High-frequency chest wall oscillation in ALS: An exploratory randomized, controlled trial

D. J. Lange, N. Lechtzin, C. Davey, W. David, T. Heiman-Patterson, D. Gelinas, B. Becker, H. Mitsumoto

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Abstract

OBJECTIVES: 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 ≤11 and ≥5, and forced vital capacity (FVC) ≥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%. CONCLUSION: 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.

Original languageEnglish (US)
Pages (from-to)991-997
Number of pages7
JournalNeurology
Volume67
Issue number6
DOIs
StatePublished - Sep 1 2006

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Chest Wall Oscillation
Randomized Controlled Trials
Vital Capacity
Dyspnea
Fatigue
Respiration
Capnography
Amyotrophic Lateral Sclerosis

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High-frequency chest wall oscillation in ALS : An exploratory randomized, controlled trial. / Lange, D. J.; Lechtzin, N.; Davey, C.; David, W.; Heiman-Patterson, T.; Gelinas, D.; Becker, B.; Mitsumoto, H.

In: Neurology, Vol. 67, No. 6, 01.09.2006, p. 991-997.

Research output: Contribution to journalArticle

Lange, DJ, Lechtzin, N, Davey, C, David, W, Heiman-Patterson, T, Gelinas, D, Becker, B & Mitsumoto, H 2006, 'High-frequency chest wall oscillation in ALS: An exploratory randomized, controlled trial', Neurology, vol. 67, no. 6, pp. 991-997. https://doi.org/10.1212/01.wnl.0000237439.78935.46
Lange, D. J. ; Lechtzin, N. ; Davey, C. ; David, W. ; Heiman-Patterson, T. ; Gelinas, D. ; Becker, B. ; Mitsumoto, H. / High-frequency chest wall oscillation in ALS : An exploratory randomized, controlled trial. In: Neurology. 2006 ; Vol. 67, No. 6. pp. 991-997.
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T2 - An exploratory randomized, controlled trial

AU - Lange, D. J.

AU - Lechtzin, N.

AU - Davey, C.

AU - David, W.

AU - Heiman-Patterson, T.

AU - Gelinas, D.

AU - Becker, B.

AU - Mitsumoto, H.

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N2 - OBJECTIVES: 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 ≤11 and ≥5, and forced vital capacity (FVC) ≥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%. CONCLUSION: 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.

AB - OBJECTIVES: 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 ≤11 and ≥5, and forced vital capacity (FVC) ≥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%. CONCLUSION: 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.

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