Lung Volume Recruitment Combined With Expiratory Muscle Strength Training in ALS


The purpose of this study is to investigate the effects of two treatment techniques called Expiratory Muscle Strength Training (EMST) and Lung Volume Recruitment (LVR) on breathing, swallowing, speech, and cough function in persons with mild to moderate ALS. Half of the participants will do EMST alone, and the other half of the participants will do EMST and LVR.

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  • Expiratory Muscle Strength Training (EMST) uses a training device that has a valve set to 50% of a patient's maximum expiratory pressure (MEP). The patient exhales forcefully until the valve releases. Patients perform 5 sets of 5 repetitions a day, 5 days a week.
  • Lung Volume Recruitment (LVR) is a technique to increase cough function that is performed with a resuscitation bag fitted with a mouthpiece and a one-way valve. The bag is used to expand the lungs, after which the patient makes a voluntary cough. Half of the participants will perform the LVR technique in addition to the ESMT technique.

For more details about study procedures, please contact Kelby Magennis:


  • ALS defined as possible, laboratory-supported probable, probable, or definite by El Escorial criteria
  • Reduced Maximal Expiratory Pressure (MEP) compared to norms for age and sex
  • Forced Vital Capacity (FVC) > 65% predicted

Additional inclusion and exclusion criteria apply. Please contact Kelby Magennis:


18 to 65
65 and over



Can be done from home



Neurology, Amyotrophic lateral sclerosis, ALS - resources, ALS

Principal Investigator

Emily Plowman, PhD, CCC-SLP



Contact Information


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