Every Breath You Take…Why How You Breathe Matters

Pulmonary and respiratory muscle function impairment are common in individuals with Idiopathic Parkinson’s Disease (PD) and may occurs with other diseases as well, such as: COPD. Reduced respiratory muscle strength and function may cause shortness of breath during exercise or other physical activity, but, it may also contribute to symptoms of weak voice and coughing or choking when eating.

Current swallowing research indicates that most healthy adults swallow on the expiratory phase of breathing, or mid-exhalation.


So, try that: inhale, than just as you begin to exhale, pause, hold your breath, and swallow. Following the swallow resume exhalation.

Swallowing on exhalation may serve to protect your airway from any material still sitting above your vocal folds. This pause in breathing, is also accomplished because your vocal folds are closed for the second or so that you swallow. It is all a part of the amazing coordination between breathing and swallowing that occurs all day, every day, and something that most of us never think about until there is a system breakdown.

A colleague of mine from the University of Pittsburgh, Roxanne Diez Gross, PhD, published some research this year focusing on the coordination of breathing and swallowing in Parkinson’s Disease. Dr Gross reports: "respiratory insufficiency due to stiff chest muscles and weakness may contribute to individuals with PD swallowing at inopportune times within the respiratory cycle." Individuals with PD, therefore, may actually swallow when they should be taking a breath, resulting in aspiration, or “something going down the wrong pipe.” Stiffness and changes of the vocal folds also associated with PD may make it difficult for one to “hold their breath” long enough to accommodate the liquid or food being swallowed, in particular if muscles of chewing have also slowed.

Respiratory muscle strengthening exercise which focuses on inhalation and exhalation may provide improved breath support for speech and swallowing. Formal speech therapy programs, such as the LSVT® (Lee Silverman Voice Treatment) may further improve the strength and use of the respiratory , swallowing and voice system.

The Voice Aerobics™ exercise program is not a substitute for formal speech and swallowing therapy, but it may also help to heighten awareness about changes in your breathing and voice due to Parkinson’s and provide you with a program of exercise you can perform at home, on your own.

Always check with your physician before beginning any exercise program. Request a consult with a speech-language pathologist if you are beginning to notice symptoms of voice, speech, or swallowing changes.

Re-printable with permission from the author: Mary Spremulli,MA,CCC-SLP.
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