Effects of Respiratory Training on Pulmonary Function, Cough, and Functional Independence in Patients with Amyotrophic Lateral Sclerosis.

IF 3.2 Q2 CLINICAL NEUROLOGY Neurology International Pub Date : 2024-11-01 DOI:10.3390/neurolint16060101

Eleonora Magni, Anja Hochsprung, Rocío Cáceres-Matos, Manuel Pabón-Carrasco, Beatriz Heredia-Camacho, Ignacio Solís-Marcos, Carlos Luque-Moreno

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Abstract

Background: Respiratory complications in patients with amyotrophic lateral sclerosis (ALS), due to the involvement of respiratory muscles, are the leading cause of death, and respiratory physiotherapy (RP) focuses on addressing these complications.

Objectives: The objective was to evaluate the effectiveness of an RP intervention that combines the four specific techniques (inspiratory muscle training, lung volume recruitment, manually assisted coughing, and diaphragmatic breathing training) in patients with ALS.

Methods: A quasi-experimental study was carried out, and a specific RP programme was implemented in 15 patients with ALS (12 sessions, 30 min/session, one session/week, duration of three months), based on directed ventilation techniques, lung volume recruitment, manually assisted coughing, and the use of incentive spirometry and a cough assist device, along with a daily home exercise programme. Respiratory functions were assessed (pre- and post-intervention, with follow-up at three months) using Forced Vital Capacity (FVC) and Peak Expiratory Cough Flow (PECF); functionality was assessed using the Revised ALS Functional Rating Scale (ALSFRS-R) and the Modified Barthel Index by Granger.

Results: FVC experienced an increase after three months of the intervention initiation (p = 0.30), which was not sustained at the three-month follow-up after the intervention ended. All other variables remained practically constant after treatment, with their values decreasing at follow-up.

Conclusion: A specific RP intervention could have beneficial effects on respiratory functions, potentially preventing pulmonary infections and hospitalisations in patients with ALS. It may improve FVC and help stabilize the patient's functional decline. Considering the progressive and degenerative nature of the disease, this finding could support the usefulness of these techniques in maintaining respiratory function.

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呼吸训练对肌萎缩侧索硬化症患者肺功能、咳嗽和功能独立性的影响

背景：肌萎缩性脊髓侧索硬化症（ALS）患者因呼吸肌受累引起的呼吸系统并发症是死亡的主要原因，而呼吸物理治疗（RP）的重点就是解决这些并发症：目的：评估结合四种特定技术（吸气肌训练、肺容量募集、人工辅助咳嗽和横膈膜呼吸训练）的呼吸理疗干预对 ALS 患者的效果：开展了一项准实验研究，对 15 名 ALS 患者实施了一项特定的 RP 计划（12 次课，每次课 30 分钟，每周一次课，为期三个月），该计划以定向通气技术、肺容积募集、人工辅助咳嗽、激励肺活量测定和咳嗽辅助装置的使用为基础，并配合日常家庭锻炼计划。使用强制生命容量（FVC）和呼气咳嗽峰值流量（PECF）评估呼吸功能（干预前和干预后，随访三个月）；使用修订版 ALS 功能评定量表（ALSFRS-R）和格兰杰改良巴特尔指数评估功能：结果：干预开始三个月后，肺活量增加（p = 0.30），但在干预结束后的三个月随访中，肺活量并未持续增加。所有其他变量在治疗后基本保持不变，其数值在随访时有所下降：结论：特定的 RP 干预可对 ALS 患者的呼吸功能产生有益影响，并有可能预防肺部感染和住院治疗。它可以改善肺活量（FVC），有助于稳定患者的功能衰退。考虑到该疾病的渐进性和退行性，这一发现可能会支持这些技术在维持呼吸功能方面的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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