Open AccessShort-term effect of air stacking and mechanical insufflation–exsufflation on lung function in patients with neuromuscular diseases
Author(s) -
Esther S. Veldhoen,
Femke Vercoelen,
Leandra A. A. Ros,
Laura P. Verweij-van den Oudenrijn,
Roelie M. Wösten–van Asperen,
Erik H.J. Hulzebos,
Bart Bartels,
Michael A. Gaytant,
Kors van der Ent,
W. Ludo van der Pol
Publication year - 2022
Publication title -
chronic respiratory disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.929
H-Index - 41
eISSN - 1479-9731
pISSN - 1479-9723
DOI - 10.1177/14799731221094619
Subject(s) - medicine , vital capacity , duchenne muscular dystrophy , exsufflation , pulmonary function testing , lung volumes , anesthesia , insufflation , lung function , lung , diffusing capacity
Air stacking (AS) and mechanical insufflation–exsufflation (MI-E) aim to increase cough efficacy by augmenting inspiratory lung volumes in patients with neuromuscular diseases (NMDs). We studied the short-term effect of AS and MI-E on lung function. We prospectively included NMD patients familiar with daily AS or MI-E use. Studied outcomes were forced vital capacity (FVC), forced expiratory volume in one second (FEV 1 ), and peak expiratory flow (PEF) prior to, immediately after, and up to 2 h after treatment. Paired sample T-test and Wilcoxon signed-rank test was used. Sixty-seven patients participated. We observed increased FVC and FEV 1 immediately after AS with a mean difference of respectively 0.090 L (95% CI 0.045; 0.135, p < .001) and 0.073 L (95% CI 0.017; 0.128, p = .012). Increased FVC immediately after MI-E (mean difference 0.059 L (95% CI 0.010; 0.109, p = .021) persisted 1 hour (mean difference 0.079 L (95% CI 0.034; 0.125, p = .003). The effect of treatment was more pronounced in patients diagnosed with Spinal Muscular Atrophy, compared to patients with Duchenne muscular dystrophy. AS and MI-E improved FVC immediately after treatment, which persisted 1 h after MI-E. There is insufficient evidence that short-lasting increases in FVC would explain the possible beneficial effect of AS and MI-E.