The EMST - how it works
Training and therapy in your pocket
The EMST is a calibrated respiratory trainer that trains the muscles involved in breathing and swallowing. Many studies have shown that the EMST is easy and simple to use, leads to success quickly and can help with a wide range of breathing and swallowing problems. Training with the EMST increases your endurance and helps you to improve your quality of life!
The training is easy and simple to use at home - on the sofa, in bed or on the way to work. You will feel the success after just five weeks!
Parkinson
Swallowing disorders ("dysphagia") in Parkinson's disease are very common, significant for everyday life and well-being, and are often not noticed by those affected (1). In several scientific studies the effectiveness of the EMST150 in the treatment of Parkinson's dysphagia was proven (2,3,4,5). The effects are still detectable several months after the end of the training. This provided class 1 evidence for the treatment of Parkinson's dysphagia. Therefore, the EMST is recommended in the S3 guideline of the German Society for Neurology (DGN 2020). It is also included in the guideline of the European Society for Clinical Nutrition and Metabolism (ESPEN 2018) as an exercise method for Parkinson's disease. For patients with Parkinson's, training with the EMST leads to more swallowing security and more mobility!
Stroke
Patients with stroke often suffer from threatening swallowing disorders. Early training with the EMST promotes strong, protective coughing and strengthens the swallowing muscles and can thus help to avert dangerous consequences of a stroke (6,7). The EMST is therefore recommended by the DGN guidelines!
Neuromuscular Diseases - ALS - Multiple Sclerosis
Neuromuscular diseases such as amyotrophic lateral sclerosis ("ALS") lead to a progressive breakdown of muscle mass and muscle strength - particularly breathing and swallowing muscles. A special, gentle training protocol adapted to these patients has been proven scientifically to lead to stabilization and to a delay in the occurrence of swallowing disorders (8). Training with the is often recommended for these patients EMST75 lite. For patients with multiple sclerosis (MS), training can also lead to a measurable improvement in quality of life and a reduction in the burden of symptoms (9).
Chronic obstructive pulmonary disease (COPD)
Poor stamina and shortness of breath are typical symptoms of COPD which, according to scientific studies, can be effectively alleviated by training with the EMST. Even with advanced and severe COPD (GOLD III-IV), training with the EMST can lead to a significant strengthening of respiratory muscles. This is accompanied by significant improvements and reduction of shortness of breath at rest and during exercise as well as improved physical performance. Additionally, quality of life could be increased significantly (10).
Obstructive sleep apnea and snoring
A flaccid soft palate leads to snoring and even to stops in breathing due to blockage of the airways (so-called obstructive sleep apnea, OSAS). The EMST has been shown to train the muscles of the soft palate, thus leading to significant less breathing stops, an improved Apnea-Hypopnea Index (AHI) and improved sleep quality (11).
References
1) Pflug, C., Bihler, M., Emich, K., Niessen, A., Nienstedt, J. C., Flügel, T., Koseki, J.-C., Plaetke, R., Hidding, U., Gerloff, C., & Buhmann, C. (2018). Critical Dysphagia is Common in Parkinson Disease and Occurs Even in Early Stages: A Prospective Cohort Study. Dysphagia, 33(1), 41–50.
2) Pitts, T., Bolser, D., Rosenbek, J., Troche, M., Okun, M. S., & Sapienza, C. (2009). Impact of expiratory muscle strength training on voluntary cough and swallow function in Parkinson disease. Chest, 135(5), 1301-1308.
3) Troche, M. S., Okun, M. S., Rosenbek, J. C., Musson, N., Fernandez, H. H., Rodriguez, R., ... & Sapienza, C. M. (2010). Aspiration and swallowing in parkinson disease and rehabilitation with EMST A randomized trial. Neurology, 75(21), 1912-1919.
4) Troche, M. S., Rosenbek, J. C., Okun, M. S., & Sapienza, C. M. (2014). Detraining outcomes with expiratory muscle strength training in Parkinson disease. Journal of rehabilitation research and development, 51(2), 305.
5) Kuo, Y.-C., Chan, J., Wu, Y.-P., Bernard, J. R., & Liao, Y.-H. (2017). Effect of expiratory muscle strength training intervention on the maximum expiratory pressure and quality of life of patients with Parkinson disease. NeuroRehabilitation, 41(1), 219–226.
6) Eom, M.-J., Chang, M.-Y., Oh, D.-H., Kim, H.-D., Han, N.-M., & Park, J.-S. (2017). Effects of resistance expiratory muscle strength training in elderly patients with dysphagic stroke. NeuroRehabilitation, 41(4), 747–752.
7) Park, J. S., Oh, D. H., Chang, M. Y., & Kim, K. M. (2016). Effects of expiratory muscle strength training on oropharyngeal dysphagia in subacute stroke patients: A randomised controlled trial. Journal of Oral Rehabilitation, 43(5), 364–372.
8) Plowman, E. K., Tabor-Gray, L., Rosado, K. M., Vasilopoulos, T., Robison, R., Chapin, J. L., Gaziano, J., Vu, T., & Gooch, C. (2019). Impact of expiratory strength training in amyotrophic lateral sclerosis: Results of a randomized, sham-controlled trial. Muscle & Nerve, 59(1), 40–46.
9) Silverman, E. P., Miller, S., Zhang, Y., Hoffman-Ruddy, B., Yeager, J., & Daly, J. J. (2017). Effects of expiratory muscle strength training on maximal respiratory pressure and swallow-related quality of life in individuals with multiple sclerosis. Multiple Sclerosis Journal - Experimental, Translational and Clinical, 3(2), 2055217317710829.
10) Mota, S., Güell, R., Barreiro, E., Solanes, I., Ramírez-Sarmiento, A., Orozco-Levi, M., Casan, P., Gea, J., & Sanchis, J. (2007). Clinical outcomes of expiratory muscle training in severe COPD patients. Respiratory Medicine, 101(3), 516–524.