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Randomized Controlled Trial
. 2019 Jan;59(1):40-46.
doi: 10.1002/mus.26292. Epub 2018 Nov 29.

Impact of expiratory strength training in amyotrophic lateral sclerosis: Results of a randomized, sham-controlled trial

Emily K Plowman  1   2   3 , Lauren Tabor-Gray  1 , K Michelle Rosado  1 , Terrie Vasilopoulos  4 , Raele Robison  1 , Jennifer L Chapin  1 , Joy Gaziano  5 , Tuan Vu  6 , Clifton Gooch  6
Affiliations
Randomized Controlled Trial

Impact of expiratory strength training in amyotrophic lateral sclerosis: Results of a randomized, sham-controlled trial

Emily K Plowman et al. Muscle Nerve. 2019 Jan.

Abstract

Introduction: The purpose of this study was to determine the impact of an in-home expiratory muscle strength training (EMST) program on pulmonary, swallow, and cough function in individuals with amyotrophic lateral sclerosis (ALS).

Methods: EMST was tested in a prospective, single-center, double-blind, randomized, controlled trial of 48 ALS individuals who completed 8 weeks of either active EMST (n = 24) or sham EMST (n = 24). The primary outcome to assess treatment efficacy was change in maximum expiratory pressure (MEP). Secondary outcomes included: cough spirometry; swallowing; forced vital capacity; and scoring on the ALS Functional Rating Scale-Revised.

Results: Treatment was well tolerated with 96% of patients completing the protocol. Significant differences in group change scores were noted for MEP and Dynamic Imaging Grade of Swallowing Toxicity scores (P < 0.02). No differences were noted for other secondary measures.

Discussion: This respiratory training program was well-tolerated and led to improvements in respiratory and bulbar function in ALS. Muscle Nerve 59:40-46, 2019.

Keywords: EMST; amyotrophic lateral sclerosis; cough; exercise; expiratory muscle strength training; rehabilitation; swallowing.

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