbations together with quality of life score (PDQ-39). Secondary outcomes were changes in respiratory function tests, cough capacity (CPEF), perceived health status (Euro-QOL-VAS), cough, and upper airways encumbrance perception evaluated by visual numeric scale (VNS). RESULTS Twenty patients concluded the study (10 each group). Albeit the difference was not significant, less respiratory infections, symptoms, hospital admissions and medical visits were found in the study group. Furthermore, there was a significant difference in cough effectiveness measured with the peak cough expiratory flow (PCEF) and other spirometry parameters (FEV1, FVC), and also in specific and generic health-related quality of life measures (PDQ-39, Euro-QoL-VAS). CONCLUSION The results of this preliminary study support the use of EFA® technology in Parkinson's patients with dysphagia to reduce the risk of respiratory complications. Nevertheless, further studies are needed in a larger, more representative sample to definitively confirm the usefulness of this technique in PD patients.

中文翻译：

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呼气流量加速对帕金森病合并吞咽障碍患者的有效性：初步研究

目的 帕金森病 (PD) 会导致吞咽和咳嗽机制功能障碍。由于食物和唾液的无声吸入，口咽部吞咽困难是肺炎的主要原因。肺炎是 PD 死亡的主要原因。存在不同的策略来降低吸入和相关肺部感染的风险，但其有效性的证据仍不清楚。这项初步研究的目的是调查在吞咽困难的标准治疗 (ST) 中添加呼气流速加速 (EFA®) 技术是否可以降低支气管肺感染的发生率并改善生活质量、呼吸功能参数、咳嗽和气道阻塞洞察力。材料和方法 25 名 PD 患者被随机分为两组：ST 与 ST + EFA。患者在 30 岁时重新评估，治疗开始后 180 天和 360 天。主要结果是呼吸恶化的发生率和生活质量评分 (PDQ-39)。次要结果是呼吸功能测试、咳嗽能力 (CPEF)、感知健康状况 (Euro-QOL-VAS)、咳嗽和通过视觉数字量表 (VNS) 评估的上呼吸道阻塞感知的变化。结果 20 名患者完成了研究（每组 10 名）。尽管差异不显着，但研究组发现呼吸道感染、症状、住院和就诊次数较少。此外，用峰值咳嗽呼气流量 (PCEF) 和其他肺活量测定参数（FEV1、FVC）以及特定和通用的健康相关生活质量测量（PDQ-39，Euro-生活质量-VAS）。结论 这项初步研究的结果支持在患有吞咽困难的帕金森病患者中使用 EFA® 技术来降低呼吸系统并发症的风险。尽管如此，还需要在更大、更具代表性的样本中进行进一步研究，以明确证实该技术在 PD 患者中的有用性。