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Mechanical Insufflation Exsufflation and Lung Volume Recruitment in Amyotrophic Lateral Sclerosis: a Prospective Study of the Prescription Process, the Outcomes and the Experience
McConnell, Rachel
<p><strong>Introduction: </strong>Mechanical Insufflation Exsufflation (M-IE) and Lung Volume Recruitment (LVR) increase cough strength in Amyotrophic Lateral Sclerosis (ALS). Changes in respiratory measures, morbidity, physical function and outcomes; participant’s characteristics prescribed a M-IE and LVR device and their experience with devices are unknown. Finally, LVR adherence is difficult to measure.</p> <p><strong>Aims/Objectives: </strong>The primary aim was to measure, respiratory measures, morbidity, physical function and outcome in an Irish ALS cohort. Secondary aims were to examine the characteristics of participants prescribed a device; to evaluate their experiences and to develop an electronic LVR adherence prototype. <strong></strong></p> <p><strong>Methods: </strong>A prospective longitudinal observational cohort study evaluated 108 participants over one year. Respiratory measures, physical function and outcomes were measured. Characteristics were assessed at device prescription. A questionnaire evaluated experience. An electronic LVR adherence prototype was developed.</p> <p><strong>Results: </strong>Participants (n=108), of mean age 62.05±11.47, were recruited. Sniff Nasal Inspiratory Pressure (SNIP), Slow Vital Capacity (SVC) percent predicted, Peak Cough Flow (PCF) and Amyotrophic Lateral Sclerosis Functional Rating Scale Revised (ALSFRS-R) declined significantly (p2O<strong>, </strong>17.49%, 124.84L/min and 9.62 units per year respectively. One third reported a chest infection and 21 died. Participants prescribed a device had significantly lower average SNIP, SVC percent predicted, PCF and ALSFRS-R (p</p> <p><strong>Conclusion: </strong>This is the first study to quantify the rate of decline of SNIP, SVC and PCF in an Irish ALS cohort and PCF in a large ALS cohort. Device prescription is detailed. This study provides a point of reference for clinicians and future trials. The electronic LVR adherence prototype has potential to be developed for clinical trials.</p> <p>A thesis submitted for the degree of Master of Science from the Royal College of Surgeons in Ireland in 2018.</p>
Keyword(s): Motor Neuron Disease; Amyotrophic Lateral Sclerosis; Mechanical Insufflation Exsufflation; Lung Volume Recruitment; Cough Assist; Physiotherapy; Medicine and Health Sciences; Neurosciences
Publication Date:
2018
Type: Master thesis (research)
Peer-Reviewed: No
Institution: Royal College of Surgeons in Ireland
Citation(s): McConnell R. Mechanical Insufflation Exsufflation and Lung Volume Recruitment in Amyotrophic Lateral Sclerosis: a Prospective Study of the Prescription Process, the Outcomes and the Experience [MSc Thesis]. Dublin: Royal College of Surgeons in Ireland; 2018.
Supervisor(s): Dr Dara Meldrum
Dr Deidre Murray
Related Link(s): https://epubs.rcsi.ie/phdtheses/65/
First Indexed: 2018-12-15 07:15:04 Last Updated: 2018-12-23 07:19:10