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Effects of Positional Changes on Airway Clearance Behaviour of Individuals with Amyotrophic Lateral Sclerosis and Healthy Age Matched Controls

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  • Peak cough flow (PCF) is a measure of cough strength and capacity. According to American Thoracic Society (ATS) standards, patients should be seated upright during pulmonary function testing. However, the effect of sitting angle on PCF and other measures of cough function in patients with ALS has not been studied systematically. This project evaluated whether there was a difference in PCF during coughing when patients with ALS sat with 90 degrees forward flexion (FF) as compared to 80 degrees FF. Ten patients with ALS participated in the pilot study. A within-group, pre-test post-test design was used and previously collected measures of PCF were analyzed. Patients were seated in a modified chair that placed patients at 90 and then 80 degrees FF. The dependent measure was the maximum of three coughs. A comparison was made between 90 and 80 degrees of FF across measures of PCF, pre-cough inspiratory volume, and cough volume acceleration. A procedural manual describing the method of analyzing cough mechanics was developed. Results indicated an increase in values when participants sat at 80-degrees FF during a cough. These results suggest that FF may be beneficial to patients who are experiencing moderate to severe symptoms of ALS, and substantiate the evidence for use of FF as a non-invasive means of enhancing symptom-management of pulmonary function; and ultimately prolonging independence and Quality of Life. Future directions are also discussed.

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    Attribution-NonCommercial 3.0 International