Voluntary Cough Airflow Differentiates Safe Versus Unsafe Swallowing in Amyotrophic Lateral Sclerosis

Dysphagia
Emily K PlowmanClifton Gooch

Abstract

Dysphagia and aspiration are prevalent in amyotrophic lateral sclerosis (ALS) and contribute to malnutrition, aspiration pneumonia, and death. Early detection of at risk individuals is critical to ensure maintenance of safe oral intake and optimal pulmonary function. We therefore aimed to determine the discriminant ability of voluntary cough airflow measures in detecting penetration/aspiration status in ALS patients. Seventy individuals with ALS (El-Escorial criteria) completed voluntary cough spirometry testing and underwent a standardized videofluoroscopic swallowing evaluation (VFSE). A rater blinded to aspiration status derived six objective measures of voluntary cough airflow and evaluated airway safety using the penetration-aspiration scale (PAS). A between groups ANOVA (safe vs. unsafe swallowers) was conducted and sensitivity, specificity, area under the curve (AUC) and likelihood ratios were calculated. VFSE analysis revealed 24 penetrator/aspirators (PAS ≥3) and 46 non-penetrator/aspirators (PAS ≤2). Cough volume acceleration (CVA), peak expiratory flow rise time (PEFRT), and peak expiratory flow rate (PEFR) were significantly different between airway safety groups (p < 0.05) and demonstrated significant discriminant ...Continue Reading

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Citations

Oct 19, 2016·Annals of Clinical and Translational Neurology·Lauren C TaborEmily K Plowman
Apr 21, 2017·Amyotrophic Lateral Sclerosis & Frontotemporal Degeneration·Emily K PlowmanGary Pattee
Aug 15, 2018·Muscle & Nerve·Chiharu MatsudaMichiko Haraguchi
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Jan 18, 2019·Amyotrophic Lateral Sclerosis & Frontotemporal Degeneration·Lauren C Tabor-GrayEmily K Plowman
Sep 12, 2019·Arquivos de neuro-psiquiatria·Bárbara Carolina BrandãoRoberta Gonçalves da Silva
May 23, 2017·Current Physical Medicine and Rehabilitation Reports·Stephanie A WattsEmily K Plowman
Sep 29, 2020·Journal of Parkinson's Disease·Veerle A van de Wetering-van DongenMaarten J Nijkrake
Sep 27, 2018·Annals of Clinical and Translational Neurology·Raele RobisonEmily K Plowman
Feb 8, 2019·Therapeutic Advances in Chronic Disease·Nicolas AudagGregory Reychler
Mar 7, 2019·Frontiers in Neurology·Yana YunusovaPeter Bede
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Amyotrophic Lateral Sclerosis (ALS) is a progressive nervous system disease associated with the death of neurons that control voluntary muscles. Discover the latest research on ALS here.