title: Impact of expiratory strength training in amyotrophic lateral sclerosis.
abstract: We evaluated the feasibility and impact of expiratory muscle strength training (EMST) on respiratory and bulbar function in persons with amyotrophic lateral sclerosis (ALS).
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: Department of Speech, Language and Hearing Sciences, University of Florida, P.O. Box 117420, Gainesville, Florida, 32610, USA.|Neuromotor Speech and Swallowing Restoration Laboratory, University of Florida, Gainesville, Florida, USA.|Joy McCann Culverhouse Center for Swallowing Disorders, University of South Florida, Tampa, Florida, USA.
authors.forename: Emily K
authors.initials: EK
authors.lastname: Plowman
authors.affiliation: Joy McCann Culverhouse Center for Swallowing Disorders, University of South Florida, Tampa, Florida, USA.
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Watts
authors.affiliation: Department of Speech, Language and Hearing Sciences, University of Florida, P.O. Box 117420, Gainesville, Florida, 32610, USA.|Neuromotor Speech and Swallowing Restoration Laboratory, University of Florida, Gainesville, Florida, USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Tabor
authors.affiliation: Department of Speech, Language and Hearing Sciences, University of Florida, P.O. Box 117420, Gainesville, Florida, 32610, USA.|Neuromotor Speech and Swallowing Restoration Laboratory, University of Florida, Gainesville, Florida, USA.
authors.forename: Raele
authors.initials: R
authors.lastname: Robison
authors.affiliation: Joy McCann Culverhouse Center for Swallowing Disorders, University of South Florida, Tampa, Florida, USA.
authors.forename: Joy
authors.initials: J
authors.lastname: Gaziano
authors.affiliation: Neuromotor Speech and Swallowing Restoration Laboratory, University of Florida, Gainesville, Florida, USA.
authors.forename: Amanda S
authors.initials: AS
authors.lastname: Domer
authors.affiliation: Joy McCann Culverhouse Center for Swallowing Disorders, University of South Florida, Tampa, Florida, USA.
authors.forename: Joel
authors.initials: J
authors.lastname: Richter
authors.affiliation: Department of Neurology, University of South Florida, Tampa, Florida, USA.
authors.forename: Tuan
authors.initials: T
authors.lastname: Vu
authors.affiliation: Department of Neurology, University of South Florida, Tampa, Florida, USA.
authors.forename: Clifton
authors.initials: C
authors.lastname: Gooch
mesh_terms: D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000150:complications*; D000704:Analysis of Variance; D010244:Bulbar Palsy, Progressive / Q000209:etiology* / Q000534:rehabilitation*; D003371:Cough; D003679:Deglutition; D005260:Female; D006801:Humans; D008297:Male; D000072277:Maximal Respiratory Pressures; D008609:Mental Status Schedule; D008875:Middle Aged; D055070:Resistance Training / Q000379:methods*; D012120:Respiration Disorders / Q000209:etiology* / Q000534:rehabilitation*; D012132:Respiratory Muscles / Q000502:physiology; D013147:Spirometry; D016896:Treatment Outcome
keywords: amyotrophic lateral sclerosis; expiratory muscle strength training; rehabilitation; respiratory training; swallowing