Additional specialist therapies

Cough augmentation

Some patients, especially those with neuromuscular conditions such as MND, will have difficulty coughing and getting rid of their phlegm. Making phlegm is a normal part of the way our lungs work, but when we can’t get rid of the phlegm it causes problems, such as chest infections. We are able to offer a specialist physiotherapy assessment to help you cough up your phlegm. This might include using a special piece of equipment called a lung volume recruitment (LVR) bag. An LVR bag is used to help you do a special breathing technique called breath stacking, which helps you take a big breath in and makes it easier for you to cough your phlegm up. We also use mechanical insufflation:exsufflation, which is commonly known as a cough assist. The cough assist is a machine that helps you take a big breath in and then sucks the air out while you're coughing. Additionally we use yankaeur suction machines to help your clear phlegm and saliva from your mouth. A yankaeur suction is similar to the suction used at the dentist. Whatever treatment we recommend we will teach you and those helping you how to use any equipment or techniques.


We use Actiwatch devices which are wrist worn activity data recorders that look like a watch and record data relevant to your sleep and activity levels, and light levels. The Actiwatch tells us information about your activity levels, sleep schedules, naps, wake episode and sleep quality and quantity. We use actigraphy as part of our assessments and we use the information to help us decide a diagnosis.


If you have been issued with a Philips Respironics RemStar auto or Dreamstation CPAP machine it will work with DreamMapper. DreamMapper is an app which works with your CPAP machine to tell you information about how much you have used your machine and how well it is working. It has video reminders about cleaning and looking after your CPAP machine as well as videos on fitting your mask. It links in with the systems at the hospital making troubleshooting easier over the phone. If you would like to use DreamMapper you will need to provide us with your email address. Read more about DreamMapper.