Assessment of Voluntary and Reflex Cough in Patients With ALS

NCT ID: NCT02495571

Last Updated: 2015-10-14

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-10-31

Study Completion Date

2016-06-30

Brief Summary

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This study aims to assess the presence and the intensity of voluntary and cough reflex in patients with amyotrophic lateral sclerosis (ALS), comparing the results with the healthy control group. The assessment of the cough is fundamental to verify the mechanism of airways protection which is particularly compromised in ALS patients.

Objective parameters of voluntary and reflex cough would be measured by the spirometer. The reflex of cough would be elicited by a solution of citric acid through an ultrasonic nebulizer.

Detailed Description

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Protocol:

1. Volitional Cough assessment by spirometer (Pony FX- Cosmed): a) Forced vital capacity (FVC); b) Volume Tidal; c) Maximum Espiratory Pressure (MEP); d) Maximum Inspiratory Pressure (MIP); e) Peak of Cough Expiratory Flow.
2. Cough Reflex would be trigged by the inhalation of 0.4M of citric acid solution using the ultrasonic nebulizer (MO-03 Norditalia Elettromedicali) connected with the spirometer and the nebulizer via a bidirectional valve. It would be measured the Peak of Cough Expiratory Flow.

Participants:

It would be recruited 60 subjects at the IRCCS Ospedale San Camillo Venezia (Italy). All participants have to provide informed consent independently. The study group is composed by thirty participants with diagnosis of ALS and the severity score of Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS). The control group consist of thirty healthy subjects matched by aged and sex with the study group.

Statistical consideration:

The variables measured will be summarized by means and standard deviations or by proportions. Numeric variables MIP-MEP-FVC-Vt-PCEF will be analyzed using the Shapiro-Wilk test to verify the normality of distribution. Depending on the outcome, for the comparison between groups will be used or the t-test (parametric) or the test of Mann Whitney (non-parametric) for independent samples.

Conditions

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ALS Cough

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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ALS Patients

Study Group: Evaluation of the cough reflex and the voluntary cough by spirometer and nebulizer

Group Type EXPERIMENTAL

Cough Assessment in ALS Patients

Intervention Type OTHER

1. Volitional Cough assessment by spirometer:

a) Peak Cough Espiratory Flow (PCEF)
2. Cough Reflex Test a) Peak Cough Espiratory Flow (PCEF)

Healthy Subjects

Control group matched by aged and sex with the study group

Group Type OTHER

Cough Assessment in ALS Patients

Intervention Type OTHER

1. Volitional Cough assessment by spirometer:

a) Peak Cough Espiratory Flow (PCEF)
2. Cough Reflex Test a) Peak Cough Espiratory Flow (PCEF)

Interventions

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Cough Assessment in ALS Patients

1. Volitional Cough assessment by spirometer:

a) Peak Cough Espiratory Flow (PCEF)
2. Cough Reflex Test a) Peak Cough Espiratory Flow (PCEF)

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Diagnosis of ALS
* Consensus

Exclusion Criteria

* Smokers
* Oxygen Therapy
* Invasive Ventilation
* Allergy of citrus
* Asthma
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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IRCCS San Camillo, Venezia, Italy

OTHER

Sponsor Role lead

Responsible Party

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Irene Battel

Speech and Language Pathologist

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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IRENE BATTEL

Role: PRINCIPAL_INVESTIGATOR

IRCCS San Camillo, Venezia, Italy

Locations

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Fondazione Ospedale San Camillo IRCCS

Venice, Venice, Italy

Site Status RECRUITING

Countries

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Italy

Central Contacts

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IRENE BATTEL

Role: CONTACT

+393395317706

Claudia Enrichi

Role: CONTACT

Facility Contacts

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Battel Irene

Role: primary

3395317706

References

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Widdicombe JG, Addington WR, Fontana GA, Stephens RE. Voluntary and reflex cough and the expiration reflex; implications for aspiration after stroke. Pulm Pharmacol Ther. 2011 Jun;24(3):312-7. doi: 10.1016/j.pupt.2011.01.015. Epub 2011 Feb 19.

Reference Type BACKGROUND
PMID: 21338708 (View on PubMed)

Luchesi KF, Kitamua S, Mourao LF. Amyotrophic Lateral Sclerosis survival analysis: Swallowing and non-oral feeding. NeuroRehabilitation. 2014;35(3):535-42. doi: 10.3233/NRE-141149.

Reference Type BACKGROUND
PMID: 25238863 (View on PubMed)

Zoccolella S, Beghi E, Palagano G, Fraddosio A, Samarelli V, Lamberti P, Lepore V, Serlenga L, Logroscino G; SLAP registry. Predictors of delay in the diagnosis and clinical trial entry of amyotrophic lateral sclerosis patients: a population-based study. J Neurol Sci. 2006 Dec 1;250(1-2):45-9. doi: 10.1016/j.jns.2006.06.027. Epub 2006 Aug 22.

Reference Type BACKGROUND
PMID: 16920152 (View on PubMed)

Miles A, Huckabee ML. Intra- and inter-rater reliability for judgement of cough following citric acid inhalation. Int J Speech Lang Pathol. 2013 Apr;15(2):209-15. doi: 10.3109/17549507.2012.692812. Epub 2012 Aug 8.

Reference Type BACKGROUND
PMID: 22873621 (View on PubMed)

Other Identifiers

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TRSLA

Identifier Type: -

Identifier Source: org_study_id

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