Measuring voluntary and reflexive cough strength in healthy individuals

Cough reflex testing is a validated tool for identifying patients at risk of silent aspiration. However, inter- and intra-rater reliabilities of perceptual judgements of cough strength are sub-optimal. Although there are clinically established methods for measuring volitional cough strength, no simi...

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Published in:Respiratory medicine 2017-11, Vol.132, p.95-101
Main Authors: Mills, Claire, Jones, Richard, Huckabee, Maggie-Lee
Format: Article
Language:English
Subjects:
Acoustic
Acoustics
Air flow
Airflow
Citric acid
Cough
Cough strength
Identification methods
Measurement methods
Patients
Pressure
Reflexive cough
Respiratory diseases
Strength
Voluntary cough
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creator Mills, Claire
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description Cough reflex testing is a validated tool for identifying patients at risk of silent aspiration. However, inter- and intra-rater reliabilities of perceptual judgements of cough strength are sub-optimal. Although there are clinically established methods for measuring volitional cough strength, no similar methods are identified for reflexive cough strength. This study evaluated three measurement methods of voluntary and suppressed reflexive cough strength. Fifty-three healthy subjects (≥50 years) participated in this study. Participants produced ‘strong’ and ‘weak’ voluntary coughs and suppressed reflexive coughs to incremental doses of citric acid. Peak and area under the curve (AUC) measurements were taken of pressure, airflow, and acoustics. There was no dose effect of citric acid on measures of reflexive cough strength. Strong voluntary coughs were stronger than reflexive coughs for all measures (p 
doi_str_mv 10.1016/j.rmed.2017.09.013
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AUC pressure and peak flow had the highest correlations and effect sizes. Correlations were low between voluntary and reflexive cough strength for all measures (r ≤ 0.46). Assessing strength of reflexive cough, rather than voluntary cough, is highly desirable in the dysphagic population. Pressure and flow provide the most useful objective measurements. •There is no dose effect on suppressed reflexive cough strength to citric acid.•Strong voluntary coughs are stronger than suppressed reflexive coughs.•Pressure and airflow are promising objective measures of reflexive cough strength.</description><identifier>ISSN: 0954-6111</identifier><identifier>EISSN: 1532-3064</identifier><identifier>DOI: 10.1016/j.rmed.2017.09.013</identifier><identifier>PMID: 29229113</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Acoustic ; Acoustics ; Air flow ; Airflow ; Citric acid ; Cough ; Cough strength ; Identification methods ; Measurement methods ; Patients ; Pressure ; Reflexive cough ; Respiratory diseases ; Strength ; Voluntary cough</subject><ispartof>Respiratory medicine, 2017-11, Vol.132, p.95-101</ispartof><rights>2017</rights><rights>Copyright © 2017. 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1532-3064
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subjects Acoustic
Acoustics
Air flow
Airflow
Citric acid
Cough
Cough strength
Identification methods
Measurement methods
Patients
Pressure
Reflexive cough
Respiratory diseases
Strength
Voluntary cough
title Measuring voluntary and reflexive cough strength in healthy individuals
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