Effectiveness of Expiratory Muscle Strength Training for Improving Communication in ALS

呼气肌力量训练对于改善 ALS 患者沟通的有效性

基本信息

批准号：
10302267
负责人：
Brianna Rose Kiefer
金额：
$ 4.68万
依托单位：
PURDUE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-01-01 至 2022-10-14
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10302267
关键词：
Address Aerobic Affect Age Air Movements Amyotrophic Lateral Sclerosis Aspiration Pneumonia Atrophic Clinical Trials Communication Communication Methods Coughing Data Deglutition Devices Disease Progression Dysarthria Eating Effectiveness Flaccid Dysarthrias Goals Impairment Individual Investigation Language Limb structure Literature Maintenance Mediating Mentors Methods Motor Motor Neurons Muscle Muscular Atrophy Neurodegenerative Disorders Parkinson Disease Pathologist Patients Pattern Perception Persons Physiology Population Production Progressive Muscular Atrophy Protocols documentation Quality of life Reflex action Research Resistance Respiration Respiratory Tract Infections Respiratory physiology Science Series Speech Speech Acoustics Surveys Testing Training Universities alternative communication career clinical practice communication device experience improved kinematics multilevel analysis muscle strength nervous system disorder neuron loss nutrition preservation pressure psychosocial respiratory response sex skills spasticity strength training therapy design training opportunity

项目摘要

PROJECT ABSTRACT The goal of the proposed project is to provide Ms. Brianna Kiefer with training opportunities at Purdue and Columbia University from Drs. Jessica Huber, Michelle Troche, and Kristine Marceau – experts in speech science, respiration, cough physiology, and multilevel modeling. To achieve this goal, Ms. Kiefer will conduct a study of expiratory muscle strength training (EMST) in people with Amyotrophic Lateral Sclerosis (ALS). Progressive muscular atrophy is a detrimental consequence of motor neuronal death associated with ALS. Atrophy of the respiratory musculature is particularly harmful since speech and cough production require ample and coordinated respiratory support. Due to respiratory musculature atrophy, people with ALS are unable to generate sufficient subglottal pressures to support speech. People with ALS are also unable to generate strong expiratory forces to effectively expel foreign materials from the airway when they cough. Consequently, people with ALS often rely on alternative communication devices and alternative methods of nutrition. Losing the abilities to speak and eat independently significantly reduces quality of life for people with ALS. Recent investigations have found that implementing moderate intensity strength training paradigms in the early stages of ALS is safe and effective. EMST is a commonly used paradigm that strengthens the respiratory musculature to improve speech and cough production. While EMST has a large body of literature to support its use for people with other neurodegenerative diseases, only one study has examined the effectiveness of EMST for people with ALS. The proposed project aims to build upon Plowman and colleagues (2016) findings to address three broad aims. Specific aim 1 will define how the underlying respiratory support patterns mediating speech and cough production are altered by ALS. We suspect that individuals with ALS will utilize less efficient and effective respiratory support patterns during speech and cough production relative to age- and sex-matched controls. Specific Aim 2 will determine how moderate intensity EMST modifies the effectiveness and efficiency of speech and cough production. In a multiple baseline, delayed-treatment design, people with ALS will undergo a six-week moderate intensity EMST protocol. We suspect that EMST will improve the effectiveness and efficiency of speech and cough production. And finally, Specific Aim 3 will identify how EMST affects the psychosocial states of people with ALS. We suspect that improved speech and cough production will positively impact the psychosocial states of people with ALS. Together, results from the proposed study will provide much needed information to guide clinical practice in the treatment of dysarthria and dystussia associated with ALS. Through conducting this study and engaging with her mentors in a variety of activities, Ms. Kiefer will greatly expand her research skills. Specifically, she will gain experience with ALS, reflexive cough production, respiratory function, multilevel models, and clinical trial management.

项目摘要拟议项目的目标是为 Brianna Kiefer 女士提供在普渡大学和哥伦比亚大学 Jessica Huber 博士、Michelle Troche 和 Kristine Marceau 博士——演讲专家为了实现这一目标，基弗女士将进行一项科学、呼吸、咳嗽生理学和多层次建模。肌萎缩侧索硬化症 (ALS) 患者呼气肌力量训练 (EMST) 的研究。进行性肌肉萎缩是与 ALS 相关的运动神经元死亡的有害后果。呼吸肌肉萎缩尤其有害，因为言语和咳嗽的产生需要充足的能量由于呼吸肌肉萎缩，ALS 患者无法进行协调的呼吸支持。患有 ALS 的人也无法产生足够的声门下压力来支持言语。测试中，人们咳嗽时有效地将异物从气道中排出的呼气力。患有 ALS 的人通常依赖替代通讯设备和替代营养方法。最近患有 ALS 的人的说话和进食能力显着降低。调查发现，在早期阶段实施中等强度的力量训练模式 ALS 的 EMST 是一种增强呼吸肌肉组织的常用范例。改善言语和咳嗽，而 EMST 有大量文献支持其用途。对于患有其他神经退行性疾病的人，只有一项研究检验了 EMST 对治疗的有效性拟议项目旨在以 Plowman 及其同事（2016）的研究结果为基础来解决 ALS 患者的问题。具体目标一将定义潜在的呼吸支持模式如何调节。 ALS 会改变言语和咳嗽的产生，我们怀疑患有 ALS 的人会减少使用。与年龄和年龄相关的言语和咳嗽产生期间高效且有效的呼吸支持模式性别匹配对照。具体目标 2 将确定中等强度 EMST 如何改变多基线、延迟治疗中言语和咳嗽产生的有效性和效率。根据设计，ALS 患者将接受为期六周的中等强度 EMST 方案，我们怀疑 EMST。将提高言语和咳嗽产生的有效性和效率最后，具体目标 3 将提高。确定 EMST 如何影响 ALS 患者的心理状态，我们怀疑这可以改善言语。和咳嗽的产生将对 ALS 患者的心理社会状态产生积极影响。拟议的研究将提供急需的信息来指导治疗的临床实践通过进行这项研究并与她的导师进行交流，发现了与 ALS 相关的构音障碍和发音困难。通过各种各样的活动，基弗女士将大大拓展她的研究技能，具体来说，她将获得经验。包括 ALS、反射性咳嗽、呼吸功能、多级模型和临床试验管理。

项目成果

期刊论文数量（1）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Rehabilitation of Airway Protection in Individuals With Movement Disorders: A Telehealth Feasibility Study.

运动障碍患者气道保护的康复：远程医疗可行性研究。

DOI：
发表时间：
2022-11-16
期刊：
影响因子：
2.6
作者：
Sevitz, Jordanna S;Borders, James C;Dakin, Avery E;Kiefer, Brianna R;Alcalay, Roy N;Kuo, Sheng;Troche, Michelle S
通讯作者：
Troche, Michelle S