{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T12:54:35Z","timestamp":1769345675317,"version":"3.49.0"},"reference-count":16,"publisher":"BMJ","issue":"1","funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP22K11412"],"award-info":[{"award-number":["JP22K11412"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,1,1]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>We report a case of amyotrophic lateral sclerosis (ALS) in a patient in their 50s, presenting with spastic paraparesis and bulbar palsy, treated with lung volume recruitment therapy (LVRT). From early stage in the disease, vital capacity (VC), lung insufflation capacity (LIC) and ALS Functional Rating Scale-Revised scores were regularly measured, and LVRT was continuously performed at home. After 10 years, the patient had complete limb function loss and required nutritional management via gastrostomy and full assistance with daily activities. Despite this, the gap between VC and LIC remained approximately 2000 mL, and the patient was not ventilator-dependent during the day after tracheostomy. Chest CT showed improvement in lower lobe atelectasis due to LVRT. Typically, respiratory physiotherapy is challenging in patients with bulbar palsy or post-tracheostomy, but in this case, LVRT successfully maintained lung mobility. Early LVRT implementation may improve ALS patients\u2019 survival prognosis and warrants further exploration.<\/jats:p>","DOI":"10.1136\/bcr-2024-262945","type":"journal-article","created":{"date-parts":[[2025,1,19]],"date-time":"2025-01-19T20:50:41Z","timestamp":1737319841000},"page":"e262945","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Long-term lung volume recruitment therapy maintains ventilator weaning in a patient with ALS following tracheostomy"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8442-821X","authenticated-orcid":false,"given":"Keisuke","family":"Yorimoto","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Physiotherapy, National Center of Neurology and Psychiatry, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yosuke","family":"Ariake","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Physiotherapy, National Center of Neurology and Psychiatry, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4946-1396","authenticated-orcid":false,"given":"Taiyo","family":"Kawaguchi","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Physiotherapy, National Center of Neurology and Psychiatry, Tokyo, Japan"},{"name":"Department of Rehabilitation Medicine, , Keio University School of Medicine, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4153-168X","authenticated-orcid":false,"given":"Takatoshi","family":"Hara","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Physiotherapy, National Center of Neurology and Psychiatry, Tokyo, Japan"},{"name":"Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,1,19]]},"reference":[{"key":"2025082623140247000_18.1.e262945.1","first-page":"123","article-title":"Progress in respiratory management of bulbar complications of motor neuron disease\/amyotrophic lateral sclerosis","volume":"78","author":"Andersen","year":"2023","journal-title":"Thorax"},{"key":"2025082623140247000_18.1.e262945.2","doi-asserted-by":"publisher","DOI":"10.1186\/cc5714"},{"key":"2025082623140247000_18.1.e262945.3","doi-asserted-by":"crossref","DOI":"10.3389\/fresc.2023.1164628","article-title":"The role of lung volume recruitment therapy in neuromuscular disease: a narrative review","volume":"4","author":"Sheers","year":"2023","journal-title":"Front Rehabil Sci"},{"key":"2025082623140247000_18.1.e262945.4","doi-asserted-by":"crossref","DOI":"10.2490\/prm.20200011","article-title":"Lung Insufflation Capacity with a New Device in Amyotrophic Lateral 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response to lung volume recruitment therapy (LVR)","volume":"9","author":"Sheers","year":"2022","journal-title":"BMJ Open Respir Res"},{"key":"2025082623140247000_18.1.e262945.9","doi-asserted-by":"crossref","first-page":"111","DOI":"10.3109\/17482968.2012.720262","article-title":"The effects of lung volume recruitment on coughing and pulmonary function in patients with ALS","volume":"14","author":"Cleary","year":"2013","journal-title":"Amyotroph Lateral Scler Frontotemporal Degener"},{"key":"2025082623140247000_18.1.e262945.10","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1002\/mus.27417","article-title":"Lung volume recruitment improves volitional airway clearance in amyotrophic lateral sclerosis","volume":"64","author":"Cleary","year":"2021","journal-title":"Muscle Nerve"},{"key":"2025082623140247000_18.1.e262945.11","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1016\/j.pmrj.2015.04.001","article-title":"Feasibility of Lung Volume Recruitment in Early Neuromuscular Weakness: A Comparison Between Amyotrophic Lateral Sclerosis, Myotonic Dystrophy, and Postpolio Syndrome","volume":"7","author":"Kaminska","year":"2015","journal-title":"PM R"},{"key":"2025082623140247000_18.1.e262945.12","doi-asserted-by":"crossref","first-page":"448","DOI":"10.3109\/21678421.2015.1051992","article-title":"A preliminary randomized trial of the mechanical insufflator-exsufflator versus breath-stacking technique in patients with amyotrophic lateral sclerosis","volume":"16","author":"Rafiq","year":"2015","journal-title":"Amyotroph Lateral Scler Frontotemporal Degener"},{"key":"2025082623140247000_18.1.e262945.13","doi-asserted-by":"crossref","first-page":"1445","DOI":"10.1513\/AnnalsATS.202212-1062OC","article-title":"A Randomized Controlled Clinical Trial of Lung Volume Recruitment in Adults with Neuromuscular Disease","volume":"20","author":"Sheers","year":"2023","journal-title":"Ann Am Thorac 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Chapter 7, respiratory management, q&a 7-2. In: Guidelines for the Diagnosis and Management of Amyotrophic Lateral Sclerosis 2023. 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