TY - JOUR T1 - Acute effects in cough flow and chest wall volume after breath-stacking maneuver in amyotrophic lateral sclerosis (ALS) JF - European Respiratory Journal JO - Eur Respir J VL - 44 IS - Suppl 58 SP - P2124 AU - Ana Cristina Maciel AU - Vanessa Resqueti AU - Guilherme Fregonezi AU - Andrea Aliverti AU - Íllia Nadinne Lima AU - Armele Dornelas de Andrade Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/Suppl_58/P2124.abstract N2 - Background: Amyotrophic Lateral Sclerosis (ALS) patients show decreased inspiratory muscle strength and weakness of the expiratory muscles associated with ineffective cough production. The breath-stacking maneuver (BS) increases inspired volume and may influence cough flow generation. Aim: To evaluate the effects of BS in cough flow and chest wall volume in ALS patients and healthy subjects by opto-electronic plethysmography (OEP). Methods: 22 subjects were assessed, 7 ALS subjects(4 M), (51.0 ± 14.53 years, BMI 24.57 ± 2.12 kg/m2, FVC 2.57 ± 0.93 L, FEV1/FVC 0.82 ± 0.08 L) and 15 matched healthy subjects (8M), (45.8 ± 15.5 years e BMI 25.3 ± 1.84 Kg/m2), with normal lung function. Voluntary cough flow and tidal volume of chest wall (VTCW) compartments were analyzed before and after the BS maneuver in 45o inclination position by OEP. Results: VTCW increased after the BS in both groups, ALS patients 0.35 ± 0.10 L vs 1.79 ± 1.11 L (Δ 1.44 L) and healthy subjects 0.42 ± 0.19 L vs 2.87 ± 0.64 L, (Δ 2.44 L), p < 0.0001 (two-way ANOVA). Cough flow significantly increased in both groups ALS (2.21 ± 0.71 L/s vs 3.39 ± 0.73 L/s) and healthy subjects (5.19 ± 1.28 L/s vs 6.30 ± 1.07 L/s), p < 0.001 (two-way ANOVA). Conclusion: Breath-stacking maneuver increases pulmonary volumes leading to an increase in cough flow in the 45o inclination position in both groups. Despite the smaller increase in ALS chest wall volume compared to healthy subjects, BS maneuver produced significant increase on flow cough generation, essential for the assistance of these patients. ER -