# User-centred design, validation and clinical testing of an anti-choking mug for people with Parkinson’s disease

## TL;DR

A specially designed mug helps people with Parkinson’s disease drink safely by promoting the correct head posture, improving swallowing efficiency.

## Contribution

A user-centred anti-choking mug was developed and clinically validated to improve swallowing in Parkinson’s disease patients.

## Key findings

- The anti-choking mug significantly improved neck flexion angles compared to a sham mug.
- Clinical assessments showed better swallowing efficiency and safer drinking with the new mug design.

## Abstract

Oropharyngeal dysphagia, or difficulty initiating swallowing, is a frequent problem in people with Parkinson’s disease (PD) and can lead to aspiration pneumonia. The efficacy of pharmacological options is limited. Postural strategies, such as a chin-down manoeuvre when drinking, have had some degree of success but may be difficult for people who have other limitations such as dementia or neck rigidity, to reproduce consistently. Using a user-centred design approach and a multidisciplinary team, we developed and tested an anti-choking mug for people with PD that helps angle the head in the optimum position for drinking. The design reflected anthropometric and ergonomic aspects of user needs with features including regulation of water flow rate and sip volume, an inner slope, a thickened handle and a wide base, which promoted a chin-down posture when used. Prototype testing using digital technology to compare neck flexion angles (the primary outcome), plus clinical outcomes assessed using standard tools (Swallowing Clinical Assessment Score in Parkinson’s Disease (SCAS-PD) and Movement Disorder Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Parts II and III), found significant improvements in a range of parameters related to efficient swallowing and safe drinking when using the anti-choking mug versus a sham mug.