Patients with amyotrophic lateral sclerosis (ALS) develop respiratory complications as a result of their disease, which can quickly worsen and ultimately contribute to an early risk of death. In an article published in the BMJ Open, researchers from South America presented a protocol for a randomized study to investigate the effects of an optimized approach to home ventilation in patients with ALS.
In their paper, the study’s researchers stated that they plan to compare the outcomes of conventional ventilation with optimized home ventilation treatment in adult patients with ALS.
The optimized model for home ventilation in the randomized study will include education about ventilation during quarterly hospital visits. In addition, the patients receive weekly house calls from a physiotherapist. Physiotherapists will provide “attitudes to use and improvement” to patients and caregivers [noninvasive] Ventilation, bronchial hygiene techniques, aspiration of the upper airways and assisted coughing through ventilation through mechanical insufflation-suction ”as well as air stacking.
In contrast, the conventional care group receives only quarterly training in the hospital and in facilities provided by physical therapists to use or improve non-invasive ventilation and mask fitting during the quarterly visits.
The study’s researchers will rate peak cough flow, number of exacerbations, and the revised ALS functional rating scale to help determine disease progression and determine how ALS interferes with daily living activities.
You will also examine chest wall volumes, nasal inspiratory pressure, nasal expiratory pressure and forced vital capacity (FVC), maximum breath pressure, forced expiratory volume in 1 second (FEV1), and FEV1 / forced vital capacity.
Overall, patients will be subjected to their assigned intervention for a planned period of 6 months, while study results will be evaluated every 3 months until the first year after the start of the interventions and 3 and 6 months after the final assessment.
The study researchers hope that the results of this study “support the importance of home physiotherapy” [specialized] Help “because they believe that such a” well-implemented therapeutic ” [program] will reduce the morbidity and mortality rates of patients with ALS. “
Pondofe K, Fregonezi GAF, Brito O, Júnior MED, Torres-Castro R, Resqueti VR. Effects of an Optimized Approach to Home Ventilation in Individuals with Amyotrophic Lateral Sclerosis: a Study Protocol for a Randomized Controlled Trial. BMJ open. 2021; 11 (4): e042780. doi: 10.1136 / bmjopen-2020-042780