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BackgroundChronic cough is a common reason for medical referral and its prevalence is on the rise. With only one pharmaceutical therapy currently under review for the treatment of refractory chronic cough, exploring non-pharmacological chronic cough management therapies is important. This systematic review summarizes the effectiveness of non-pharmacological chronic cough therapies in adults with non-productive refractory chronic cough or cough due to chronic respiratory diseases.MethodsWe searched Medline, Embase, Cochrane, CINAHL, and Scopus from inception to September 2021. Randomized controlled trials published in English, Portuguese, or French, and examining the effects of non-pharmacological therapies in adults with chronic non-productive cough (>8 weeks; <2 teaspoons sputum) were included. Mean differences, medians, and odds ratios were calculated as appropriate.Results16,546 articles were identified and six articles representing five unique studies were included. Studies evaluated 228 individuals with refractory chronic cough or chronic cough due to a chronic respiratory disease [162 women (71%); 52 ± 11 to 61 ± 8 years old]. Obstructive sleep apnea was the only chronic respiratory disease studied. Non-pharmacological therapies included education, cough suppression, breathing techniques, mindfulness, and continuous positive airway pressure. When standing alone, non-pharmacological cough therapies improved cough-specific health related quality of life when not associated with interventions (mean diff MD 1.53 to 4.54), cough frequency (MD 0.59 95%CI 0.36 to 0.95), and voice outcomes (MD 0.3 to 1) when compared to control interventions.ConclusionThe evidence of non-pharmacological therapies for non-productive chronic cough is limited. Existing studies reflect the heterogeneity in study design, sample size, and outcome measures. Thus, clinical recommendations for using the most effective interventions remain to be confirmed.

Research Objectives 1) To identify challenges for conducting ongoing and future rehabilitation research during and after the COVID-19 pandemic, and 2) to develop strategies that can support ongoing and future rehabilitation research. Design A two-hour facilitated online workshop with guided discussion. Setting Online workshop synchronously recorded via Zoom. Participants Trainees (14 doctoral; 2 MSc students; 1 post-doctoral fellow) and research faculty (5 physiotherapy; 3 occupational therapy), School of Rehabilitation Science, McMaster University, Canada. Interventions Not applicable. Main Outcome Measures Workshop transcript and field notes were cross-compared by 4 workshop facilitators from which 3 main categories emerged: 1) pandemic protocol adjustment, 2) participant accessibility, and 3) knowledge dissemination. Results 1) Pandemic protocol adjustment: Workshop participants identified concerns with transitioning pre- to post-pandemic research, such as variations in intervention protocols and psychometric properties of virtually guided outcome assessments. Strategies identified: Delivering toolkits containing equipment needed for virtually guided assessments, and their comprehensive psychometric evaluation prior to use. 2) Participant accessibility: Virtually guided rehabilitation research may present barriers to participation for some populations due to a lack of internet access and proficiency. Strategies identified: Including community stakeholders in the decision-making process to help guide the development of safe and feasible study protocols, and simplifying protocols to maintain participants’ adherence. 3) Knowledge dissemination: Virtually delivered conferences have required additional preparation time due to requirements of pre-recorded presentations, and hinder important conversations between conference attendees. Strategies identified: Researchers should account for delays in knowledge translation plans for funding applications, and conference organizers should consider hosting networking events for attendees. Conclusions This workshop served as a catalyst for creative solutions to complex methodological challenges that can be integrated within existing and future rehabilitation-focused studies during the COVID-19 pandemic and beyond. Author(s) Disclosures None.