Abstract
SESSION TITLE: Wednesday Electronic Posters 5 SESSION TYPE: Original Inv Poster Discussion PRESENTED ON: 10/23/2019 09:45 AM - 10:45 AM PURPOSE: Parkinson's disease causes dysfunction both to swallowing in its various phases as well as to the mechanism of cough. Oropharyngeal dysphagia is present at all stages of the disease, and is the main cause of pneumonia due to silent aspiration of food and saliva. Hence, it may increase the risk of death, pneumonia being often the final cause of death . Different strategies exist to reduce the risk of inhalation, and consequently the risk and number of lung infections. In this preliminary study, we aimed to evaluate whether adding to the standard therapy a technique designed to accelerate the expiratory flow could reduce the number of inflammatory events. Our aim was to investigate the efficacy of the Expiratory Flow Acceleration (EFA) technique, applied using the device Free Aspire®, to reduce the incidence of bronchopulmonary infections . Moreover, changes in respiratory function parameters, cough and encumbrance and quality of life ( QoL) scores METHODS: Twenty patients with Parkinson' s disease were enrolled (13 males and 7 females. Inclusion criteria were:-Stage III and IV of the H&Y classification (Hoehn & Yahr scale)-Score 3-4 on the DOSS scale (Dysphagia Outcome and Severity Scale)-Score ≥ 5 on the Pooling Score-Score ≥ 4 on the PAS scale (Penetration Aspiration Scale) Treatment-10 patients treated with standard therapy + EFA with Free Aspire®-10 patients treated with standard therapy (control group) Re-evaluation at 30 - 60 - 180 days after the start of treatment Primary outcome : the incidence of bronchopulmonary infections in patients with Parkinson's disease affected by swallowing deficits Secondary outcomes : - Respiratory function tests (FVC, FEV1), Cough capacity test (PCEF) Questionnaires on QoL (Euro-QOL, PDQ-39),VAS (Visual Analogue Scale) for cough and bronchial encumbrance. RESULTS: Among the primary outcomes, no significant difference was found between the two groups as regards the number of respiratory infections, number of accesses to the Emergency Department, or number of admissions. Secondary outcomes ( spirometric parameters[FEV1 and CVF),cough effectiveness(PCEF)and questionnaire of QoL showed a significant improvement in the EFA group compared to the control group . CONCLUSIONS: The treatment with the EFA device seems to lead to an improvement in the functional indices as well as in the quality of life of Parkinson's patients with dysphagia. Nevertheless, definitive conclusions cannot be drawn due to the small sample size. The results of this pilot study seem to support the effectiveness of the treatment with EFA technology. However, further studies are needed in a larger, and hence more representative, sample of patients in order to be able to definitively confirm the usefulness of this technique for this type of patient. CLINICAL IMPLICATIONS: Adding EFA technology to standard therapy is useful for Parkins's disease patients with swallowing disorders DISCLOSURES: No relevant relationships by NICOLINI ANTONELLO, source=Web Response No relevant relationships by Bruna Grecchi, source=Web Response
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