2012 Volume 16 Issue 1 Pages 75-80
[Purpose] Expiratory muscle training (EMT) has been attempted to prevent aspiration pneumonia in recent years. Some researchers reported that EMT was effective for a cough and swallow function. However, there have been very few reports on the effect of EMT for a swallow function. This study was conducted in a single case. The purpose of this study was to observe respiratory, oral and swallow functions through EMT in a single patient.
[Subject] A patient was a 64-year-old man with Parkinson's disease. He had received nursing care insurance services at home. He was at stage Ⅲ in the Hoehn and Yahr scale and partially dependent on activities of daily living. His cognitive function was normal.
[Method] This study design was A-B-A. This training was not under supervision. The protocol was 15 min twice a day for 4 weeks in the B period. The expiratory threshold of EMT was set at 30% of the maximum expiratory pressure by the reverse use of Threshold IMT. This pressure was measured and the threshold was adjusted every week. We measured respiratory and cough functions by spirometer, and respiratory muscle strength by a pressure meter at an interval of a week. In addition, we measured oral and swallow functions by questionnaire at the first and last timing of B. [Results] The respiratory function showed an increase of the peak expiratory flow and cough flow. The respiratory muscle strength showed an increase of the maximum expiratory and inspiratory pressure. His RSST was improved by three to four times. His labial closing strength was increased by 4.82 to 5.61 Newton. His dysphagia, choking, air-leakage from his lips in closing his mouth improved in some questionnaire items.
[Conclusion] EMT was affected not only respiratory function, respiratory muscle strength, and oral function, but a swallow function for a single case in this study. This intervention was acceptable for the elderly and may have a possibility to prevent aspiration pneumonia by improved swallowing. Further investigation is necessary to identify the effect of EMT for swallow function.
