Does EMST improve airway protection during swallowing?

Clinical Question

In patients with dysphagia does EMST improve airway protection during swallowing?

Critically Appraised Topic

Expiratory Muscle Strength Training may be an effective treatment to maintain or improve swallow function in patients with Parkinson’s disease when compared to no treatment.

There are a limited number of studies which investigate the benefits of EMST rehabilitation in patients with dysphagia. Any benefits of EMST in improving airway protection in swallowing are suggestive and based on findings on healthy participants or in patients with Parkinson’s disease.

Findings from the literature, including articles on healthy participants suggest that EMST improves, expiratory muscle function, cough function, UES opening, hyolaryngeal elevation and penetration/aspiration scale. These improvements may increase airway protection during swallowing in a variety of dysphagia cohorts and prevent aspiration-related pulmonary complications. PDF Format

Critically Appraised Papers

Pitts, T., Bolser, D., Rosenbek, J., Troche, M., Okun, M., Sapienza, C. (2009) Impact of expiratory muscle strength on voluntary cough and swallow function in Parkinson’s disease. Chest, Vol 135 (5): 1301-1308

Sapeienza et al (2011). Respiratory strength training. Concept and intervention outcomes. Seminars in speech and language. 32, 21-30.

Troche, M. S., Okun, M. S., Rosenbek, J. C., Musson, N., Fernandez, H. H., Rodriguez, R., … & Sapienza, C. M. (2010). Aspiration and swallowing in parkinson disease and rehabilitation with EMST A randomized trial. Neurology, 75(21), 1912-1919.