Effects of expiratory muscle training on respiratory indices and swallowing function in elderly individuals receiving home care

Expiratory muscle training （EMT） for improving cough function and prevention of aspira‑ tion pneumonia in healthy elderly individuals as well as patients with neurological disorders has received recent attention. Although 2 studies elucidated its effects on swallowing function in a small population of patients with Parkinson’ s disease its overall efficacy remains uncertain. The purpose of this study was to examine the effects of EMT on respiratory indices and swallowing function in elderly individuals receiving home care. The subjects were 22 community‑dwelling elderly individuals receiving home care. An EMT training device （Threthold IMT） was applied with reversed use and the training period was 4 weeks. The loading pressure was 30% of baseline MEP and the training sessions were performed for 15 minutes twice a day. Each training session was monitored by a family mem‑ ber and recorded. Respiratory function ［forced‑vital capacity （FVC） and %FVC］ and respirato‑ ry muscle strength ［maximal expiratory pressure （MEP） and maximal inspiratory pressure （MIP） ］ were measured at baseline and after 1 2 3 and 4 weeks of EMT while swallowing function ［repetitive saliva swallowing test （RSST） ］ was measured at baseline and after 4 weeks. Two‑way ANOVA was performed with the factors of ADL score and measurement week. Statistical analysis showed that both factors had effects though there was no correlation be‑ tween them. MEP was significantly improved at 3 and 4 weeks after EMT as compared to the baseline whereas other respiratory indices and RSST were unchanged after EMT. Our findings indicate that EMT can strengthen expiratory muscles and suggest the need for higher expiratory loading pressure. Further research should define the target population more clearly and establish an effective EMT protocol to improve swallowing function.