Lay summary
Neurological disease or injury can damage the cough reflex, which is critical for protecting the airway from foreign matter during swallowing. An absent cough reflex results in pneumonia for many patients, due to the decreased sensory perception of food and fluid entering the lungs. Pneumonia increases hospitalisation costs by approximately $10,000 for stroke patients, and is a leading cause of death in the elderly. Therefore, damage to the cough reflex represents a substantial economic and welfare issue. Currently, there are no rehabilitation strategies available to address specific impairments of the cough reflex. Instead, patients endure non-oral methods of eating, or compensatory strategies that require execution with every swallow. This research proposal represents the first to investigate a sensory rehabilitation protocol designed specifically to address impaired airway protection during swallowing. It will expand opportunities for recovery of swallowing function in patients with sensory deficits, who have previously had no rehabilitative options.