Cough, Neuro-Degenerative Disease, Old Age; Dementia, Parkinson Disease, Swallowing Disorder
Conditions
Keywords
dementia, swallowing, physical exercise, parkinson disease
Brief summary
Swallowing impairment (dysphagia) is extremely common in older adults living with dementia due to age-related changes in swallowing and other disease-specific impairments. Dysphagia is commonly managed by modifying diet textures rather than engaging in rehabilitative swallowing therapy. This means that countless people with dementia are left to eat pureed foods and drink thickened liquids, which are unpalatable and lead to malnutrition. As the disease progresses, many are transferred to nursing homes. In Canada, speech-language pathologists, who manage dysphagia, are consultants within nursing homes; therefore, swallowing therapy is non-existent. However, exercise therapy is more commonly available. Rodent models have demonstrated that physical exercise strengthens tongue and vocal-fold musculature, which are critical components of swallowing. Therefore, it is possible that whole-body physical exercise, which increases rate of respiration, will help to strengthen swallowing-related musculature in older adults with dementia. In this study, older adults (65+) with early-stage dementia will complete a 12-week physical exercise program to determine improvement of swallowing function.
Interventions
BEHAVIORALWhole-body exercise
10-week one-on-one, virtual, whole-body exercise class, 3x/week, focused on increasing respiratory rate through moderate-intensity aerobic exercises.
Sponsors
Joseph Brant Hospital
McMaster University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
60 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* \> 59 years of age * able to walk independently with or without an assistive device for a distance of at least 10 meters * able to be active for 60 minutes with rest breaks * abe to independently follow directions * not involved in active rehabilitation * a diagnosis of a progressive neurologic disease * a maximum value for tongue strength \<40 kPa
Exclusion criteria
* neurological conditions other than a progressive neurologic disease * significant cardiovascular conditions * severe aphasia * pain, other medical conditions or behavioural issues that would limit safe participation in the exercise program * individuals with known structural causes of dysphagia * individuals with known allergies to latex * individuals receiving swallowing rehab
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in respiratory function from baseline to end of intervention | baseline, week 4, week 14 and week 16 | Measure via peak cough flow using a peak flow meter |
| Change in swallowing function from baseline to end of intervention | baseline, week 4, week 14 and week 16 | Measure via isometric tongue strength using an Iowa Oral Performance Instrument |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in aerobic fitness from baseline to end of intervention | baseline, week 4, week 14 and week 16 | Measure via physical capacity using the 6-minute walk test |
Countries
Canada
Outcome results
None listed