Diaphragm training in amyotrophic lateral sclerosis.
There is a continued need for therapies to improve respiratory function and quality of life in patients with amyotrophic lateral sclerosis. In this pilot trial, we studied 8 subjects with amyotrophic lateral sclerosis and respiratory involvement. We measured respiratory function and quality of life at baseline. We then taught subjects diaphragm training, a method of breath control designed to improve respiratory muscle strength and efficiency. We repeated measures of respiratory function and quality of life 6 and 12 weeks later. There was no significant improvement in any outcome measure after instituting diaphragm training. There was a nonsignificant trend toward a slower rate of decline in respiratory function in those subjects who mastered the technique; however, only half the subjects were able to successfully change their pattern of breathing. A larger study of this technique is warranted; however, in determining the sample size for a larger study, the difficulty for patients in mastering the technique must be taken into consideration.
Nardin
Rachel
R
Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA. rnardin@bidmc.harvard.edu
O'Donnell
Carl
C
Loring
Stephen H
SH
Nie
Rui
R
Hembre
Kristi
K
Walsh
Joy
J
Arboleda
Barbara Wilson
BW
Muzikansky
Alona
A
Nguyen
Dang
D
Raynor
Elizabeth
E
D000328:Adult; D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000503:physiopathology / Q000628:therapy*; D001945:Breathing Exercises; D003964:Diaphragm / Q000294:innervation / Q000503:physiopathology*; D005081:Exercise Therapy / Q000379:methods*; D045853:Exhalation / Q000502:physiology; D005260:Female; D006801:Humans; D001239:Inhalation / Q000502:physiology; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness / Q000502:physiology*; D010865:Pilot Projects; D011788:Quality of Life; D012132:Respiratory Muscles / Q000294:innervation / Q000503:physiopathology; D012133:Respiratory Paralysis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D015996:Survival Rate; D016896:Treatment Outcome