34 Participants Needed

Combined Respiratory Training for ALS

LT
DM
Overseen ByDonovan Mott
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: Nova Southeastern University
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial examines how two specific breathing exercises—lung volume recruitment (which helps the lungs take in more air) and expiratory muscle strength training (which strengthens muscles used in breathing out)—can improve breathing and quality of life for people with ALS. Researchers aim to determine if these exercises strengthen coughing, ease breathing, and affect daily life for both patients and caregivers. This trial suits those diagnosed with ALS within the last two years who have trouble coughing and have not tried these specific breathing exercises before. As an unphased trial, it offers a unique opportunity to explore innovative breathing techniques that could enhance daily living for ALS patients and their caregivers.

Will I have to stop taking my current medications?

The trial information does not specify if you need to stop taking your current medications. However, if you are using prescription cough assist or non-invasive volume ventilation devices, you cannot participate in the trial.

What prior data suggests that this combined respiratory training is safe for ALS patients?

Research has shown that combined breathing exercises, which include techniques to expand the lungs and strengthen breathing muscles, are generally safe for people with ALS, a disease affecting the nervous system. Studies have found that these exercises can strengthen breathing muscles. For instance, one study found that a moderate-level breathing exercise program was manageable for participants and led to short-term improvements in muscle strength. Another study observed that exercises to expand the lungs improved lung function for a short time after treatment. These findings suggest that the combined exercises might be safe for participants, with no major safety concerns reported so far.12345

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores a novel approach to managing ALS through Combined Respiratory Training, which includes lung volume recruitment and expiratory muscle strength training. Unlike traditional ALS treatments that focus primarily on slowing disease progression or managing symptoms with medications like riluzole or edaravone, this method directly targets respiratory muscle function, potentially improving breathing capacity and quality of life. By integrating exercises that strengthen the muscles involved in breathing, this technique could offer a complementary benefit that current drug therapies do not provide. This trial could pave the way for innovative, non-pharmacological interventions that address specific physical challenges faced by ALS patients.

What evidence suggests that combined respiratory training is effective for ALS?

Research has shown that a combination of breathing exercises, which includes techniques to expand lung capacity and strengthen breathing muscles, can benefit people with ALS (amyotrophic lateral sclerosis). In this trial, all participants will follow a regimen of combined lung volume recruitment and expiratory muscle strength training. One study demonstrated that exercises to increase lung capacity significantly improved lung function for up to 15 minutes after the session. Another study found that training the breathing muscles increased their strength, particularly enhancing the ability to breathe out and breathe in forcefully. Specifically, one participant's ability to breathe in improved by 89% after this training. These findings suggest that combined breathing exercises could enhance breathing and muscle strength in people with ALS.12345

Who Is on the Research Team?

MT

Magalie Thomas, MBA

Principal Investigator

Nova Southeastern University

Are You a Good Fit for This Trial?

This trial is for people with ALS who have had symptoms for less than 2 years, can't already use respiratory training devices, and don't have a tracheostomy or need invasive breathing support. They shouldn't be in other studies that affect coughing or breathing and must not have severe lung diseases like COPD.

Inclusion Criteria

I have never undergone lung volume or expiratory muscle strength training.
My symptoms started less than 2 years ago.
My cough strength is weaker than normal for my age and gender.
See 1 more

Exclusion Criteria

I have a tracheostomy or use a ventilator to help me breathe.
I am not part of another study that could affect my cough or breathing.
I do not have severe lung problems or a history of collapsed lung.
See 3 more

Timeline for a Trial Participant

Screening/Baseline 1

Participants are screened for eligibility to participate in the trial

1 week
1 visit (in-person)

Baseline 2

Introduction of LVR and EMST training with initial training session

1 week
1 visit (in-person)

Active Training

Weekly telehealth therapy sessions including LVR and EMST training, peak cough flow assessment, and patient-reported outcomes

5 weeks
4 visits (virtual)

Final Evaluation

Final assessment procedures identical to Baseline 2

1 week
1 visit (in-person)

Follow-up

Monthly telehealth visits for peak cough flow and maximum phonation time assessments, and clinician-administered surveys

6 months
6 visits (virtual)

What Are the Treatments Tested in This Trial?

Interventions

  • Combined Respiratory Training
Trial Overview The study tests if combining two types of breathing exercises (LVR+EMST) helps improve cough strength, breath control, swallowing difficulties, and overall quality of life in up to 39 patients with ALS. It also looks at the impact on caregiver burden.
How Is the Trial Designed?
1Treatment groups
Experimental Treatment
Group I: Lung Volume Recruitment +Expiratory Muscle Strength TrainingExperimental Treatment1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

Nova Southeastern University

Lead Sponsor

Trials
103
Recruited
12,000+

Congressionally Directed Medical Research Programs

Collaborator

Trials
59
Recruited
10,600+

Published Research Related to This Trial

In a pilot study involving 20 ALS patients, those who used POWERbreathe® inspiratory muscle training alongside usual care showed significant improvements in maximum inspiratory pressure (PImax) and heart rate compared to the control group, indicating enhanced respiratory function.
The experimental group also experienced better quality of life and functionality, as evidenced by increased scores on the ALS Functional Rating Scale, suggesting that inspiratory muscle training could be a beneficial addition to standard care for ALS patients.
POWERbreathe® Inspiratory Muscle Training in Amyotrophic Lateral Sclerosis.Vicente-Campos, D., Sanchez-Jorge, S., Chicharro, JL., et al.[2023]
Lung volume recruitment (LVR) significantly improved forced vital capacity (FVC) for up to 15 minutes after treatment in 29 individuals with amyotrophic lateral sclerosis (ALS), indicating a temporary enhancement in pulmonary function.
LVR also positively affected peak cough flow (PCF) during unassisted coughing at both 15 and 30 minutes post-treatment, suggesting it may help improve coughing effectiveness in ALS patients.
The effects of lung volume recruitment on coughing and pulmonary function in patients with ALS.Cleary, S., Misiaszek, JE., Kalra, S., et al.[2015]
In a study of 40 ALS patients, both the breath-stacking technique and mechanical insufflator-exsufflator (MI-E) showed similar rates of chest infections and hospitalization, indicating comparable safety profiles for these cough augmentation methods.
Although there were no statistically significant differences in outcomes, the breath-stacking technique is recommended as a low-cost first-line intervention for cough support in ALS patients, pending further research to confirm its efficacy compared to MI-E.
A preliminary randomized trial of the mechanical insufflator-exsufflator versus breath-stacking technique in patients with amyotrophic lateral sclerosis.Rafiq, MK., Bradburn, M., Proctor, AR., et al.[2017]

Citations

Combined respiratory training in an individual with C9orf72 ...A.C.'s MIP improved by 89% over baseline (71–134 cmH2O) following respiratory training (see Figure 1). A previous study investigating IMST in ALS reported non‐ ...
Lung Volume Recruitment Combined With Expiratory ...The purpose of this study is to investigate the effects of two treatment techniques called Expiratory Muscle Strength Training (EMST) and Lung Volume ...
Respiratory Strength Training in Amyotrophic Lateral ...This study provides Class II evidence that a mild-intensity respiratory strength training program improves maximum expiratory pressure, but not maximum ...
Efficacy of respiratory muscle training in improving ...The results showed that respiratory muscle training improved muscle strength, particularly maximum expiratory and inspiratory pressures. One ...
Combined Respiratory Training for ALSLung volume recruitment (LVR) significantly improved forced vital capacity (FVC) for up to 15 minutes after treatment in 29 individuals with amyotrophic lateral ...
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