Pulmonary Rehabilitation in Patients with Neuromuscular Disease.
10.3349/ymj.2006.47.3.307
- Author:
Seong Woong KANG
1
Author Information
1. Department of Physical Medicine & Rehabilitation, Rehabilitation Institute of Muscular Disease, Yongdong Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. kswoong@yumc.yonsei.ac.kr
- Publication Type:Review
- Keywords:
Pulmonary rehabilitation;
neuromuscular disease;
inspiratory muscle aid;
expiratory muscle aid
- MeSH:
Respiratory Insufficiency/etiology/*rehabilitation/*therapy;
Respiration, Artificial;
Neuromuscular Diseases/complications/*rehabilitation;
Humans;
Breathing Exercises
- From:Yonsei Medical Journal
2006;47(3):307-314
- CountryRepublic of Korea
- Language:English
-
Abstract:
In neuromuscular disease (NMD) patients with progressive muscle weakness, respiratory muscles are also affected and hypercapnia can increase gradually as the disease progresses. The fundamental respiratory problems NMD patients experience are decreased alveolar ventilation and coughing ability. For these reasons, it is necessary to precisely evaluate pulmonary function to provide the proper inspiratory and expiratory muscle aids in order to maintain adequate respiratory function. As inspiratory muscle weakening progresses, NMD patients experience hypoventilation. At this point, respiratory support by mechanical ventilator should be initiated to relieve respiratory distress symptoms. Patients with adequate bulbar muscle strength and cognitive function who use a non-invasive ventilation aid, via a mouthpiece or a nasal mask, may have their hypercapnia and associated symptoms resolved. For a proper cough assist, it is necessary to provide additional insufflation to patients with inspiratory muscle weakness before using abdominal thrust. Another effective method for managing airway secretions is a device that performs mechanical insufflation-exsufflation. In conclusion, application of non-invasive respiratory aids, taking into consideration characterization of respiratory pathophysiology, have made it possible to maintain a better quality of life in addition to prolonging the life span of patients with NMD.
