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Testing a Pressure Setting on Cough Machines in People With ALS

Compares two cough-assist machine settings in adults living with amyotrophic lateral sclerosis.

Plain-language title generated from the registry record
Registry title: The Importance of Positive Expiratory Pressure Associated With the In-exsufflator in ALS Patients

Key facts

Where
Le Havre, FranceSee the site

Could this be for you?

Answer for yourself. This is not a decision: only the study team can say whether you can take part.

  • Are you between 18 and 100 years old?

Source: NCT06249412, who can take part

Where in France

  • GH HavreLe Havre, FranceTaking people

Questions to ask the study team

  1. How often do I need to come in, and for how long each time?
  2. Are travel costs paid?
  3. Can I keep my own doctor?
  4. What happens if I want to stop?
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Trial details

Who runs it
Groupe Hospitalier du Havre
Trial code
NCT06249412
Record updated
21 January 2026
Original description
Amyotrophic Lateral Sclerosis (ALS) is a fatal neurodegenerative disorder that impairs motor neurons, with a life expectancy of 2 to 7 years after diagnosis. ALS manifests as 'spinal' when it primarily affects limbs, or 'bulbar' when it impairs speech and swallowing. The disease progressively weakens all skeletal muscles, causing respiratory issues and increased risk of lung infections due to ineffective coughing. Mechanical cough assistance via In-exsufflation therapy/ mechanical in-exsufflator devie (INEX/MI-E) applies positive and negative airway pressures non-invasively to improve coughing. However, MI-E may fail in some ALS patients due to airway collapse, often related to brainstem muscle dysfunction.Research by Andersen et al. in 2017 highlighted that during MI-E, ALS patients often experience adverse laryngeal movements, which can obstruct airways and reduce the therapy's effectiveness. To combat this, they suggested individualized MI-E settings to minimize airway collapse. Modern MI-E devices, such as the EOVE-70, offer adjustable positive expiratory pressure (PEP) between cycles to potentially enhance airway stability and coughing efficiency. The current study focuses on the impact of PEP during therapy pauses on the peak expiratory flow rate in ALS patients, which could lead to improved therapeutic outcomes.Read full original descriptionShow less

The Importance of Positive Expiratory Pressure Associated With the In-exsufflator in Patients With Amyotrophic Lateral Sclerosis on the Effectiveness of Therapy

Amyotrophic Lateral Sclerosis (ALS) is a fatal neurodegenerative disorder that impairs motor neurons, with a life expectancy of 2 to 7 years after diagnosis. ALS manifests as 'spinal' when it primarily affects limbs, or 'bulbar' when it impairs speech and swallowing. The disease progressively weakens all skeletal muscles, causing respiratory issues and increased risk of lung infections due to ineffective coughing. Mechanical cough assistance via In-exsufflation therapy/ mechanical in-exsufflator devie (INEX/MI-E) applies positive and negative airway pressures non-invasively to improve coughing. However, MI-E may fail in some ALS patients due to airway collapse, often related to brainstem muscle dysfunction.Research by Andersen et al. in 2017 highlighted that during MI-E, ALS patients often experience adverse laryngeal movements, which can obstruct airways and reduce the therapy's effectiveness. To combat this, they suggested individualized MI-E settings to minimize airway collapse. Modern MI-E devices, such as the EOVE-70, offer adjustable positive expiratory pressure (PEP) between cycles to potentially enhance airway stability and coughing efficiency. The current study focuses on the impact of PEP during therapy pauses on the peak expiratory flow rate in ALS patients, which could lead to improved therapeutic outcomes.

Inclusion: Male or female patient aged over 18 years; Patient with Amyotrophic Lateral Sclerosis (ALS); Patients with established or beginning bulbar disorders, identified by the healthcare team (speech impairment, hypersalivation, or swallowing difficulties); Patient naive to INEX therapy but prescribed for its installation or patient already treated by an INEX device; Patient followed by the ALS mobile team of the Groupe Hospitalier du Havre or the CHU of Dijon; Patient whose disease progression kinetics is medically deemed compatible with inclusion in the study; Patient willing to participate in the research after receiving adequate information and the information letter; Patient affiliated with social security or a beneficiary of such a scheme.

Exclusion: "● Patient not presenting an episode of infection or a past episode of respiratory infection less than one month old; Mental illness interfering with the proper use of the device; History of laryngospasm; Inability to come for consultation with the ALS team of the Groupe Hospitalier du Havre or the CHU of Dijon; Pregnancy; Person deprived of liberty by judicial or administrative decision, person subject to a legal protection measure (patient under guardianship or curatorship) Article L1121-8; Appearance of a non-inclusion criterion; Refusal to participate after inclusion; Death from any cause".

ClinicalTrials.gov NCT06249412