Refining Cough Skill Training in Parkinson's Disease and Dysphagia

Inclusion Criteria

• •40 years of age or older
• •have dysphagia as documented by a penetration-aspiration score \> 2 on a flexible endoscopic evaluation of swallowing
• •have cough disorder as defined as a maximal voluntary cough peak flow \< 5 L/s
• •have no history of other neurological disorders, head and neck cancer, respiratory disease, smoking within 5 years, uncontrolled hypertension, or allergy to capsaicin (reflex cough stimulus)