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Related Experiment Videos

Cough augmentation in amyotrophic lateral sclerosis.

N Mustfa1, M Aiello, R A Lyall

  • 1Respiratory Muscle Laboratory, Guy's, King's and St. Thomas' School of Medicine, King's College Hospital, London, UK. naveed@doctors.org.uk

Neurology
|November 12, 2003
PubMed
Summary

Cough augmentation techniques, including manual assistance and mechanical insufflation-exsufflation, significantly improved airflow in patients with amyotrophic lateral sclerosis (ALS). These methods were most effective in individuals with the weakest coughs, highlighting their potential for respiratory support.

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Area of Science:

  • Respiratory Physiology
  • Neuromuscular Disorders

Background:

  • Patients with amyotrophic lateral sclerosis (ALS) often experience impaired cough function, increasing risks of respiratory complications.
  • Effective cough augmentation strategies are crucial for managing airway clearance in individuals with neuromuscular weakness.

Purpose of the Study:

  • To evaluate the efficacy of manual assistance and mechanical insufflation-exsufflation (MIE) in augmenting cough flows.
  • To compare the effects of these interventions across healthy subjects and patients with bulbar and nonbulbar ALS.
  • To determine if the degree of cough weakness influences the effectiveness of augmentation techniques.

Main Methods:

  • Measurements of cough flows and pressures were conducted in healthy individuals and ALS patients.
  • Interventions included manual assistance and mechanical insufflation-exsufflation.

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  • Statistical analysis was performed to assess the significance of observed changes.

    • Main Results:

    • Manual assistance increased cough flow by 11% in bulbar ALS and 13% in nonbulbar ALS patients.
    • Mechanical insufflation-exsufflation increased cough flow by 17% in healthy subjects, 26% in bulbar ALS, and 28% in nonbulbar ALS patients.
    • The most substantial improvements in cough flow were observed in patients with the weakest baseline coughs.

    Conclusions:

    • Both manual assistance and MIE are effective methods for augmenting cough flows in ALS patients.
    • The effectiveness of cough augmentation is influenced by the patient group (bulbar vs. nonbulbar ALS) and the severity of respiratory muscle weakness.
    • These findings support the use of cough augmentation strategies to improve airway clearance in individuals with ALS.