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My drooling is out of control! How EMST can help when you have Parkinson's

Updated: Oct 19, 2023


Man's mouth, drooling, Parkinson's Disease
Man's mouth

One of the most discussed symptoms of Parkinson’s disease with my clients is drooling. There are many tips to decrease saliva pooling in the mouth (keep a water bottle close and take small sips throughout the day!) but currently, the main treatment that is offered for drooling is botulinum toxin injections to the saliva glands. This can have a number of side effects and do not treat the causes of drooling, such as impaired swallowing and lip closure.


A study from the journal Dysphagia titled “Expiratory Muscle Strength Training for Drooling in Adults with Parkinson’s Disease” (full citation at the bottom of this post), explores Expiratory Muscle Strength Training as an alternative therapy approach for drooling. I have been trained in EMST and love to implement it with a variety of my clients.


The study found that sialorrhea, which is excessive drooling in people with Parkinson's disease, improved significantly following a period of expiratory muscle strength training (EMST). This suggests that EMST may be an effective alternative treatment for sialorrhea without the reported side effects associated with botulinum toxin injections.


Participant Satisfaction: All participants reported high satisfaction with EMST as a treatment for sialorrhea. Attendance at face-to-face treatment sessions was also high, indicating that the treatment approach was well-tolerated and not burdensome for the participants.


Swallow Function: EMST resulted in an improvement in swallow function, as indicated by higher scores on the Mann Assessment of Swallowing Ability (MASA). This suggests that EMST may target the underlying factors contributing to sialorrhea, including reduced swallow efficiency.

Quality of Life: Participants reported an improvement in health-related quality of life (HRQoL) associated with swallowing, further supporting the positive impact of EMST on their well-being.

Peak Cough Flow: The study also found that EMST led to an improvement in peak cough flow. This is significant because aspiration pneumonia is a common cause of death for people with Parkinson's, and the ability to cough effectively is crucial in preventing aspiration pneumonia. EMST may reduce the risk of aspiration pneumonia by targeting both swallow function and peak cough flow.

In conclusion, this study serves as an important initial step in exploring the potential benefits of EMST for sialorrhea in people with Parkinson's disease. The results suggest those that are seeking ways to improve quality of life while living with Parkinson's disease should consider exploring EMST under the guidance of a qualified speech-language pathologist.

At True Self Speech Therapy, we are trained and specialize in using this modality. Contact us to learn how we can help.

[Cocks N, Rafols J, Embley E, Hill K. Expiratory Muscle Strength Training for Drooling in Adults with Parkinson's Disease. Dysphagia. 2022 Dec;37(6):1525-1531.]


Disclaimer: This blog post is for informational purposes only and should not be considered a substitute for professional medical advice. Please consult with a qualified speech pathologist for a personalized evaluation and treatment plan.

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