Breathing With Amyotrophic Lateral Sclerosis

This study looks at whether a device called a Mechanical Insufflator-Exsufflator (MIE) — sometimes called a cough assist machine — can help people with Amyotrophic Lateral Sclerosis (ALS) breathe and clear their airways more effectively. ALS is a progressive disease that weakens the muscles, including those used for breathing. Over time, people with ALS often struggle to cough forcefully enough to clear mucus from their lungs, which can lead to serious respiratory infections. The MIE device helps by simulating a strong, effective cough. To be eligible, participants must have a confirmed ALS diagnosis with spinal, bulbar, or respiratory involvement, a peak flow measurement between 160 and 255 L/min, and must not have received MIE treatment more than 10 times in the past year. Participants need to see a physiotherapist at least twice a week and be able to use the device themselves or with a caregiver's assistance. The study is conducted in French, so participants must have sufficient French language comprehension. Participants will use the MIE device regularly and be followed over time to see whether it improves their breathing capacity, quality of life, and ability to manage respiratory symptoms. This study is important because respiratory failure is one of the leading causes of death in ALS, and better tools to delay its onset could meaningfully extend and improve the lives of people living with this condition.