Journal
CHEST
Volume 118, Issue 1, Pages 61-65Publisher
AMER COLL CHEST PHYSICIANS
DOI: 10.1378/chest.118.1.61
Keywords
cough; maximum insufflation capacity; neuromuscular disease; peak cough flow; pulmonary compliance; range-of-motion therapy
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Objective: To investigate the effect of deep lung insufflations on maximum insufflation capacities (MICs) and peak cough flows (PCFs) for patients with neuromuscular disease, Method: Forty-three patients with neuromuscular disease were trained in stacking delivered volumes of air to deep lung insufflation and were prescribed a program of air stacking once their vital capacities (VCs) mere noted to be < 2,000 mt. VC, MIG, and unassisted and assisted PCF were monitored, The initial data were compared with the highest MICs subsequently achieved. For those patients whose MICs only decreased, we compared the initial data with the most recent data, Results: The MICs increased from (mean +/- SD) 1,402 +/- 530 mt to 1,711 +/- 599 mt (p < 0.001) for 30 patients and only decreased for 13 patients. Patients for whom the MICs increased also had a significant increase in assisted PCF from 3.7 +/- 1.4 to 4.3 +/- 1.6 L/s (p < 0.05) despite hating somewhat decreasing VCs and unassisted PCFs, Conclusion: With training, the capacity to slack air to deep insufflations can improve despite progressive neuromuscular disease. This can result in increased cough effectiveness.
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