파킨슨병 환자들의 행동학적 기침재활: 주제범위 문헌고찰

Abstract

Airway protective behaviors including both swallowing and cough are highly interrelated and share sensorimotor control. However, the majority of airway protective rehabilitation has predominantly focused on swallowing function. The aim of this scoping review was to explore the latest evidence on the effects of cough rehabilitation in patients with Parkinson's disease (PD) in order to improve clinical decision-making. A comprehensive search was conducted for articles published in English from January 2013 to March 2023 in PubMed, Embase, and Web of Science. The search was performed using the terms ‘Parkinson's disease’ combined with ‘cough rehabilitation.’ Initial selection was followed by a review of titles, abstracts and/or full texts to exclude irrelevant literature. The final selection included only those articles that focused on behavioral interventions for cough rehabilitation carried out by speech-language pathologists. Among the eight selected articles, four current therapeutic approaches for cough rehabilitation were identified: respiratory muscle strength training (5 studies), Lee Silverman Voice Treatment (LSVT LOUD®) (1 study), respiratory-swallow coordination training (1 study), and sensorimotor training for airway protection (1 study). The review revealed that existing behavioral interventions for cough rehabilitation in PD were effective. Notably, there is an increasing focus on enhancing overall upper airway functions and augmenting sensory perception as well as strengthening muscles for airway protection through cough rehabilitation. Future research would be crucial to facilitate conclusive decision-making for airway protection in clinical environments.