Saleem, S.Miles, A.Allen, J.2023-08-172023-08-172024International Journal of Speech-language Pathology.2024;26(4):457-474. [Epub 2023 Aug 3]1754-9507 (Print)1754-9515 (Electronic)http://repository.kln.ac.lk/handle/123456789/26501Indexed in MEDLINE.Purpose: This systematic review evaluated the efficacy of therapeutic interventions on improving swallow, respiratory, and cough functions in Parkinson's disease (PD).Method: A PRISMA systematic search was implemented across six databases. We selected studies reporting pre- and post-assessment data on the efficacy of behavioural therapies with a swallow or respiratory/cough outcome, and excluded studies on medical/surgical treatments or single-session design. Cross-system outcomes across swallow, respiratory, and cough functions were explored. Cochrane's risk of bias tools were utilised to evaluate study quality.Result: Thirty-six articles were identified and further clustered into four treatment types: swallow related (n = 5), electromagnetic stimulation (n = 4), respiratory loading (n = 20), and voice loading (n = 7) therapies. The effects of some behavioural therapies were supported with high-quality evidence in improving specific swallow efficiency, respiratory pressure/volume, and cough measures. Only eleven studies were rated with a low risk of bias and the remaining studies failed to adequately describe blinding of assessors, missing data, treatment adherence, and imbalance assignment to groups.Conclusion: Behavioural therapies were diverse in nature and many treatments demonstrated broad cross-system outcome benefits across swallow, respiratory, and cough functions. Given the progressive nature of the condition, the focus of future trials should be evaluating follow-up therapy effects and larger patient populations, including those with more severe disease.enParkinson’s diseasebehavioural therapiescoughrespirationswallowingtreatment effectsArticle