Chest
Clinical Investigations: Pulmonary FunctionMaximum Insufflation Capacity
Section snippets
Materials and Methods
All patients with neuromusculoskeletal disease diagnosed by standard criteria15 and monitored in a Jerry Lewis Muscular Dystrophy Association clinic were candidates for this study, provided that they were old enough to cooperate. The exclusion criteria for taking part in the deep insufflation program were the following: VC > 2,000 mL; the presence of concomitant intrinsic lung disease to the extent of necessitating oxygen therapy; bulbar muscle dysfunction so severe that glottic closure could
Results
One hundred eight patients with neuromuscular weakness underwent initial evaluations. Forty-three patients returned for reevaluation and satisfied the inclusion criteria. The 108 patients had the following diagnoses: DMD, 32 patients; amyotrophic lateral sclerosis (ALS), 30 patients; SMA, 15 patients; post-poliomyelitis syndrome, 12 patients; non-DMD myopathies, 14 patients; and miscellaneous, 5 patients. Two of the 108 patients had tracheostomy tubes. One patient did not return to clinic.
Discussion
Extremity ROM therapy is a cornerstone of physical medicine and rehabilitation interventions to maintain limb mobility (joint mobilization) for patients with muscular weakness. The loss of limb function results from weakness as well as from musculotendinous tightness or contractures.16 Contracture prevention or correction can help to maintain function.16,17 Lung and chest wall ROM can be provided by giving deep insufflations. By contrast with ROM therapy for the extremities, the ROM of the lung
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