between muscular rigidity and dysmotility of the pharyngeal wall. The poor correlation

between swallowing dysfunction and disease severity rating, along with patient

complaints of swallow problems and findings on videofluoroscopic examinations makes

swallow assessment and subsequent treatment in PD a difficult task (Bushmann et al.,

1989).

 Currently the primary treatment for PD is Levodopa (L-Dopa). L-Dopa has been

found to be efficacious for the treatment of the primary clinical features of the PD

syndrome (Calne, Shaw, Spiers, & Stem, 1970). The same results have not been

observed consistently in the treatment of dysphagia in PD (Born et al., 1996; Hunter,

Crameri, Austin, Woodward, & Hughes, 1997; Leopold & Kagel, 1997). Nilson,

Ekberg, Olsson, & Hindfelt (1996) assert that oral and pharyngeal function in PD are not

the result of reduced dopamine levels, therefore L-Dopa is ineffective. On the other

hand, Bushmann et al. (1989) found less vallecular residue and decreased coating of the

pharyngeal walls post treatment with L-dopa. The strongest theory as to the

ineffectiveness of dopaminergic medications in PD swallow is the dual involvement of

muscle tissue described previously. Therefore treatment for swallow dysfunction in PD

cannot be treated solely with medical interventions, but instead by compensatory

strategies and dietary modifications.

 Dysfunction in swallow, also called dysphagia, can lead to many life-threatening

problems such as dehydration, malnutrition, weight loss, aspiration of solids and liquids,

and pneumonia (Bushmann et al., 1989; Raut, McKee, & Johnston, 2001). A timely and

safe swallow, is essential to health and quality of life. Assessment of swallow safety and

treatment of swallowing disorders is an integral part of a speech-language pathologist's