title: High-frequency chest wall oscillation in ALS: an exploratory randomized, controlled trial.
abstract: 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.
authors.affiliation: Department of Neurology, Mt. Sinai School of Medicine, One Gustave L. Levy Place, Box 1052, New York, NY 10029, USA. dale.lange@mssm.edu
authors.forename: D J
authors.initials: DJ
authors.lastname: Lange
authors.forename: N
authors.initials: N
authors.lastname: Lechtzin
authors.forename: C
authors.initials: C
authors.lastname: Davey
authors.forename: W
authors.initials: W
authors.lastname: David
authors.forename: T
authors.initials: T
authors.lastname: Heiman-Patterson
authors.forename: D
authors.initials: D
authors.lastname: Gelinas
authors.forename: B
authors.initials: B
authors.lastname: Becker
authors.forename: H
authors.initials: H
authors.lastname: Mitsumoto
mesh_terms: 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