Respiratory rehabilitation in patients with amyotrophic lateral sclerosis

Česká verzia

Authors: D. Botiková- ^{1 3}; E. Vlčková ^2,3; S. Voháňka ^2,3
Authors place of work: Rehabilitační oddělení, FN Brno ¹; Neurologická klinika, ERN-EURO NMD, Centrum, FN Brno ²; LF MU, Brno ³
Published in the journal: Cesk Slov Neurol N 2020; 83/116(5): 491-498
Category: Review Article
doi: https://doi.org/10.14735/amcsnn2020491

Summary

Amyotrophic lateral sclerosis (ALS) is a serious neurodegenerative disease, which belongs to a group of conditions affecting the motor neuron system, called motor neuron disease. During the course of the disease, a reduction in the voluntary muscle strength occurs, along with the loss of strength in muscles of respiration. This results in ineffective cough, restrictive changes in ventilation along with dyspnoea. Respiratory muscle weakness progressively leads to respiratory insufficiency, which is the major cause of death in this disease. That is why it is important to monitor respiratory and motor functions in patients with ALS from the moment the diagnosis is given. Functional vital capacity and maximal inspiratory pressure are regarded as the main determinants of respiratory symptomatology and respiratory insufficiency predicting also the life longevity in patients with ALS. Respiratory physiotherapy provides patients with a wide spectrum of techniques, which have a potential to slow down the progress and the severity of respiratory symptoms in case the exercise program is initiated early enough, before the onset of more serious respiratory involvement. The program consists mainly of methods focused on inspiratory and expiratory muscle training, for which special respiratory devices are used. Later in the course of the disease, patients are being provided with techniques which may decrease shortness of breath and which increase effectivity of cough by aiding the manoeuvres. This palliative symptomatic care aims to increase the quality of life in patients with ALS, while being helpful right from the onset as well as during the whole course of the disease.

Keywords:

motor neuron disease – respiratory insuffi ciency – dyspnea – muscle weakness – respiratory muscles – cough – physiotherapy techniques

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