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Lung volume recruitment improves volitional airway clearance in amyotrophic lateral sclerosis.
Cleary, Stuart; Misiaszek, John E; Wheeler, Sonya; Kalra, Sanjay; Genuis, Shelagh K; Johnston, Wendy S.
Afiliação
  • Cleary S; Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada.
  • Misiaszek JE; Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada.
  • Wheeler S; Misericordia Hospital, Covenant Health Group, Edmonton, Alberta, Canada.
  • Kalra S; Division of Neurology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
  • Genuis SK; Division of Neurology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
  • Johnston WS; Division of Neurology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
Muscle Nerve ; 64(6): 676-682, 2021 12.
Article em En | MEDLINE | ID: mdl-34505708
INTRODUCTION/AIMS: In this study we evaluated the effects of lung volume recruitment treatment (LVR), a low-tech, low-cost, manual "breath-stacking" technique used to help people cough with enough force to clear their airways, thereby reducing the risk of aspiration and choking, on five volitional airway clearance and protection behaviors used by people living with amyotrophic lateral sclerosis (PwALS). METHODS: Using a repeated-measures cross-over design, 29 PwALS performed five volitional airway clearance and protection behaviors in LVR treatment and in no-treatment, control conditions. Peak cough flow (PCF) was used to measure maximum expiratory rate during forced expiration, throat clearing, hawking, post-swallow coughing, and the supraglottic swallowing maneuver. Comparisons were made as a function of condition (treatment or control) and three time-points (pretreatment, and 15 and 30 minutes posttreatment). RESULTS: LVR treatment had a significant positive effect on maximum expiratory rates during all tested airway clearance and protection behaviors. Increased PCF values lasted for up to 30 minutes post-LVR for all tested behaviors in the treatment condition. DISCUSSION: We found that LVR treatment could increase control over airway clearance in PwALS, as well as provide improved airway protection for up to 30 minutes, the duration of a typical meal. This study has implications for patient care. These include offering patients control over some of the most feared symptoms of ALS, particularly choking during activities of daily living, and enhanced ALS respiratory care in low-resource settings. Findings may have implications for other neurodegenerative disorders in which dysphagia occurs with retained sensory function.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Esclerose Lateral Amiotrófica Tipo de estudo: Clinical_trials / Guideline Aspecto: Patient_preference Limite: Humans Idioma: En Revista: Muscle Nerve Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Esclerose Lateral Amiotrófica Tipo de estudo: Clinical_trials / Guideline Aspecto: Patient_preference Limite: Humans Idioma: En Revista: Muscle Nerve Ano de publicação: 2021 Tipo de documento: Article