Variability of Voluntary Cough Airflow in Healthy Adults and Parkinson’s Disease

Dysphagia ◽  
2020 ◽  
Author(s):  
James C. Borders ◽  
Alexandra E. Brandimore ◽  
Michelle S. Troche
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Healthy Adults ◽  
Voluntary Cough ◽  
Cough Airflow

scholarly journals Voluntary upregulation of reflex cough is possible in healthy older adults and Parkinson’s disease

2017 ◽  
Vol 123 (1) ◽  
pp. 19-26 ◽  
Author(s):  
Alexandra E. Brandimore ◽  
Karen W. Hegland ◽  
Michael S. Okun ◽  
Paul W. Davenport ◽  
Michelle S. Troche
Keyword(s):  
Older Adults ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Motor Output ◽  
Protective Mechanism ◽  
Airflow Rate ◽  
Healthy Older Adults ◽  
Voluntary Cough ◽  
Cough Airflow ◽  
Reflex Cough

Cough is an airway-protective mechanism that serves to detect and forcefully eject aspirate material. Existing research has identified the ability of healthy young adults to suppress or modify cough motor output based on external cueing. However, no study has evaluated the ability of people with Parkinson’s disease (PD) and healthy older adults (HOAs) to upregulate cough motor output. The goal of this study was to evaluate the ability of people with PD and healthy age-matched controls (HOAs) to upregulate reflex and voluntary cough function volitionally with verbal instruction and visual biofeedback of airflow targets. Sixteen participants with PD and twenty-eight HOAs (56–83 yr old) were recruited for this study. Experimental procedures used spirometry to evaluate 1) baseline reflex cough (evoked with capsaicin) and voluntary sequential cough and 2) reflex and voluntary cough with upregulation biofeedback. Cough airflow was recorded and repeated-measures ANOVA was used to analyze differences in cough airflow parameters. Cough peak expiratory airflow rate and cough expired volume were significantly greater in the cueing condition for both induced reflex ( P < 0.001) and voluntary cough ( P < 0.001) compared with baseline measures. This is the first study to demonstrate the ability of people with PD and HOAs to upregulate induced reflex and voluntary cough motor output volitionally. These results support the development of studies targeting improved cough effectiveness in patients with airway-protective deficits. NEW & NOTEWORTHY Aspiration pneumonia is a leading cause of death in Parkinson’s disease (PD) and results from concurrent dysphagia and dystussia (cough dysfunction). This is the first study to demonstrate that people with PD and healthy age-matched controls can volitionally upregulate induced reflex and voluntary cough effectiveness when presented with novel cueing strategies. Thus targeting upregulation of cough effectiveness via biofeedback may be a viable way to enhance airway protection in people with PD.

scholarly journals Quantification of Arm Swing during Walking in Healthy Adults and Parkinson’s Disease Patients: Wearable Sensor-Based Algorithm Development and Validation

Sensors ◽  
2020 ◽  
Vol 20 (20) ◽  
pp. 5963 ◽  
Author(s):  
Elke Warmerdam ◽  
Robbin Romijnders ◽  
Julius Welzel ◽  
Clint Hansen ◽  
Gerhard Schmidt ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Angular Velocity ◽  
Wearable Sensors ◽  
Healthy Adults ◽  
Wearable Sensor ◽  
Arm Swing ◽  
Optical Motion ◽  
Optical Motion Capture ◽  
Development And Validation

Neurological pathologies can alter the swinging movement of the arms during walking. The quantification of arm swings has therefore a high clinical relevance. This study developed and validated a wearable sensor-based arm swing algorithm for healthy adults and patients with Parkinson’s disease (PwP). Arm swings of 15 healthy adults and 13 PwP were evaluated (i) with wearable sensors on each wrist while walking on a treadmill, and (ii) with reflective markers for optical motion capture fixed on top of the respective sensor for validation purposes. The gyroscope data from the wearable sensors were used to calculate several arm swing parameters, including amplitude and peak angular velocity. Arm swing amplitude and peak angular velocity were extracted with systematic errors ranging from 0.1 to 0.5° and from −0.3 to 0.3°/s, respectively. These extracted parameters were significantly different between healthy adults and PwP as expected based on the literature. An accurate algorithm was developed that can be used in both clinical and daily-living situations. This algorithm provides the basis for the use of wearable sensor-extracted arm swing parameters in healthy adults and patients with movement disorders such as Parkinson’s disease.

scholarly journals Sequential Voluntary Cough and Aspiration or Aspiration Risk in Parkinson’s Disease

Lung ◽  
2014 ◽  
Vol 192 (4) ◽  
pp. 601-608 ◽  
Author(s):  
Karen Wheeler Hegland ◽  
Michael S. Okun ◽  
Michelle S. Troche
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Voluntary Cough ◽  
Aspiration Risk

scholarly journals Improved cognition while cycling in Parkinson’s disease patients and healthy adults

2017 ◽  
Vol 113 ◽  
pp. 23-31 ◽  
Author(s):  
Audrey A. Hazamy ◽  
Lori J.P. Altmann ◽  
Elizabeth Stegemöller ◽  
Dawn Bowers ◽  
Hyo Keun Lee ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Healthy Adults

scholarly journals Voluntary Cough Production and Swallow Dysfunction in Parkinson’s Disease

Dysphagia ◽  
2008 ◽  
Vol 23 (3) ◽  
pp. 297-301 ◽  
Author(s):  
Teresa Pitts ◽  
Donald Bolser ◽  
John Rosenbek ◽  
Michelle Troche ◽  
Christine Sapienza
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Voluntary Cough

scholarly journals 8B45 A Statistical Classification of Upright Postural Sway in Healthy Adults and Patients with Parkinson's Disease

2012 ◽  
Vol 2012.24 (0) ◽  
pp. _8B45-1_-_8B45-2_
Author(s):  
Tomohisa YAMAMOTO ◽  
Charles E. SMITH ◽  
Yasuyuki SUZUKI ◽  
Takao TANAHASHI ◽  
Takayuki ENDO ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Postural Sway ◽  
Healthy Adults ◽  
Statistical Classification

scholarly journals Visual perturbation of balance suggests impaired neuromuscular stability but intact visuo-motor control in Parkinson's disease

2021 ◽  
Author(s):  
David Engel ◽  
Justus Student ◽  
Jakob C.B. Schwenk ◽  
Adam P. Morris ◽  
Josefine Waldthaler ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Visual Motion ◽  
Phase Locking ◽  
Healthy Adults ◽  
The Body ◽  
Body Motion ◽  
Upper Body ◽  
Control Group ◽  
Visual Perturbation

Postural instability marks one of the most disabling features of Parkinson's disease (PD), but only reveals itself after affected brain areas have already been significantly damaged. Thus, there is a need to detect deviations in balance and postural control before visible symptoms occur. In this study, we visually perturbed balance in the anterior-posterior direction using sinusoidal oscillations of a moving room in virtual reality at different frequencies. We tested three groups: individuals with PD under dopaminergic medication, an age-matched control group, and a group of young healthy adults. We tracked their centre of pressure and their full-body motion. We investigated sway amplitudes and applied newly introduced phase-locking analyses to investigate responses across participants' bodies. Patients exhibited significantly higher sway amplitudes as compared to the control subjects. However, their sway was phase-locked to the visual motion like that of age-matched and young healthy adults. Furthermore, all groups successfully compensated for the visual perturbation by - most likely reflexively - phase-locking their sway to the stimulus. As frequency of the perturbation increased, distribution of phase-locking (PL) across the body revealed a shift of the highest PL-values from the upper body towards the hip-region for young healthy adults, which could not be observed in patients and elderly healthy adults. Our findings suggest an impaired neuromuscular stability, but intact visuomotor processing in early stages of PD, while less flexibility to adapt postural strategy to different perturbations revealed to be an effect of age rather than disease.

scholarly journals A Statistical Approach for the Assessment of Muscle Activation Patterns during Gait in Parkinson’s Disease

Electronics ◽  
2020 ◽  
Vol 9 (10) ◽  
pp. 1641
Author(s):  
Giulia Pacini Panebianco ◽  
Davide Ferrazzoli ◽  
Giuseppe Frazzitta ◽  
Margherita Fonsato ◽  
Maria Cristina Bisi ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Tibialis Anterior ◽  
Muscle Activation ◽  
Statistical Approach ◽  
Healthy Adults ◽  
Activation Patterns ◽  
Gastrocnemius Medialis ◽  
Muscle Activation Patterns ◽  
Co Activation

Recently, the statistical analysis of muscle activation patterns highlighted that not only one, but several activation patterns can be identified in the gait of healthy adults, with different occurrence. Although its potential, the application of this approach in pathological populations is still limited and specific implementation issues need to be addressed. This study aims at applying a statistical approach to analyze muscle activation patterns of gait in Parkinson’s Disease, integrating gait symmetry and co-activation. Surface electromyographic signal of tibialis anterior and gastrocnemius medialis were recorded during a 6-min walking test in 20 patients. Symmetry between right and left stride time series was verified, different activation patterns identified, and their occurrence (number and timing) quantified, as well as the co-activation of antagonist muscles. Gastrocnemius medialis presented five activation patterns (mean occurrence ranging from 2% to 43%) showing, with respect to healthy adults, the presence of a first shorted and delayed activation (between flat foot contact and push off, and in the final swing) and highlighting a new second region of anticipated activation (during early/mid swing). Tibialis anterior presented five activation patterns (mean occurrence ranging from 3% to 40%) highlighting absent or delayed activity at the beginning of the gait cycle, and generally shorter and anticipated activations during the swing phase with respect to healthy adults. Three regions of co-contraction were identified: from heel strike to mid-stance, from the pre- to initial swing, and during late swing. This study provided a novel insight in the analysis of muscle activation patterns in Parkinson’s Disease patients with respect to the literature, where unique, at times conflicting, average patterns were reported. The proposed integrated methodology is meant to be generalized for the analysis of muscle activation patterns in pathologic subjects.

Visual perturbation of balance suggests impaired motor control but intact visuo-motor processing in Parkinson's disease

2021 ◽  
Author(s):  
David Engel ◽  
Justus Student ◽  
Jakob Christian Benjamin Schwenk ◽  
Adam Morris ◽  
Josefine Waldthaler ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Motor Control ◽  
Visual Motion ◽  
Phase Locking ◽  
Healthy Adults ◽  
The Body ◽  
Control Group ◽  
Motor Processing ◽  
Visual Perturbation

Postural instability marks one of the most disabling features of Parkinson's disease (PD), but only reveals itself after affected brain areas have already been significantly damaged. Thus, there is a need to detect deviations in balance and postural control before visible symptoms occur. In this study, we visually perturbed balance in the anterior-posterior direction using sinusoidal oscillations of a moving room in virtual reality at different frequencies. We tested three groups: individuals with PD under dopaminergic medication, an age-matched control group, and a group of young healthy adults. We tracked their centre of pressure and their full-body motion, from which we also extracted the centre of mass. We investigated sway amplitudes and applied newly introduced phase-locking analyses to investigate responses across participants' bodies. Patients exhibited significantly higher sway amplitudes as compared to the control subjects. However, their sway was phase-locked to the visual motion like that of age-matched and young healthy adults. Furthermore, all groups successfully compensated for the visual perturbation by phase-locking their sway to the stimulus. As frequency of the perturbation increased, distribution of phase-locking (PL) across the body revealed a shift of the highest PL-values from the upper body towards the hip-region for young healthy adults, which could not be observed in patients and elderly healthy adults. Our findings suggest an impaired motor control, but intact visuo-motor processing in early stages of PD, while less flexibility to adapt postural strategy to different perturbations revealed to be an effect of age rather than disease.

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