Breath-stacking in Neuromuscular Disease

What is the breath-stacking in neuromuscular disease (NMD) study?

The breath-stacking in NMD study is a multi-centre randomised controlled clinical trial investigating the effect of regularly performing types of breathing exercises on respiratory function in people with neuromuscular conditions such as motor neurone disease (MND).

Use of a mask ventilator (non-invasive ventilation) helps people with breathing muscle weakness live longer, but it only addresses one aspect of the respiratory problems faced by some people with MND. Respiratory complications such as chest infections or pneumonia are also common, and symptoms such as a weak cough, a soft voice or losing the ability to take a deep breath can also be distressing.

Breath-stacking is a simple and inexpensive technique that can be employed to help people take a deep breath and improve cough strength. It is currently unknown if undertaking an exercise program of these assisted deep breaths each day is beneficial or has a preventative effect. This clinical trial investigates whether performing specialised breathing exercises slows decline in breathing function, and if these exercises maintain or improve the flexibility of the chest wall, cough effectiveness, respiratory symptoms or quality of life in people with MND.
What is involved?

This study is being conducted through the Victorian Respiratory Support Service and Institute for Breathing and Sleep at Austin Health, in conjunction with Calvary Health Care Bethlehem. Recruitment commenced in September 2015 and will conclude at the end of 2018.

People with a neuromuscular condition diagnosed more than three months ago and respiratory system involvement (FVC or vital capacity < 80% predicted normal) are invited to participate.

Participants perform a number of different breathing tests and complete questionnaires at the baseline visit at the Austin Hospital in Melbourne, before being randomly allocated to one of two different types of breathing exercises. People are asked to do their assigned exercises twice a day for a 3-month period, with each exercise session taking between 5-10 minutes. Researchers visit people in their home at the 1-month and 2-month mark to conduct follow-up breathing tests. The final 3-month visit repeats these breathing tests and questionnaires to assess changes in breathing, cough and quality of life. Check the ANZCTR website for more details of the study.

How far off is a treatment?

This research is ongoing; researchers are continuing to recruit clinical trial participants and collect data. They are starting to analyse baseline data, specifically the relationship between people’s lung function, cough and whether they have experienced any respiratory tract infections. With better understanding of these factors, they can then tailor respiratory interventions at the appropriate stage of a person’s disease.

Contact details

Contact Nicole Sheers, Respiratory Physiotherapist, Austin Health, by email or phone (03) 9496 3877.

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