Nachalon Yuval, Shpunt Dina, Zait Anat, Oestreicher-Kedem Yael, Hayat Liav, Ashkenazi Yarden, Nativ-Zeltzer Nogah, Belafsky Peter C, Maayan Eshed Gadi, Gurevich Tanya, Manor Yael
Department of Otolaryngology, Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, 6 Weizman Street, Tel-Aviv, Israel.
Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.
Dysphagia. 2025 Feb 25. doi: 10.1007/s00455-025-10815-5.
To evaluate the impact of the elevation training mask (ETM) on swallowing safety and swallowing efficiency in patients with Parkinson's disease (PWP) when used as a respiratory muscle strengthening tool. Study Design. Prospective cohort study. Setting. Tertiary university-affiliated medical center. Thirteen PWP underwent Fiberoptic Endoscopic Evaluation of Swallowing and spirometry assessments both before and after a 4-week ETM use, which included incrementally increasing resistance each week. Measurements taken included EAT-10, swallowing disturbances questionnaire (SDQ), Penetration Aspiration Score (PAS), Yale Pharyngeal Residue Severity Rating Scale, and Peak Expiratory Flow (PEF). Disease severity was assessed using the Unified Parkinson's Disease Rating Scale (UPDRS). Eleven out of 13 male participants (median age 70 years, UPDRS 33, disease duration 8.5 years) completed the 4-week protocol (84.6% completion rate). Vallecular residue significantly decreased for solids (median from 3.0 [IQR: 2.0-3.0] to 2.0 [IQR: 1.0-2.0], p = 0.028) and semi-solids (from 3.0 [IQR: 2.0-4.0] to 2.0 [IQR: 1.0-3.0], p = 0.025), with a non-significant improvement for liquids (from 2.0 [IQR: 2.0-2.0] to 2.0 [IQR: 1.0-2.0], p = 0.19). Patient-reported outcomes (EAT-10, SDQ, VHI-10, RSI) and PEF showed non-significant trends toward improvement. A 4-week use of ETM, serving as a form of respiratory muscle strengthening, demonstrated specific improvements in vallecular residue for semi-solid and solid consistencies in PWP with dysphagia. While other swallowing and respiratory measures showed positive trends, these changes did not reach statistical significance. Further research with a larger cohort is needed to evaluate ETM's role in swallowing rehabilitation.
评估海拔训练面罩（ETM）作为呼吸肌强化工具用于帕金森病患者（PWP）时对吞咽安全性和吞咽效率的影响。研究设计。前瞻性队列研究。研究地点。大学附属三级医疗中心。13名帕金森病患者在使用ETM 4周前后（每周逐渐增加阻力）接受了纤维内镜吞咽评估和肺活量测定评估。测量指标包括EAT-10、吞咽障碍问卷（SDQ）、渗透误吸评分（PAS）、耶鲁咽残留严重程度评定量表和呼气峰值流量（PEF）。使用统一帕金森病评定量表（UPDRS）评估疾病严重程度。13名男性参与者中有11名（中位年龄70岁，UPDRS为33，病程8.5年）完成了为期4周的方案（完成率84.6%）。固体食物的会厌谷残留显著减少（中位数从3.0[四分位间距：2.0 - 3.0]降至2.0[四分位间距：1.0 - 2.0]，p = 0.028），半固体食物的会厌谷残留也显著减少（从3.（四分位间距：2.0 - 4.0]降至2.0[四分位间距：1.0 - 3.0]，p = 0.025），而液体食物的会厌谷残留改善不显著（从2.0[四分位间距：2.0 - 2.0]降至2.0[四分位间距：1.0 - 2.0]，p = 0.19）。患者报告的结果（EAT-10、SDQ、VHI-10、RSI）和PEF显示出改善的非显著趋势。作为一种呼吸肌强化形式，使用4周的ETM在吞咽困难的帕金森病患者中，对于半固体和固体食物的会厌谷残留有特定改善。虽然其他吞咽和呼吸指标显示出积极趋势，但这些变化未达到统计学意义。需要更大样本量的进一步研究来评估ETM在吞咽康复中的作用。
