{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T01:20:04Z","timestamp":1776388804439,"version":"3.51.2"},"reference-count":37,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T00:00:00Z","timestamp":1715644800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000971","name":"ALS Association","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000971","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["1R01NS100859"],"award-info":[{"award-number":["1R01NS100859"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction\/Aims<\/jats:title><jats:p>Evaluations of pulmonary, cough, and swallow function are frequently performed to assess disease progression in amyotrophic lateral sclerosis (ALS), yet the relationship between these functions remains unknown. We therefore aimed to determine relationships between these measures in individuals with ALS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>One hundred individuals with ALS underwent standardized tests: forced vital capacity (FVC), maximum expiratory\/inspiratory pressure (MEP, MIP), voluntary cough peak expiratory flow (PEF), and videofluoroscopic swallow evaluation (VF). Duplicate raters completed independent, blinded ratings using the Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) scale. Descriptives, Spearman's Rho correlations, Kruskal\u2013Wallis analyses, and Pearson's chi\u2010squared tests were completed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean and standard deviation across pulmonary and cough measures were FVC: 74.2% predicted (\u00b1\u200922.6), MEP: 91.6\u2009cmH<jats:sub>2<\/jats:sub>O (\u00b1\u200946.4), MIP\u2009cmH<jats:sub>2<\/jats:sub>O: 61.1 (\u00b1\u200928.9), voluntary PEF: 352.7\u2009L\/min (\u00b1\u2009141.6). DIGEST grades included: 0 (normal swallowing): 31%, 1 (mild dysphagia): 48%, 2 (moderate dysphagia): 10%, 3 (severe dysphagia): 10%, and 4 (life\u2010threatening dysphagia): 1%. Positive correlations were observed: MEP\u2010MIP: <jats:italic>r<\/jats:italic>\u2009=\u2009.76, MIP\u2010PEF: <jats:italic>r<\/jats:italic>\u2009=\u2009.68, MEP\u2010PEF: <jats:italic>r<\/jats:italic>\u2009=\u2009.61, MIP\u2010FVC: <jats:italic>r<\/jats:italic>\u2009=\u2009.60, PEF\u2010FVC: <jats:italic>r<\/jats:italic>\u2009=\u2009.49, and MEP\u2010FVC: <jats:italic>r<\/jats:italic>\u2009=\u2009.46, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.0001. MEP (<jats:italic>p<\/jats:italic>\u2009=\u2009.009) and PEF (<jats:italic>p<\/jats:italic>\u2009=\u2009.04) differed across DIGEST safety grades. Post hoc analyses revealed significant between group differences in MEP and PEF across DIGEST safety grades 0 versus 1 and grades 0 versus 3, (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>In this cohort of individuals with ALS, pulmonary function, and voluntary cough were associated. Expiratory metrics (MEP, PEF) were diminished in individuals with unsafe swallowing, increasing their risk for effectively defending the airway.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mus.28113","type":"journal-article","created":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T10:07:26Z","timestamp":1715681246000},"page":"140-147","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Relationship between pulmonary, cough, and swallowing functions in individuals with amyotrophic lateral sclerosis"],"prefix":"10.1002","volume":"70","author":[{"given":"Cara","family":"Donohue","sequence":"first","affiliation":[{"name":"Aerodigestive Research Core Laboratory The Ohio State University  Columbus Ohio USA"},{"name":"Department of Hearing and Speech Sciences Vanderbilt University  Nashville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terrie","family":"Vasilopoulos","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology University of Florida  Gainesville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James P.","family":"Wymer","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Florida  Gainesville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily K.","family":"Plowman","sequence":"additional","affiliation":[{"name":"Aerodigestive Research Core Laboratory The Ohio State University  Columbus Ohio USA"},{"name":"Department of Otolaryngology\u2014Head and Neck Surgery The Ohio State University  Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,5,14]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2017.3339"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/21678421.2021.1910713"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/ane.12136"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455\u2010021\u201010315\u20102"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2004.09.092"},{"key":"e_1_2_11_7_1","doi-asserted-by":"crossref","unstructured":"WangBJ CarterFL AltmanKW.Relationship between dysarthria and oral\u2010oropharyngeal dysphagia: the present evidence.Ear Nose Throat J. 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