{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:46:07Z","timestamp":1787877967448,"version":"build-2784847793"},"reference-count":48,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,11,29]],"date-time":"2018-11-29T00:00:00Z","timestamp":1543449600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"National Institutes of Child Health and Development","award":["1R21 HDO75327"],"award-info":[{"award-number":["1R21 HDO75327"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The purpose of this study was to determine the impact of an in\u2010home expiratory muscle strength training (EMST) program on pulmonary, swallow, and cough function in individuals with amyotrophic lateral sclerosis (ALS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>EMST was tested in a prospective, single\u2010center, double\u2010blind, randomized, controlled trial of 48 ALS individuals who completed 8 weeks of either active EMST (<jats:italic>n<\/jats:italic>\u2009=\u200924) or sham EMST (<jats:italic>n<\/jats:italic>\u2009=\u200924). The primary outcome to assess treatment efficacy was change in maximum expiratory pressure (MEP). Secondary outcomes included: cough spirometry; swallowing; forced vital capacity; and scoring on the ALS Functional Rating Scale\u2014Revised.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Treatment was well tolerated with 96% of patients completing the protocol. Significant differences in group change scores were noted for MEP and Dynamic Imaging Grade of Swallowing Toxicity scores (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.02). No differences were noted for other secondary measures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>This respiratory training program was well\u2010tolerated and led to improvements in respiratory and bulbar function in ALS. <jats:italic>Muscle Nerve<\/jats:italic> <jats:bold>59<\/jats:bold>:40\u201346, 2019<\/jats:p><\/jats:sec>","DOI":"10.1002\/mus.26292","type":"journal-article","created":{"date-parts":[[2018,7,7]],"date-time":"2018-07-07T10:38:58Z","timestamp":1530959938000},"page":"40-46","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":135,"title":["Impact of expiratory strength training in amyotrophic lateral sclerosis: Results of a randomized, sham\u2010controlled trial"],"prefix":"10.1002","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0198-4297","authenticated-orcid":false,"given":"Emily K.","family":"Plowman","sequence":"first","affiliation":[{"name":"Swallowing Systems Core University of Florida  Gainesville Florida USA"},{"name":"Department of Speech, Language and Hearing Sciences, College of Public Health and Health Professions University of Florida  P.O. 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Michelle","family":"Rosado","sequence":"additional","affiliation":[{"name":"Swallowing Systems Core University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terrie","family":"Vasilopoulos","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raele","family":"Robison","sequence":"additional","affiliation":[{"name":"Swallowing Systems Core University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer L.","family":"Chapin","sequence":"additional","affiliation":[{"name":"Swallowing Systems Core University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joy","family":"Gaziano","sequence":"additional","affiliation":[{"name":"Joy McCann Culverhouse Center for Swallowing Disorders University of South Florida  Tampa Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuan","family":"Vu","sequence":"additional","affiliation":[{"name":"Department of Neurology University of South Florida  Tampa Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clifton","family":"Gooch","sequence":"additional","affiliation":[{"name":"Department of Neurology University of South Florida  Tampa Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,11,29]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.53.5.1059"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0404.2001.d01-22.x"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/ncpneuro0853"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/ane.12136"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/1750-1172-4-3"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brainres.2009.11.051"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.2009.169748"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0045503"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.20451"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0960-8966(03)00104-4"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000264418.92308.a4"},{"issue":"6","key":"e_1_2_7_13_1","first-page":"965","article-title":"Results of resistance exercise on a patient with amyotrophic lateral sclerosis","volume":"63","author":"Bohannon RW","year":"1983","journal-title":"A case report. 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