Chronic refractory cough (CRC) is a challenging condition for patients and healthcare providers alike. When traditional medical interventions fail to provide relief, patients are often left with persistent symptoms that can severely impact their quality of life. This new study from just this year (cited below), explores the effectiveness of Expiratory Muscle Strength Training (EMST) using the EMST-150 device as a treatment for CRC. The results were promising, showing significant improvements in respiratory strength, cough severity, and even voice quality.
Â
I use EMST with a variety of my clients including those with Parkinson’s, swallowing difficulties, and reduced cough strength. It’s great to have evidence that supports using it with my chronic cough clients.
Results Overview
The study included 19 participants, all female, ranging in age from 24 to 80, with a mean age of 62.2 years. Many participants had comorbidities such as GERD, allergies, asthma, and voice disorders. Despite these varying conditions, the group showed statistically significant improvements across several key respiratory and vocal measures after just four weeks of EMST training.
Â
Key Findings:
Maximum Inspiratory Pressure (MIP): After four weeks, it increased significantly. This shows enhanced respiratory strength post-treatment.
Maximum Expiratory Pressure (MEP): MEP also saw a significant increase post-treatment suggesting greater expiratory muscle strength, crucial for managing chronic cough.
Laryngeal Airway Resistance (LAR): LAR decreased indicating reduced airway resistance, which may have contributed to reduced cough severity.
Maximum Phonation Time (MPT): After treatment, MPT increased showing improved breath control during speech.
Self-Assessment Questionnaires:
Voice Handicap Index (VHI-10): VHI-10 scores improved post.
Cough Severity Index (CSI): CSI scores dropped significantly from 19.37 pre-treatment to 15.00 post-treatment, indicating a perceived reduction in cough severity.
Patient Feedback and Subjective Results
Out of the 19 participants, 68% reported an improvement in their cough symptoms after using the EMST-150 device for four weeks. Specifically:
42% reported a 25% improvement in their cough.
21% reported a 50% improvement.
15% reported a 75% improvement.
The majority (16 out of 19) expressed a desire to continue using the EMST-150 beyond the study period, further suggesting the perceived benefit of the treatment.
Â
Discussion
This study demonstrates that EMST, a relatively simple intervention that can be done with visits to an SLP and with a structured home exercise plan, can significantly improve respiratory strength and cough control in patients with CRC. The reduction in laryngeal airway resistance and improvement in maximum phonation time suggests that EMST may be beneficial not only for reducing cough but also for improving voice function in patients with co-occurring voice disorders.
Â
Previous research has shown that breath training can help control chronic cough by stabilizing breathing patterns and reducing airway hypersensitivity. The results of this study align with those findings, supporting the idea that stronger respiratory muscles can help manage the cough reflex more effectively.
Â
Conclusion
Expiratory Muscle Strength Training using the EMST-150 device offers a promising treatment option for patients with chronic refractory cough who have not found relief through conventional medical treatments.
Kassandra Quibin, Brianna K. Crawley, Rim Saab, Priya Krishna, Thomas Murry,
"Expiratory Muscle Strength Treatment for Refractory Chronic Cough: A Short-term Single Exercise Program", Journal of Voice, Volume 38, Issue 4, 2024, Pages 864-869,
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.
Comments