{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T16:19:05Z","timestamp":1787933945340,"version":"build-2784847793"},"reference-count":48,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T00:00:00Z","timestamp":1784332800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["NeuroRehabilitation"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Progressive respiratory muscle weakness in neuromuscular diseases (NMD) impairs cough effectiveness and increases respiratory morbidity. We compared peak cough flow (PCF) and vital capacity (VC) across airway clearance\/cough augmentation techniques in adolescents and young adults using home noninvasive ventilation (NIV).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this cross-sectional physiological study, adolescents and young adults with NMD receiving home NIV were evaluated at home. PCF and VC were measured at baseline and immediately after manual assisted cough (MAC), NIV at usual settings, NIV at inspiratory positive airway pressure of 30 cmH2O, air stacking (AS), glossopharyngeal breathing (GPB), and mechanical insufflation-exsufflation (MI-E). Techniques were tested alone and in combination with MAC; the sequence was randomized within participants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-four participants (70.8% male; age 17.5\u2009\u00b1\u20092.4 years) were included. Baseline PCF was 211.2\u2009\u00b1\u200989.4 L\/min. Compared with baseline, PCF increased with MAC, AS, NIV at usual settings, NIV at 30 cmH2O, and MI-E (all p\u2009&lt;\u20090.05), whereas GPB showed no significant change. When combined with MAC, all techniques further increased PCF (e.g., AS\u2009+\u2009MAC, 306.7\u2009\u00b1\u200998.4; NIV-30\u2009+\u2009MAC, 297.1\u2009\u00b1\u200994.0 L\/min; all p\u2009&lt;\u20090.001), with no between-technique differences. VC increased after AS, MI-E, and NIV (all p\u2009&lt;\u20090.005), but not after GPB.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In adolescents and young adults with NMD using home NIV, AS, NIV, and MI-E improved cough effectiveness and lung volume, and adding MAC produced additional PCF gains.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10538135261468009","type":"journal-article","created":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T14:49:50Z","timestamp":1784386190000},"page":"228-240","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Cough Assistance Techniques in Adolescents and Young Adults with Neuromuscular Diseases Using Home Noninvasive Ventilatory Support: A Preliminary Cross-Sectional Physiological Study"],"prefix":"10.1177","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4639-9574","authenticated-orcid":false,"given":"Roberto","family":"Vera-Uribe","sequence":"first","affiliation":[{"name":"Servicio de Ventilaci\u00f3n Domiciliaria, Departamento de Procesos Cl\u00ednicos y Gesti\u00f3n Hospitalaria, DIGERA \/ Subsecretar\u00eda de Redes Asistenciales, Unidad de Respiratorio, Ministerio de Salud, Chile"},{"name":"Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edna Karla","family":"Ferreira Laurentino","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de Inova\u00e7\u00e3o Tecnol\u00f3gica em Reabilita\u00e7\u00e3o, Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil"},{"name":"PneumoCardioVascular LAB\/HUOL, Hospital Universit\u00e1rio Onofre Lopes, Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7974-4333","authenticated-orcid":false,"given":"Rodrigo","family":"Torres-Castro","sequence":"additional","affiliation":[{"name":"Servicio de Ventilaci\u00f3n Domiciliaria, Departamento de Procesos Cl\u00ednicos y Gesti\u00f3n Hospitalaria, DIGERA \/ Subsecretar\u00eda de Redes Asistenciales, Unidad de Respiratorio, Ministerio de Salud, Chile"},{"name":"Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0405-3831","authenticated-orcid":false,"given":"Luis","family":"Vasconcello-Castillo","sequence":"additional","affiliation":[{"name":"Servicio de Ventilaci\u00f3n Domiciliaria, Departamento de Procesos Cl\u00ednicos y Gesti\u00f3n Hospitalaria, DIGERA \/ Subsecretar\u00eda de Redes Asistenciales, Unidad de Respiratorio, Ministerio de Salud, Chile"},{"name":"Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3288-5363","authenticated-orcid":false,"given":"Marisol","family":"Barros-Poblete","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5784-275X","authenticated-orcid":false,"given":"Mat\u00edas","family":"Otto-Y\u00e1\u00f1ez","sequence":"additional","affiliation":[{"name":"Grupo de Investigaci\u00f3n en Salud, Funcionalidad y Actividad F\u00edsica (GISFAF), Kinesiolog\u00eda, Facultad de Ciencias de la Salud, Universidad Aut\u00f3noma de Chile, Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javiera","family":"Rosales-Fuentes","sequence":"additional","affiliation":[{"name":"Servicio de Ventilaci\u00f3n Domiciliaria, Departamento de Procesos Cl\u00ednicos y Gesti\u00f3n Hospitalaria, DIGERA \/ Subsecretar\u00eda de Redes Asistenciales, Unidad de Respiratorio, Ministerio de Salud, Chile"},{"name":"Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime","family":"Ahumada","sequence":"additional","affiliation":[{"name":"Servicio de Ventilaci\u00f3n Domiciliaria, Departamento de Procesos Cl\u00ednicos y Gesti\u00f3n Hospitalaria, DIGERA \/ Subsecretar\u00eda de Redes Asistenciales, Unidad de Respiratorio, Ministerio de Salud, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebeca","family":"Paiva Reinero","sequence":"additional","affiliation":[{"name":"Servicio de Ventilaci\u00f3n Domiciliaria, Departamento de Procesos Cl\u00ednicos y Gesti\u00f3n Hospitalaria, DIGERA \/ Subsecretar\u00eda de Redes Asistenciales, Unidad de Respiratorio, Ministerio de Salud, Chile"},{"name":"Unidad de Broncopulmonar. Hospital Exequiel Gonzalez Cort\u00e9s, Santiago, ChileDepartamento de Pediatr\u00eda y Cirug\u00eda Infantil Sur. Universidad de Chile, Santiago, Chile"},{"name":"Blanquerna Faculty of Health Sciences. GRoW, Global Research on Wellbeing, Blanquerna Faculty of Health Sciences, Ramon Llull University, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4938-7018","authenticated-orcid":false,"given":"Guilherme","family":"Augusto De Freitas Fregonezi","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de Inova\u00e7\u00e3o Tecnol\u00f3gica em Reabilita\u00e7\u00e3o, Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil"},{"name":"PneumoCardioVascular LAB\/HUOL, Hospital Universit\u00e1rio Onofre Lopes, Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2150-8992","authenticated-orcid":false,"given":"Jordi","family":"Vilar\u00f3","sequence":"additional","affiliation":[{"name":"Blanquerna Faculty of Health Sciences. 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