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. 2020 Nov;62(5):597-600.
doi: 10.1002/mus.27040. Epub 2020 Sep 11.

Differences in voluntary and reflexive cough strength in individuals with amyotrophic lateral sclerosis and healthy adults

Lauren Tabor-Gray  1   2 , Terrie Vasilopoulos  3 , Emily K Plowman  2   4   5
Affiliations

Differences in voluntary and reflexive cough strength in individuals with amyotrophic lateral sclerosis and healthy adults

Lauren Tabor-Gray et al. Muscle Nerve. 2020 Nov.

Abstract

Introduction: Dystussia impacts the ability to protect the airway. Voluntary cough provides a metric of airway defense but differs from the reflexive response to aspiration during swallowing. Therefore, we evaluated relationships between voluntary and reflexive cough among individuals with amyotrophic lateral sclerosis (ALS) and a healthy cohort.

Methods: Twenty-eight individuals with ALS and 26 healthy individuals completed voluntary and reflexive cough testing. Descriptive statistics, reliability, and paired t tests were conducted to evaluate differences in cough volume acceleration (CVA) and peak expiratory flow rate (PEFR) in voluntary vs reflexive cough.

Results: Compared with reflexive cough, voluntary CVA and PEFR were greater in individuals with ALS [t(27) = 4.83, P < .001 and t(27) = 8.69, P < .001] and the healthy cohort [t(21) = 5.91, P < .001 and t(21) = 12.26, P < .001], respectively.

Discussion: These findings hold important implications for the use and interpretation of voluntary peak cough flow during clinical swallowing evaluations.

Keywords: ALS, cough, deglutition, dysphagia, neuromuscular, respiratory.

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References

REFERENCES

    1. Nichols NL, Van Dyke J, Nashold L, Satriotomo I, Suzuki M, Mitchell GS. Ventilatory control in ALS. Respir Physiol Neurobiol. 2013;189:429-437.
    1. Plowman EK, Watts SA, Robison R, et al. Voluntary cough airflow differentiates safe versus unsafe swallowing in amyotrophic lateral sclerosis. Dysphagia. 2016;31:383-390.
    1. Gaziano J. Prevalence, timing and source of aspiration in individuals with ALS. Dysphagia Res Soc. 2015.
    1. Tabor-Gray LC, Gallestagui A, Vasilopoulos T, Plowman EK. Characteristics of impaired voluntary cough function in individuals with amyotrophic lateral sclerosis. Amyotroph Lateral Scler Frontotemporal Degener. 2019;20:37-42.
    1. Tabor-Gray L, Vasilopoulos T, Plowman EK. Concordant validity of a digital peak cough flow meter to assess voluntary cough strength in individuals with ALS. Dysphagia. 2020;35:568-573.

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