Your Mind Can Exercise Too: Swallowing Motor Imagery Practice

Summary

Swallowing difficulty (dysphagia) is a clinical symptom of Parkinson's disease (PD) that significantly impacts nutrition, oral secretion management, health status, and quality of life\]. Specific hallmarks of dysphagia in patients with PD include tongue weakness, reduced swallowing frequency and efficiency, and airway invasion. Evidence for effective treatment techniques to address dysphagia in patients with PD is limited and urgently needed, substantiating the systematic study of standard-of-care treatments in this population as well as the development of novel techniques. Motor imagery practice (MIP) is a mentally rehearsed form of exercise that does not involve muscle activation and has been shown to improve motor outcomes in limb rehabilitation. MIP is novel to swallowing rehabilitation. Our group has conducted preliminary MIP studies in healthy older adults and demonstrated improved measures of tongue strength and swallowing pressure when MIP is used in combination with physical tongue exercise compared to physical tongue exercise alone. The next step is to evaluate the use of MIP in patients with dysphagia. The purpose of this research is to determine the feasibility and effect of MIP when added to a physical swallowing-related exercise protocol for patients with PD. Changes in tongue pressure generation, spontaneous swallowing frequency, functional physiological swallowing outcomes, and patient-reported outcomes will be examined. This research aims to fill gaps in evidence specific to dysphagia in patients with PD and to evaluate a novel rehabilitation method. The investigators anticipate that the results of this study will inform clinical practice, with evidence for supporting the improvement of swallowing function and quality of life in patients with PD, and lay the groundwork for the design of future randomized controlled clinical trials.

Conditions

• Dysphagia

Interventions

BEHAVIORAL

Swallowing exercises

Standard-of-care swallowing exercises include tongue exercise. The experimental part added in Phase 3 includes some participants completed standard-of-care exercises again and others completing standard-of-care exercises and motor imagery practice of those exercises.

Sponsors & Collaborators

• Case Western Reserve University

  collaborator OTHER

• Emerson College

  collaborator OTHER

• James Madison University

  collaborator OTHER

• Texas Christian University

  collaborator OTHER

• Samford University

  lead OTHER

Principal Investigators

• Sarah Szynkiewicz, PhD · Samford University

Study Design

Allocation

NON_RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

SEQUENTIAL

Eligibility

Min Age

65 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2024-08-08

Primary Completion

2024-12-31

Completion

2024-12-31