High-frequency chest wall oscillation therapy in amyotrophic lateral sclerosis

OBJECTIVES: To evaluate the effectiveness of high-frequency chest wall oscillation (HFCWO) therapy in patients with amyotrophic lateral sclerosis (ALS). METHODS: A retrospective chart review was performed of 18 patients receiving HFCWO therapy. Data was obtained pre-treatment and post-treatment including ALS Functional Rating Scale-Revised (ALSFRS-R), forced vital capacity (FVC), maximal inspiratory pressure (MIP), peak cough expiratory flow (PCEF), and daytime oximetry. RESULTS: Daytime oximetry increased for 8 of 18 patients. None of the other measures changed significantly over the 3 months, although the change in slope of FVC, MIP, and PCEF following initiation of treatment suggested a reduction in the rate of decline of each measure. A patient survey revealed that 92% felt better after therapy and that their breathing was easier. Of patients, 85% agreed that it was easier to clear airways and that it had improved their quality of life. CONCLUSIONS: HFCWO appears to be an effective tool for airway secretion management in ALS patients and may also have an impact in improving daytime oxygen saturation.