Article

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 degrees 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.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS