title: External control of exhalation for cough assistance: a method for patients with glottis dysfunction and/or tracheostomy.
abstract: OBJECTIVE
  To investigate the effectiveness of our method of assisting a cough by mimicking the functions of the glottis in patients with bulbar muscle weakness or paralysis and/or those who had a tracheostomy tube.
  
  
  METHODS
  Before-after trial.
  
  
  METHODS
  University rehabilitation hospital.
  
  
  METHODS
  Patients (N=35) with bulbar muscle weakness or paralysis and/or those who had a tracheostomy tube.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  The unassisted peak cough flow (PCF), the assisted PCF, and the assisted PCF with the external control method mimicking glottis function by an end-inspiratory external closure of the airways.
  
  
  RESULTS
  Of the 35 patients, 13 were tracheostomized cervical cord injury patients, 11 were neuromuscular disease (NMD) patients with glottis dysfunction only, and 11 were NMD patients with a tracheostomy and glottis dysfunction. Assisted PCF with the external control method were higher than unassisted PCF and/or assisted PCF in all patients. Assisted PCF with the external control methods were measured in all of the patients even when the unassisted PCFs and/or assisted PCFs could not be measured. For patients with measurable assisted PCFs, the assisted PCF with the external control methods were significantly higher than the assisted PCFs.
  
  
  CONCLUSIONS
  We showed the effectiveness of our method of assisting a cough by external control of the glottis in patients with bulbar muscle weakness or paralysis and/or those who had a tracheostomy tube who cannot effectively cough with the help of existing cough assistance methods.
authors: Department of Physical Medicine and Rehabilitation, Myongji Hospital, Kwandong University College of Medicine, Koyang, Kyunggi, Korea.
authors: Sang Chul
authors: SC
authors: Lee
authors: Jung Hyun
authors: JH
authors: Park
authors: Seong-Woong
authors: SW
authors: Kang
authors: Dong Hyun
authors: DH
authors: Kim
authors: Sang Ha
authors: SH
authors: Song
mesh_terms: D000293:Adolescent; D000328:Adult; D003371:Cough / Q000503:physiopathology*; D004867:Equipment Design; D045853:Exhalation / Q000502:physiology*; D005260:Female; D005931:Glottis / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000503:physiopathology*; D009468:Neuromuscular Diseases / Q000503:physiopathology*; D012138:Respiratory Therapy / Q000295:instrumentation*; D013119:Spinal Cord Injuries / Q000503:physiopathology*; D018709:Statistics, Nonparametric; D014139:Tracheostomy