Dysphagia is closely associated with stroke, and aspiration pneumonia is a main cause of death among stroke patients (Perry L, et al., 2001; Hinchey J. A, et al., 2005). Dysphagia and related complications increase length of acute stay and are associated with increased mortality, comorbidity, and increased health care costs (Smithard et al., 1997). In many neurogenic populations, dystussia (impaired cough) and dysphagia are present in parallel (Mann et al,2000; Vellas et al ,2000), a finding that is not surprising given the shared neural and anatomical substrates of respiration, cough and swallowing function (Gestreauet,al 1996; Pitts T et,al 2012; Troche et al, 2014).

An effective cough is critical in removing aspirated material from the airway during swallowing, particularly in patients with additional co-morbidities who are more susceptible to developing pulmonary sequelae. However off late the cough testing in the clinical swallowing evaluation has also been a recent topic of interest to provide information regarding mechanisms of airway safety and the physiologic ability of an individual to defend their airway (Smith Hammond CA, et al. 2001; Pitts T, et al.2008; Plowman EK, et al. 2016).

Currently, however, cough testing is not routinely incorporated in the CSE across all settings, although there are several investigations probed into the cough, its different types, aerodynamic analysis of cough. 

This study aims to investigate the cough using acoustic analysis in individuals with dysphagia.

A total of 30 participants will be recruited for the study and cough sample will be recorded before and after swallow  with an Olympus Linear Pcm LS-P2 Voice Recorder placed approximately 10cm from the participant’s mouth using the PRAAT software installed in the laptop. The participant will be instructed to cough voluntarily on three trials. The best cough sample will be used for both perceptual and acoustic analysis. 

Cough will be analysed perceptually on a rating scale. Objectively the cough samples will be analysed by computing the Mel-Frequency Cepstral Coefficients (MFCC) and its derivatives with the help of MATLAB tool.