High-frequency chest wall oscillation in ALS: an exploratory randomized, controlled trial.
OBJECTIVE
To evaluate changes in respiratory function in patients with ALS after using high-frequency chest wall oscillation (HFCWO).


METHODS
This was a 12-week randomized, controlled trial of HFCWO in patients with probable or definite ALS, an Amyotrophic Lateral Sclerosis Functional Rating Scale respiratory subscale score < or = 11 and > or = 5, and forced vital capacity (FVC) > or = 40% predicted.


RESULTS
We enrolled 46 patients (58.0 +/- 9.8 years; 21 men, 25 women); 22 used HFCWO and 24 were untreated. Thirty-five completed the trial: 19 used HFCWO and 16 untreated. HFCWO users had less breathlessness (p = 0.021) and coughed more at night (p = 0.048) at 12 weeks compared to baseline. At 12 weeks, HFCWO users reported a decline in breathlessness (p = 0.048); nonusers reported more noise when breathing (p = 0.027). There were no significant differences in FVC change, peak expiratory flow, capnography, oxygen saturation, fatigue, or transitional dyspnea index. When patients with FVC between 40 and 70% predicted were analyzed, FVC showed a significant mean decrease in untreated patients but not in HFCWO patients; HFCWO patients had significantly less increased fatigue and breathlessness. Satisfaction with HFCWO was 79%.


CONCLUSIONS
High-frequency chest wall oscillation was well tolerated, considered helpful by a majority of patients, and decreased symptoms of breathlessness. In patients with impaired breathing, high-frequency chest wall oscillation decreased fatigue and showed a trend toward slowing the decline of forced vital capacity.
Lange
D J
DJ
Department of Neurology, Mt. Sinai School of Medicine, One Gustave L. Levy Place, Box 1052, New York, NY 10029, USA. dale.lange@mssm.edu
Lechtzin
N
N
Davey
C
C
David
W
W
Heiman-Patterson
T
T
Gelinas
D
D
Becker
B
B
Mitsumoto
H
H
D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000628:therapy*; D001499:Bayes Theorem; D035641:Chest Wall Oscillation / Q000379:methods*; D016009:Chi-Square Distribution; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012119:Respiration; D012129:Respiratory Function Tests / Q000379:methods; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014797:Vital Capacity / Q000502:physiology