Respiratory Muscle Strength Training

Christine Sapienza, PhD, CCC-SLP, serves as the Dean of the Jacksonville University, Brooks Rehabilitation College of Healthcare Sciences. Previously, Dr. Sapienza was a longstanding tenured professor and chair of the Department of Communication Sciences and Disorders at the University of Florida, as well as a research career scientist at the Brain Rehabilitation Research Center at the Malcom Randall Veterans Administration Hospital. As a principal investigator of National Institutes of Health grants, VA Research Rehabilitation Research and Development Awards, and a M.J. Fox Foundation grant, Dr. Sapienza has provided extensive mentoring to 16 doctoral students, all of whom have contributed back to academics and clinical service. She has built a strong national and international reputation for expertise in the design and implementation of larger scale randomized clinical trials examining treatments as well as the careful reporting of peer-reviewed outcomes from these studies. Dr. Sapienza methodically disseminates this information to the scientific community at large in the form of invited presentations, workshops, and clinical teaching platforms. Through writing, she works to integrate research findings in journal articles, textbooks, and clinical manuals. As a frequent contributor to patient support groups she aspires to assist patients and caregivers as they navigate available treatments and emerging science. Most recently, Dr. Sapienza was selected as Jacksonville's Women of Influence.++++++++++++++++++++++++++++++++++++++++++++++++++++++++++Bari Hoffman, PhD, CCC-SLP, is an Associate Professor in the Department of Communication Sciences and Disorders and jointly appointed as Associate Professor, Internal Medicine at the University of Central Florida. Dr. Hoffman serves as research partner to the Florida Hospital Cancer Institute and Director of the Center for Voice Care and Swallowing Disorders at the Ear Nose Throat and Plastic Surgery Associates. She has worked clinically in this setting for more than 18 years treating individuals with voice and upper airway disorders specializing in pediatric, professional and neurogenic populations, along with individuals undergoing treatment for head and neck cancer. Dr. Hoffman Ruddy received her doctoral degree from the University of Florida in 2001. Her current research involves studying novel treatment technologies and biomechanical mechanisms for disorders of laryngeal function while defining the high impact on quality of life factors. She implements 3-D computer modeling of upper and lower airway function, coping strategies of individuals with dysphonia and respiratory muscle strength paradigms in a variety of patient groups. Dr. Hoffman has a significant record of peer-reviewed publications, authorship of multiple textbooks, and actively lectures across the country on these topics. In recognition of her contributions to teaching, research, and service, she has received numerous awards within her University and state association.

Preface
About the Editors
Contributors

Chapter 1. Respiratory Anatomy and Physiology
Christine Sapienza

Chapter 2. Neuroanatomy and Neurophysiology of the Respiratory System 
Christine Sapienza

Chapter 3. The Laryngeal Valve
Gayle Woodson

Chapter 4. Skeletal Muscle Structure and Function
David Hooper, Catherine Saenz and Carena Winters

Chapter 5. Respiratory Muscle Training
Scott K. Powers, Mustafa Ozdemir, Matthew P. Bomkamp, and Hayden Hyatt

Chapter 6. Respiratory Muscle Strength Training Devices
Christine Sapienza

Chapter 7. Respiratory Training for Special Populations
Christine Sapienza, PhD and Michelle Troche

Chapter 8. Inspiratory Muscle Strength Training in an Adolescent with Grade 1 Subglottic Stenosis
Susan Brehm and Barbara D. Weinrich

Chapter 9. Exercise Induced Laryngeal Obstruction and Inspiratory Muscle Training
Astrid Sandnes, Hege Havstad Clemm, Tiina Andersen, Thomas Halvorsen, and Ola Drange Røksund 

Chapter 10: Using Expiratory Muscle Strength Training with Velopharyngeal Insufficiency (VPI) Conditions 
Yaser S. Natour and Wesam B. Darawsheh

Chapter 11: Incorporating RMST into Voice Therapy for a Patient with Vocal Fold Paresis
Adam T. Lloyd, Michelle M. Bretl, and Jennylee Diaz

Chapter 12. Using EMST for Treatment of Dysphagia for a Complex Patient in the Acute Care Setting 
Vicki Lewis

Chapter 13. The Use of Expiratory Muscle Strength Training in the Treatment of Chronic Refractory Cough and Presbyphonia 
Austin Collum and Emily Dunn

Chapter 14. Respiratory Muscle Strength Training for Treatment of Communication and Swallowing Deficits in Tracheostomy and Ventilator Dependent Patients
Maribel Ciampitti

Chapter 15. Respiratory Muscle Strength Training for a Patient with Head and Neck Cancer
Irene de Pedro Netto Vartanian, Jose Guilherme Vartanian, and Renan Bezerra Lira

Chapter 16. RMST Case: Late Radiation-Associated Dysphagia (Late-RAD) in Head and Neck Cancer Survivorship 
Carly E. A. Barbon and Katherine A. Hutcheson

Chapter 17. Expiratory Muscle Strength Training (EMST) in the Laryngectomized Patient
Bari Hoffman Ruddy, Vicki Lewis, and Henry Ho

Chapter 18. Frequently Asked Questions
Christine Sapienza

Appendix A. Representative Sample of Devices Used for Respiratory Training

Appendix B. Instructions for Using Respiratory Training Devices

Index