Expiratory Muscle Strength Training (EMST) in Neuromuscular Disorders

Inclusion Criteria: * Diagnosis of oculopharyngeal muscular dystrophy (OPMD) * 18 years of age or older * Must be capable of providing informed consent * Must be able to undergo respiratory function testing and swallowing studies * Must have a forced vital capacity (FVC) greater than 60% * A score of 3 or greater on the Eating Assessment Tool-10 (EAT-10; self-administered, symptom-specific outcome instrument for dysphagia. A score of 3 or greater indicates increased stress around eating) * A score of 26 or greater on the Montreal Cognitive Assessment (MoCA; 30-point screening assessment used for detecting cognitive impairment. A score of 26 or greater is considered to be within functional limits.) Exclusion Criteria: * Severe coronary artery disease * Acute myocardial infarction * Moderate to severe hypovolemia * Acute neurological events * Unstable cardiac status * Recent hernia * Severe chronic obstructive pulmonary disease (COPD) * Uncontrolled reflux issues * Women who are pregnant, or who suspect they may be pregnant * Cognitive impairment that would prevent comprehension of instructions and adherence to intervention guidelines (a score of less than 26 points on the MoCA)