Speak Out June 2020

Association news

Member research

Can we rehabilitate silent aspiration?

Research and COVID-19 This unprecedented time in which we live has given rise to numerous challenges – and some opportunities as well. Are you undertaking research driven by COVID-19 challenges? This might be around service delivery to a particular population, implementation of telepractice, effects of COVID-19, or something different. We would love to hear about your project. Send a short (250 – 300 word) summary of your project to ebp@speechpathologyaustralia.org.au. Tell us a bit about what you’re investigating, your rationale for doing this, how you’re going about it and any challenges you might have faced on the way. We’ll put together an article for the next Speak Out , so have your information to us by 9 July. We look forward to including some results in a later edition, once you have them available. Member Emma Wallace, PhD, Speech-Language Therapist and Post-Doctoral Research Associate at the Adelaide Institute for Sleep Health and Flinders Health and Medical Research Institute shares a summary of her latest work published in the American Journal of Speech-Language Pathology. What was the study aim? Our aim was to evaluate the safety and efficacy of a novel sensory stimulation protocol that was designed to enhance cough sensitivity, as a potential treatment for silent aspiration. Study design The study was a randomized control trial. Twenty-four participants were randomly assigned to one of three groups: high intensity stimulation, low intensity stimulation and a control group. What was the sensory stimulation protocol? The sensory stimulation involved repeated inhalations of nebulized distilled water. Distilled water is a cough evoking, or “tussigenic” stimulus. We hypothesised that repeatedly stimulating the sensory receptors in the larynx may sensitise them. We used two different types of stimulation: (1) low intensity and (2) high intensity stimulation. These differed by the flow rate of the nebulizer (i.e. higher flow rate = more distilled water inhaled). The control group inhaled 0.9% saline. What did we find? When compared to the control group, the high intensity stimulation protocol significantly increased cough sensitivity. There were no adverse reactions to the inhalations. What does this mean? We can safely increase cough sensitivity using the high intensity

Image: Wikimedia Commons

sensory stimulation protocol. This is promising for patients with silent aspiration and reduced cough sensitivity. Why is it important? Silent aspiration is associated with increased mortality, morbidity, length of hospital stays and hospital costs. Currently, we have no treatment for silent aspiration. Clinicians are forced to assume a “wait and see” approach with reviews to assess for spontaneous recovery - which may or may not happen. This study represents the first steps towards developing a treatment for silent aspiration. Where can I access the study? Wallace, E., et al. 2020. A Sensory Stimulation Protocol to Modulate Cough Sensitivity: A randomized controlled trial safety study. American Journal of Speech-Language Pathology (ePub ahead of print). For a copy of the paper please email emma.wallace@flinders. edu.au.

Have you recently had your research published? Tell us about it. Please send us your research summary for publication in the next edition of Speak Out. Summaries should be between 200-300 words. For more information and to submit your summary contact Cori Williams, ebp@ speechpathologyaustralia.org.au. Deadline 9 July, 2020

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