Objective: The purpose of this study was to investigate the effects of air-stacking (AS) and an expiratory-muscle training (EMT) program to increase voluntary and reflex PCF.
Background: The volume of air inspired prior coughing and the strength of expiratory muscles are determinants of an effective cough. In individuals with Parkinson’s disease (PD), respiratory muscle weakness and reduced chest wall compliance have the capacity to reduce maximum insufflation capacity and peak cough flow (PCF).
Method: Thirty-three individuals with PD were allocated to the control (n=11), EMT (n=11) or EMT plus AS group (n=11) [table 1]. The EMT plus AS and the EMT group performed expiratory muscle training (5 sets of 5 repetitions), 6 times a week for 2 months using a progressively increased resistance. The EMT plus AS group additionally performed 10 series of three to four consecutive lung insufflations using a manual resuscitator bag. The control group performed EMT using the same protocol and a fixed resistance. Voluntary and reflex PCF, maximum expiratory pressure, and slow vital capacity were assessed before and after training. Maximum expiratory pressure was measured over 3 testing sessions, each week apart to assess the test-retest reliability.
Results: Participants in the EMT plus AS demonstrated greater improvements in reflex (d=1.34) and voluntary (d=1.00) PCF when compared to the control group. Reflex PCF had a large effect (d=0.90) while voluntary PCF had a small effect (d=0.25) in the EMT plus AS group in comparison to the EMT group [figure 1]. The test-retest reliability of maximum expiratory pressure was good [table 2]. There were significant differences between day 1 and day 2 (p=0.015), between day 3 and day 1 (p<0.000) and borderline significant differences between day 3 and day 2 (p=0.059).
Conclusion: EMT plus AS were more beneficial than EMT alone for improving reflex and voluntary PCF. The effect of the EMT and AS was greater for reflex PCF than for voluntary PCF.
To cite this abstract in AMA style:
A. Reyes, A. Castillo, J. Castillo. Effects of Expiratory Muscle Training and Air Stacking on Peak Cough Flow in Individuals with Parkinson´s Disease [abstract]. Mov Disord. 2020; 35 (suppl 1). https://www.mdsabstracts.org/abstract/effects-of-expiratory-muscle-training-and-air-stacking-on-peak-cough-flow-in-individuals-with-parkinsons-disease/. Accessed June 15, 2025.« Back to MDS Virtual Congress 2020
MDS Abstracts - https://www.mdsabstracts.org/abstract/effects-of-expiratory-muscle-training-and-air-stacking-on-peak-cough-flow-in-individuals-with-parkinsons-disease/