Abstract
Objectives
To assess the acute effects of air stacking on cough peak flow (CPF) and chest wall
compartmental volumes of persons with amyotrophic lateral sclerosis (ALS) versus healthy
subjects positioned at 45° body inclination.
Design
Cross-sectional study with a matched-pair design.
Setting
University hospital.
Participants
Persons (N=24) with ALS (n=12) and age-matched healthy subjects (n=12).
Main Outcomes Measures
CPF, chest wall compartmental inspiratory capacity, chest wall vital capacity, chest
wall tidal volume and operational volumes, breathing pattern, and percentage of contribution
of the compartments to the inspired volume were measured by optoelectronic plethysmography.
Results
Compared with healthy subjects, significantly lower CPF (P=.007), chest wall compartmental inspiratory capacity (P<.001), chest wall vital capacity (P<.001), and chest wall tidal volume (P<.001) were found in subjects with ALS. Immediately after air stacking, CPF (P<.001) and chest wall compartmental inspiratory capacity (P<.001) significantly increased in both groups, with values returning to basal only
in healthy subjects. After air stacking, the abdominal compartment (P=.004) was determined to be responsible for the inspired volume in subjects with ALS.
Significantly higher chest wall vital capacity (P=.05) was observed in subjects with ALS 5 minutes after air stacking, with the rib
cage compartment (P=.049) being responsible for volume change. No differences were found in chest wall
vital capacity and compartmental volumes of healthy subjects. Chest wall tidal volume
(P<.001) significantly increased during the protocol in the healthy subjects, mainly
because of end-inspiratory (P<.001) and abdominal volumes (P=.008). No significant differences were observed in percentage of contribution of
the compartments to the inspired volume and end-expiratory volume of both groups.
No significant differences were found in chest wall tidal volume, operational volume,
and breathing pattern in persons with ALS.
Conclusions
Air stacking is effective in increasing CPF, chest wall compartmental inspiratory
capacity, and chest wall vital capacity of persons with ALS with no hyperinflation.
Differences in compartmental volume contributions are probably because of lung and
chest wall physiological changes.
Keywords
List of abbreviations:
ALS (amyotrophic lateral sclerosis), CPF (cough peak flow), CW (chest wall), FVC (forced vital capacity), IC (inspiratory capacity), OEP (optoelectronic plethysmography), RC (rib cage), VT (tidal volume)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 16, 2017
Footnotes
Supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico (grant nos. 307353/2015-0 and 310091/2015-2).
Disclosures: none.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
