The impact of expiratory muscle strength training on voluntary cough effectiveness in Huntington's disease

IF 4.5 2区医学 Q1 CLINICAL NEUROLOGY

European Journal of Neurology Pub Date : 2024-09-30 DOI:10.1111/ene.16500

Romana Konvalinkova, Martin Srp, Kristyna Doleckova, Vaclav Capek, Ota Gal, Martina Hoskovcova, Radim Kliment, Jan Muzik, Evzen Ruzicka, Jiri Klempir

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Abstract

Background and purpose

Dysfunction of the airway defence system in Huntington's disease (HD) is a significant but often overlooked problem. Although expiratory muscle strength training (EMST) is frequently utilized in cough effectiveness treatment, its specific impact in HD patients has not yet been explored. This study investigated the effects of EMST on voluntary peak cough flow (vPCF) in HD patients and evaluated the retention of potential gains post-intervention.

Methods

In this prospective case-controlled trial, 29 HD patients completed an 8-week wait-to-start period, which served to identify the natural development of expiratory muscle strength and vPCF. This was followed by 8 weeks of EMST training and an additional 8 weeks of follow-up. The study's outcome parameters, vPCF and maximum expiratory pressure (MEP), were measured against those of age- and sex-matched healthy controls.

Results

Huntington's disease patients had significantly lower MEP (p < 0.001) and vPCF (p = 0.012) compared to healthy controls at baseline. Following the EMST, significant improvements in MEP (d = 1.39, p < 0.001) and vPCF (d = 0.77, p = 0.001) were observed, with HD patients reaching the cough performance levels of healthy subjects. However, these gains diminished during the follow-up, with a significant decline in vPCF (d = −0.451, p = 0.03) and in MEP (d = −0.71; p = 0.002).

Conclusions

Expiratory muscle strength training improves expiratory muscle strength and voluntary cough effectiveness in HD patients, but an ongoing maintenance programme is necessary to sustain the improvements.

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呼气肌力训练对亨廷顿氏症患者自主咳嗽效果的影响

背景和目的：亨廷顿氏病（Huntington's disease，HD）患者的气道防御系统功能障碍是一个重要问题，但往往被忽视。尽管呼气肌力训练（EMST）经常被用于咳嗽有效性治疗，但其对 HD 患者的具体影响尚未得到探讨。本研究调查了呼气肌力训练对 HD 患者自主咳嗽峰值流量（vPCF）的影响，并评估了干预后潜在收益的保持情况：在这项前瞻性病例对照试验中，29 名血液透析患者完成了为期 8 周的等待开始期，以确定呼气肌力和自主咳嗽流量的自然发展情况。随后进行为期8周的EMST训练和另外8周的随访。研究的结果参数，即呼气肌力和最大呼气压力（MEP），与年龄和性别匹配的健康对照组进行了对比测量：结果发现：亨廷顿氏病患者的最大呼气压力明显降低（p 结论：亨廷顿氏病患者的最大呼气压力明显降低：呼气肌力训练可改善 HD 患者的呼气肌力和自主咳嗽效果，但要保持这种改善效果，还需要持续的维护计划。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Neurology 医学-临床神经学

CiteScore

9.70

自引率

2.00%

发文量

418

审稿时长

1 months

期刊介绍： The European Journal of Neurology is the official journal of the European Academy of Neurology and covers all areas of clinical and basic research in neurology, including pre-clinical research of immediate translational value for new potential treatments. Emphasis is placed on major diseases of large clinical and socio-economic importance (dementia, stroke, epilepsy, headache, multiple sclerosis, movement disorders, and infectious diseases).