Rehabilitation of Airway Protection in Parkinson's Disease
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ClinicalTrials.gov Identifier: NCT05700825 |
Recruitment Status :
Recruiting
First Posted : January 26, 2023
Last Update Posted : April 11, 2024
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Condition or disease | Intervention/treatment | Phase |
---|---|---|
Parkinson Disease Dysphagia | Behavioral: Expiratory Muscle Strength Training + Cough Skill Training | Phase 2 |
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 120 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | Double (Investigator, Outcomes Assessor) |
Primary Purpose: | Treatment |
Official Title: | Rehabilitation of Airway Protection in Parkinson's Disease: Comparing In-person and Telehealth Service Delivery Models |
Actual Study Start Date : | May 2, 2023 |
Estimated Primary Completion Date : | September 1, 2027 |
Estimated Study Completion Date : | September 1, 2027 |
Arm | Intervention/treatment |
---|---|
Active Comparator: In-person |
Behavioral: Expiratory Muscle Strength Training + Cough Skill Training
Expiratory Muscle Strength Training (EMST). EMST is a widely used and efficacious treatment approach that uses a calibrated device with a one-way, spring-loaded pressure relief valve to mechanically overload the expiratory and submental muscles. Cough Skill Training (CST) involves a digital peak flow meter device which measures PEFR (peak expiratory flow rate) in liters/second and allows patients to receive immediate biofeedback. |
Experimental: Telehealth |
Behavioral: Expiratory Muscle Strength Training + Cough Skill Training
Expiratory Muscle Strength Training (EMST). EMST is a widely used and efficacious treatment approach that uses a calibrated device with a one-way, spring-loaded pressure relief valve to mechanically overload the expiratory and submental muscles. Cough Skill Training (CST) involves a digital peak flow meter device which measures PEFR (peak expiratory flow rate) in liters/second and allows patients to receive immediate biofeedback. |
- Change in Peak Expiratory Flow Rate (Cough PEFR) - phase 1 [ Time Frame: Pretraining to posttraining (after four weeks of intensive training) ]
- Change in Peak Expiratory Flow Rate (Cough PEFR) - phase 2 [ Time Frame: post-training to post one-year maintenance ]
- Change in Penetration-Aspiration Scale (PAS) - phase 1 [ Time Frame: Pretraining to posttraining (after four weeks of intensive training) ]PAS, max value: 8 (most impaired), min value 1 (least impaired).
- Change in Penetration-Aspiration Scale (PAS) - phase 2 [ Time Frame: post-training to post one-year maintenance ]PAS, max value: 8 (most impaired), min value 1 (least impaired).
- Change in Maximum Expiratory Pressure - phase 1 [ Time Frame: Pretraining to posttraining (after four weeks of intensive training) ]
- Change in Maximum Expiratory Pressure - phase 2 [ Time Frame: post-training to post one-year maintenance ]
- Change in Cough expired volume - phase 1 [ Time Frame: Pretraining to posttraining (after four weeks of intensive training) ]
- Change in Cough expired volume - phase 2 [ Time Frame: post-training to post one-year maintenance ]
- Treatment Adherence - phase 1 [ Time Frame: posttraining (after four weeks of intensive training) ]percent of prescribed training coughs and breaths completed
- Change in Treatment Adherence- phase 2 [ Time Frame: post-training to post one-year maintenance ]percent of prescribed training coughs and breaths completed
- Change in SWAL-QOL- phase 1 [ Time Frame: Pretraining to posttraining (after four weeks of intensive training) ]self-report questionnaire of swallowing quality of life, 44 min score, 220 max score - higher score is better QOL
- Change in SWAL-QOL - phase 2 [ Time Frame: post-training to post one-year maintenance ]self-report questionnaire of swallowing quality of life, 44 min score, 220 max score - higher score is better QOL
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Ages Eligible for Study: | 50 Years to 90 Years (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion criteria:
- Diagnosed with PD (Hoehn and Yahr Stages II-IV)126,127 confirmed by a Movement Disorders fellowship trained neurologist having reviewed the video recorded Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) assessment for each participant and using strict UK brain bank criteria
- airway protective deficits as defined as a minimum of penetration of thin liquids (penetration-aspiration score>3) as determined by instrumental swallowing assessment and/or dystussia as determined by voluntary cough assessment (PEFR ≤4.1 L/s)
- not actively receiving exercise-based swallowing therapy
- between the ages of 50 and 90.
Exclusion criteria:
- Other neurological disorders (e.g., multiple sclerosis, stroke, brain tumor, etc.)
- history of head and neck cancer
- history of breathing disorders or diseases (e.g., COPD)
- history of smoking in the last five years
- uncontrolled hypertension
- difficulty complying due to neuropsychological dysfunction (i.e., severe depression with >28 on the Beck Depression Index (BDI-II), dementia with <19 on the Montreal Cognitive Assessment (MoCA))
- allergy to capsaicin or barium
- further than 1.5 hours (door to door) distance from either Teachers College, Columbia University or Purdue University.
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT05700825
Contact: Michelle Troche, PhD | 212-678-3072 | uadlab@tc.columbia.edu |
United States, Indiana | |
Purdue University | Recruiting |
West Lafayette, Indiana, United States, 47907 | |
Contact: Georgia Malandraki, PhD malandraki@purdue.edu | |
United States, New York | |
Teachers College, Columbia University | Active, not recruiting |
New York, New York, United States, 10027 |
Principal Investigator: | Michelle Troche, PhD | Teachers College, Columbia University |
Responsible Party: | Michelle Troche, Associate Professor, Principle Investigator, Teachers College, Columbia University |
ClinicalTrials.gov Identifier: | NCT05700825 |
Other Study ID Numbers: |
NS126319 1R01NS126319 ( U.S. NIH Grant/Contract ) |
First Posted: | January 26, 2023 Key Record Dates |
Last Update Posted: | April 11, 2024 |
Last Verified: | April 2024 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | Yes |
Studies a U.S. FDA-regulated Drug Product: | No |
Studies a U.S. FDA-regulated Device Product: | No |
Parkinson Disease Parkinsonian Disorders Basal Ganglia Diseases Brain Diseases Central Nervous System Diseases |
Nervous System Diseases Movement Disorders Synucleinopathies Neurodegenerative Diseases |