Cough reflex sensitivity improves with speech language pathology management of refractory chronic cough

Nicole M Ryan; Anne E. Vertigan; Sarah Bone; Peter G. Gibson

doi:10.1186/1745-9974-6-5

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$Cough reflex sensitivity improves with speech language pathology management of refractory chronic cough$

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Cough reflex sensitivity improves with speech language pathology management of refractory chronic cough

Nicole M Ryan, Anne E. Vertigan, Sarah Bone and Peter G. Gibson

Cough (London, England), Vol.6, 5

28/07/2010

DOI: https://doi.org/10.1186/1745-9974-6-5

PMID: 20663225

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Abstract

Capsaicin

Chronic Cough

Treatment Visit

Cough Reflex Sensitivity

Cough Frequency

Rationale Speech language pathology is an effective management intervention for chronic cough that persists despite medical treatment. The mechanism behind the improvement has not been determined but may include active cough suppression, reduced cough sensitivity or increased cough threshold from reduced laryngeal irritation. Objective measures such as cough reflex sensitivity and cough frequency could be used to determine whether the treatment response was due to reduced underlying cough sensitivity or to more deliberate control exerted by individual patients. The number of treatments required to effect a response was also assessed. Objective The aim of this study was to investigate subjective and objective measures of cough before, during and after speech language pathology treatment for refractory chronic cough and the mechanism underlying the improvement. Methods Adults with chronic cough (n = 17) were assessed before, during and after speech language pathology intervention for refractory chronic cough. The primary outcome measures were capsaicin cough reflex sensitivity, automated cough frequency detection and cough-related quality of life. Results Following treatment there was a significant improvement in cough related quality of life (Median (IQR) at baseline: 13.5 (6.3) vs. post treatment: 16.9 (4.9), p = 0.002), objective cough frequency (Mean ± SD at baseline: 72.5 ± 55.8 vs. post treatment: 25 ± 27.9 coughs/hr, p = 0.009), and cough reflex sensitivity (Mean ± SD log C5 at baseline: 0.88 ± 0.48 vs. post treatment: 1.65 ± 0.88, p < 0.0001). Conclusions This is the first study to show that speech language pathology management is an effective intervention for refractory chronic cough and that the mechanism behind the improvement is due to reduced laryngeal irritation which results in decreased cough sensitivity, decreased urge to cough and an increased cough threshold. Speech language pathology may be a useful and sustained treatment for refractory chronic cough.

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Title: Cough reflex sensitivity improves with speech language pathology management of refractory chronic cough
Creators: Nicole M Ryan - University of Newcastle Australia
Anne E. Vertigan - University of Newcastle Australia
Sarah Bone - John Hunter Hospital
Peter G. Gibson - University of Newcastle Australia
Publication Details: Cough (London, England), Vol.6, 5
Publisher: BioMed Central
Identifiers: 991013184711302368
Copyright: © 2010 Ryan et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0).
Academic Unit: Faculty of Health
Language: English
Resource Type: Journal article

Cough reflex sensitivity improves with speech language pathology management of refractory chronic cough

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