Abstract
The specific purpose of this case study was to investigate whether forced expiratory technique (FET) improves the peak expiratory flow compared to coughing in a 53-year-old man with amyotrophic lateral sclerosis (ALS) who presented with bulbar symptoms. Approximately 12 months after diagnosis, his peak cough flow did not exceed 160 L/min, and cough became ineffective. However, FET could generate peak expiratory flow to a point over the 160 L/min threshold until 14.5 months after diagnosis. As a result, FET delayed the need for tracheostomy. When the forced vital capacity (FVC) was observed to be markedly decreased and it was 1,600 mL, the patient was unable to achieve 160 L/min of peak expiratory flow generated by FET. Patients with bulbar onset ALS who have FVC greater than 1,600 mL may benefit from FET.
