Speech Therapy Benefits for a Chronic Cough
There are numerous reasons a patient may be experiencing a chronic cough, including rhinitis, asthma, and reflux. Medications are effective in controlling a cough for most patients. Unfortunately, some patients will develop a laryngeal motor dysfunction or heightened sensitivity to triggers, which create a chronic cough for reasons that may be addressed through speech therapy. In some cases, the cough is idiopathic, making it even more difficult to treat. Some studies have shown significant improvement in symptoms when speech pathology was included in their treatment plan.
Environment and Awareness
Patients with a chronic cough first need to increase their awareness of situations which precipitate a bought of coughing, and do what they can to improve the laryngeal environment. By becoming more aware of the environments and situations which trigger a cough, they can begin to reduce the stimuli. The laryngeal environment can be improved most effectively by increasing hydration, and encouraging nasal respiration with targeted breathing therapies.
There are several methods to choose from when retraining a patient’s respiratory functions. The following methods are attributed to Murry and Sapienza. First, is encouraging quietly focused rhythmic breathing. The individual sits with shoulders relaxed and exhales slowly with focused abdominal movement, with a consistent inhalation and exhalation pattern. Another method involves having the patient exhale while maintain the sound /f/, /sh/, or /z/ for increased periods of time. Pulsed exhalation encourages the patient to exhale rapidly making the /sha/ or /ha/ sounds, followed by inhaling through the nose with the mouth closed.
There are numerous other methods with which patients can modify their respiration in order to alleviate a chronic cough. Inhaling and exhaling through the nose only is the easiest method for patients to master. Various methods which involve inhaling through the nose and exhaling with lips pursed are a bit more difficult. Using a straw to focus the exhalation process can make this method slightly easier.
Most of the retraining methods listed above should be done in increments of no more than one minute each. This helps alleviate patient boredom and ensure that each repetition is as accurate as possible. This also allows more techniques to be utilized in each practice session. Eventually patients should incorporate their exercises into daily life, and utilize them to interrupt the coughing process.
Studies have shown that speech therapy sessions can improve a chronic cough with the first session; however, it takes three to four sessions for more substantial improvement to become evident. The true key to success seems to be in combining therapies in order to teach a variety of techniques and methods which allow the patient to resume control over their laryngeal functions.