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Trial registered on ANZCTR
Registration number
ACTRN12625000601437p
Ethics application status
Not yet submitted
Date submitted
29/05/2025
Date registered
12/06/2025
Date last updated
12/06/2025
Date data sharing statement initially provided
12/06/2025
Type of registration
Prospectively registered
Titles & IDs
Public title
Expiratory muscle strength training in Parkinson’s disease after Deep Brain Stimulation
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Scientific title
Expiratory muscle strength training in Parkinson’s disease after Deep Brain Stimulation
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Secondary ID [1]
314560
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Parkinson's disease
337661
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Hypokinetic Dysarthria
337662
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Condition category
Condition code
Neurological
333993
333993
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0
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Parkinson's disease
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Physical Medicine / Rehabilitation
334054
334054
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0
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Speech therapy
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The device that will be used for Expiratory Muscle strength Training (EMST) will be the EMST150 (Aspire Products, Gainesville, FL, USA). During the initial face-to-face session, participants will be instructed in proper technique. To use the device, participants will place their lips tightly around the mouthpiece to form a secure seal. The training level with the EMST150 will be set to approximately 75% of each participant's maximum expiratory pressure (MEP) and will be individually adapted using the EMST150 to determine the optimal resistance level. The MEP is done by taking a deep breath and exhaling out through the device intensively. This process is repeated until there is no air coming out from the device. This is a similar level of exertion as blowing out candles as hard as possible. The resistance in the EMST150 ranges from 30–150H2O and can be adjusted in intervals of 30H2O.
The 4-week training program for the therapy group will be conducted in the participants’ homes following written instructions provided by the research team. This training program has been used elsewhere (Claus et al., 2021). Each at-home training session will involve 25 forceful exhalations using the EMST150 device. Participants will begin each exercise with a deep inhalation, followed by a forceful exhalation lasting a few seconds. After each exhalation, they will rest briefly. The exercise will comprise five exhalations, followed by a rest period of at least 15–30 seconds. This sequence will be repeated until the participants complete a total of 25 exhalations. Training sessions will be scheduled five times a week, and participants will use a paper-based journal to document session completions to ensure compliance with the training protocol. The participants will be instructed to continue day-to-day life as normal.
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Intervention code [1]
331181
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Rehabilitation
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Intervention code [2]
331223
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Treatment: Devices
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Assessment of Intelligibility of Dysarthric Speech
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Assessment method [1]
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This is a standardized test designed to measure the intelligibility and speaking rate of individuals with dysarthria, a motor speech disorder. Dysarthria is a term that encompasses symptoms that include but are not limited to slurred, slow and monotonous speech.
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Timepoint [1]
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Post test after 4 weeks of training
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Primary outcome [2]
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Voice Handicap Index
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Assessment method [2]
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This is a self-assessment tool used to measure the psychological and social impact of voice disorders on an individual’s quality of life. It includes 30 items across three domains—functional, physical, and emotional—allowing individuals to rate how their voice condition affects their functional capacity to complete daily activities, physical sensations, and emotional well-being.
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Timepoint [2]
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Post test after 4 weeks of training
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Secondary outcome [1]
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Dysphagia
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Assessment method [1]
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A self-reported Swallowing Disturbance Questionnaire for individuals with Parkinson’s disease
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Timepoint [1]
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Post test after 4 weeks of training
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Eligibility
Key inclusion criteria
clinically diagnosed with idiopathic PD;
aged between 50 and 75 years;
undergone bilateral STN-DBS surgery no less than 12 months earlier; independently living within the community, able to speak English and free of any signs of dementia (score of 88 and above on the Addenbrooke's Cognitive Examination).
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Minimum age
50
Years
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Maximum age
75
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Participants will be excluded if they are undertaking concurrent weekly speech pathology therapy sessions.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Linear mixed model analyses will be used to examine the effect of EMST for the outcome measures derived from the clinical scales and speech measurements. The level of significance for all statistical tests will be set at p<0.05.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/08/2025
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Actual
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Date of last participant enrolment
Anticipated
6/05/2026
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Actual
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Date of last data collection
Anticipated
6/06/2026
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Actual
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Sample size
Target
24
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
QLD
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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Australian Catholic University
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Address [1]
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Country [1]
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Australia
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Primary sponsor type
University
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Name
Australian Catholic University
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Address
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
321573
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Address [1]
321573
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Country [1]
321573
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Ethics approval
Ethics application status
Not yet submitted
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Ethics committee name [1]
317705
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ACU Human Research Ethics Committee
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Ethics committee address [1]
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https://staff.acu.edu.au/our_university/research/research-services/research-ethics
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Ethics committee country [1]
317705
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Australia
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Date submitted for ethics approval [1]
317705
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18/06/2025
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Approval date [1]
317705
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Ethics approval number [1]
317705
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Summary
Brief summary
This study aims to investigate the effects of a 4-week Expiratory Muscle Strength Training (EMST) program on speech and swallowing in people with Parkinson’s disease (PD) who have undergone Deep Brain Stimulation to the subthalamic nucleus (STN-DBS). While EMST has shown benefits in PD populations, its impact following STN-DBS has not yet been explored. Twenty-four eligible participants will complete pre- and post-intervention testing, with home-based EMST sessions conducted five times per week. Outcome measures will include speech, voice, and swallowing assessments, alongside quality of life and cognitive screening. Results will be analysed using linear mixed models to evaluate the effectiveness of EMST in improving communication-related outcomes in this population.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Zachary Conway
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Address
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Australian Catholic University PO Box 456 Virginia Queensland 4014
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Country
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Australia
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Phone
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+61 7 36237385
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Zachary Conway
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Address
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Australian Catholic University PO Box 456 Virginia Queensland 4014
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Country
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Australia
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Phone
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+61 7 36237385
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Zachary Conway
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Address
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Australian Catholic University PO Box 456 Virginia Queensland 4014
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Country
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Australia
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Phone
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+61 7 36237385
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Fax
141876
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Email
141876
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[email protected]
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Data sharing statement
Will the study consider sharing individual participant data?
No
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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