Dissertations and Theses @ UNI

Award Winner

Recipient of the 2019 Outstanding Master's Thesis Award - First Place.

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Open Access Thesis


Deglutition disorders--Exercise therapy; Parkinson's disease--Complications--Exercise therapy;


The leading cause of death in Parkinson’s disease (PD) is aspiration pneumonia, a negative consequence of swallowing impairment. Approximately 80%, and upward of 95%, of persons with Parkinson’s disease (PwPD) will present with progressive dysphagia, or swallowing impairment. Dysphagia may also lead to dehydration, malnutrition, weight loss, reduced quality of life, hospital readmissions, and high financial burden. Recent evidence suggests swallowing exercise is beneficial for PwPD and there is growing evidence that supports intense programs combining exercises, which may provide sufficient treatment intensity to improve swallowing. The present study investigated whether a four-week Intensive exercise-based Swallowing Program (ISP) combining lingual and respiratory exercises for two PwPD would improve outcomes on multiple probe and endpoint measures of swallowing, respiratory, and vocal functions. Specifically, probes included maximum isometric pressures (MIP) of the tongue, maximum expiratory pressure (MEP), maximum phonation time (MPT), and maximum phonation intensity (MPI). Endpoint measurements consisted of the Mann Assessment of Swallowing Ability (MASA), Timed Water Test (TWT), Repetitive Saliva Swallow Test (RSST), and Swallowing Quality of Life Questionnaire (SWAL-QOL). Post-treatment gains occurred in lingual strength, MEP, and MPI (p < .003) with moderate-to-strong effect sizes. Both MASA scores and TWT swallowing capacity increased, and RSST performance improved to or was maintained within healthy ranges. Neither MPT, an untrained task, nor SWAL-QOL scores significantly changed. Overall, results suggest a positive, synergistic effect of combined treatment modalities evidenced by gains in both swallowing and respiratory systems. Future investigation is warranted to further develop efficacious ISPs for PwPD and to determine their effectiveness to ameliorate the negative consequences of dysphagia.

Year of Submission


Year of Award

2019 Award

Degree Name

Master of Arts


Department of Communication Sciences and Disorders

First Advisor

Laura Pitts, Chair, Thesis Committee

Date Original


Object Description

1 PDF file (viii, 75 pages)



File Format