Expiratory Muscle Strength Training in Patients with Parkinson's Disease : A Pilot Study of Mobile Monitoring Application
Abstract
Introduction: Long-term management of airway protective mechanisms is a priority throughout the progression of Parkinson's disease (PD). The aim of this pilot feasibility study was to test the usability of a mobile phone-based visual feedback (MPVF) application for expiratory muscle strength training in individuals with Parkinson's disease.
Methods: 12 patients with PD performed an intensive home-based expiratory muscle strength training (EMST) with MPVF for 2 weeks. Usability of the MPVF was assessed using a satisfaction and application usability questionnaire and semi-structured interview.
Peak cough flow, maximum expiratory pressure and maximum inspiratory pressure were also measured. Results: All participants appreciated EMST coupled with MPVF and they found the application motivating, comprehensible and user-friendly.
Maximum expiratory pressure and peak cough flow significantly increased from the pre- to post-training period (p = 0.041 and p = 0.003 respectively). There was a strong correlation between the total number of forceful expirations performed and the difference between pre- and post-training maximum expiratory pressure (R = 0.768, p = 0.004).
Conclusions: These findings indicate that MPVF is feasible and potentially useful in PD patients. Future research should verify whether EMST coupled with MPVF produces better short-term results as compared to EMST without visual feedback, and whether it is motivating enough to improve adherence to a long-term EMST maintenance programme to sustain airway protective mechanism in progressive diseases such as PD