Instrumental Assessment of Aero-Resistive Expiratory Muscle Strength Rehabilitation Devices

Authors

Angela M. Dietsch, University of Nebraska-LincolnFollow
Rahul Krishnamurthy, University of Nebraska-LincolnFollow
Kelsey Young, University of Nebraska-LincolnFollow
Steven M. Barlow, University of Nebraska-LincolnFollow

ORCID IDs

Dietsch 0000-0003-4554-5365

Krishnamurthy 0000-0003-1736-1737

Barlow 0000-0002-6628-6748

Date of this Version

2024

Citation

Journal of Speech, Language, and Hearing Research (March 2024) 32(4): 729–739

doi: 10.1044/2023_JSLHR-23_00381

Comments

Copyright 2024, American Speech-Language-Hearing Association. Used by permission

Abstract

Purpose

Expiratory muscle strength training (EMST) is increasingly being used to treat voice, cough, and swallowing deficits in a wide range of conditions. However, a multitude of aero-resistive EMST models are commercially available, and the ab-sence of side-by-side comparative data interferes with clinicians’ ability to assess which model is best suited to a particular client’s needs. The primary aim of this research was to test and compare the pressure and flow parameters of six currently available EMST models to help inform clinical decision making.

Method

We identified and tested five devices of each of six different EMST models to generate benchmark data for minimum trigger pressures across settings. The reliability was tested within each device and between five devices of the same model across settings using coefficient of variation.

Results

All six models required higher pressures to initiate flow at the highest setting compared to the lowest setting, as expected. Detailed descriptive statistics for each model/setting combination include average flow-triggering pressure for each model/setting and the variability across trials within a device and across devices of the same model. From these, ranked order of the least to most stable EMST model was derived.

Conclusions

Systematic testing of several commercially available expiratory re-sistance training devices yielded clinical benchmarks and reliability data to aid clinicians in selecting an appropriate therapy device and regimen for a client based on their available airflow and air pressure as well as reliability of the device. These findings allow clinicians to directly compare key parameters across EMST devices.