Research

Lab News

Current Projects

“SwallowFIT” an exercise program for US service members, Veterans, and family with Parkinson’s Disease: randomized clinical trial.

The goal of this 3-year double blind randomized clinical trial  is to test a preventative behavioral swallowing exercise program called “SwallowFIT”.

This study  will explore if early swallowing exercise improves function and reduces adverse outcomes for persons with PD.

Specific aims are to a) evaluate the effectiveness of a proactive swallow exercise program [SwallowFIT] in US Service members, Veterans and family members With Parkinson’s Disease and b) determine the acceptability, adherence and longer-term maintenance of swallowing fitness following the SwallowFIT program.

This study is a pilot pre-post interventional swallowing therapy study with 1 month follow up of persons with Parkinson’s Disease. The overarching objective in this study is to evaluate an established swallow exercise intervention [McNeil Dysphagia Therapy Program: MDTP] that is simple, accessible, pleasurable, and engages patients and families, to promote swallow fitness to optimize swallow function longer into PD progression.

Upper esophageal sphincter (UES) dysfunction, defined as inappropriate opening or failed relaxation of the UES during swallowing, is a common cause of dysphagia. This research project consists of two parts: I- a systematic review of the literature  to assess UES intervention trends and their impact on patient outcomes. II- Development of a multi-site study to explore the comparative effectiveness of two common intervention types.

Despite the high incidence and prevalence of dysphagia, particularly in the adult aging population, there is no uniform definition of adult dysphagia. Instead, heterogenous definitions in the extant literature pave the way for ambiguity and philosophical differences among dysphagia experts and other key stakeholders. Establishing an accepted and cogent definition for dysphagia is a critical step in quantifying the exact magnitude of disease in a specific population and assuring accuracy and consistency across healthcare settings, researchers, third party payers, and other key stakeholders.

The aim of this NIH directed research and conference therefore is to engage experts and key stakeholders who work with older adults with dysphagia and to collaborate and develop a consensus validation for a unified definition of dysphagia and guidelines that can be applied for use in clinical patient populations, public health, and policy.

Student Projects

Spontaneous swallow frequency (SSF) has been proposed as a potential physiologic indicator of swallowing system integrity and dysphagia. However, clinical implementation has been limited by inconsistent measurement methods and a lack of normative reference values. This ongoing study evaluates SSF in healthy community-dwelling adults using a standardized acoustic recording method during morning and afternoon sessions. Participants complete swallowing-related questionnaires, including FOIS, EAT-10, and RSI. Relationships between SSF and demographic variables (age, weight, BMI) are examined, along with potential diurnal differences. Findings will provide normative data and guidance regarding measurement conditions, supporting integration of SSF into clinical dysphagia assessment and management by speech-language pathologists.

Although dysphagia is traditionally conceptualized as a disorder of the oropharyngeal phase of swallowing, evidence indicates that swallowing dysfunction extends throughout the entire upper aerodigestive tract. Esophageal motility abnormalities have been identified in early stages of Parkinson’s disease (PD) and gastrointestinal dysmotility is considered an early or prodromal symptom suggesting that autonomic and enteric nervous system dysfunction may precede or accompany motor symptoms. Most research on dysphagia in PD has focused primarily on the oral and pharyngeal phases of swallowing. As a result, the role of esophageal motility in the overall swallow impairment in PD remains poorly characterized. This is a critical gap, as esophageal dysfunction may contribute to persistent dysphagia symptoms even when oropharyngeal assessments are relatively unremarkable, potentially leading to under-recognition or misclassification of dysphagia severity. This review aims to synthesize information about esophageal dysmotility in PD and its relationship to dysphagia symptoms.

Oral microbiota differs between PD patients and healthy individuals. The aim of this pilot study is to evaluate changes in the oral microbial environment following normalization of oral feeding through intensive swallowing therapy in PD.

When spontaneous swallowing (SSF), an innate protective mechanism, is impaired, aspiration prevalence and the risk of pneumonia are increased, especially in individuals with dysphagia. Data on SSF change and its significance in Parkinson’s disease are unknown. This study compared SSF rates in a cohort of early PD patients to age and gender-matched healthy controls.

SSF in early PD_Final (pdf)