Impact of expiratory strength training in amyotrophic lateral sclerosis

Muscle Nerve. 2016 Jun;54(1):48-53. doi: 10.1002/mus.24990. Epub 2016 Mar 3.


Introduction: We evaluated the feasibility and impact of expiratory muscle strength training (EMST) on respiratory and bulbar function in persons with amyotrophic lateral sclerosis (ALS).

Methods: Twenty-five ALS patients participated in this delayed intervention open-label clinical trial. Following a lead-in period, patients completed a 5-week EMST protocol. Outcome measures included: maximum expiratory pressure (MEP); physiologic measures of swallow and cough; and penetration-aspiration scale (PAS) scores.

Results: Of participants who entered the active phase of the study (n = 15), EMST was well tolerated and led to significant increases in MEPs and maximum hyoid displacement during swallowing post-EMST (P < 0.05). No significant differences were observed for PAS scores or cough spirometry measures.

Conclusions: EMST was feasible and well tolerated in this small cohort of ALS patients and led to improvements in expiratory force-generating pressures and swallow kinematics. Further investigation is warranted to confirm these preliminary findings. Muscle Nerve 54: 48-53, 2016.

Keywords: amyotrophic lateral sclerosis; expiratory muscle strength training; rehabilitation; respiratory training; swallowing.

MeSH terms

  • Aged
  • Amyotrophic Lateral Sclerosis / complications*
  • Analysis of Variance
  • Bulbar Palsy, Progressive / etiology*
  • Bulbar Palsy, Progressive / rehabilitation*
  • Cough
  • Deglutition
  • Female
  • Humans
  • Male
  • Maximal Respiratory Pressures
  • Mental Status Schedule
  • Middle Aged
  • Resistance Training / methods*
  • Respiration Disorders / etiology*
  • Respiration Disorders / rehabilitation*
  • Respiratory Muscles / physiology
  • Spirometry
  • Treatment Outcome