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Breath stacking in children with neuromuscular disorders
H M Jenkins1, A Stocki, D Kriellaars
1Department of Physiotherapy Services, Winnipeg Children's Hospital, Winnipeg, Manitoba, Canada.
Pediatric Pulmonology
|August 20, 2013
Summary
Involuntary breath stacking (IBS) can increase lung volumes in children with neuromuscular disorders (NMD). This technique may be beneficial for non-cooperative patients with mild respiratory muscle weakness.
Area of Science:
- Pediatric Pulmonology
- Neuromuscular Disorders
- Respiratory Physiology
Background:
- Respiratory muscle weakness in neuromuscular disorders (NMD) leads to reduced lung volumes and breathing difficulties.
- Children with NMD often struggle with techniques to improve lung capacity.
- Breath stacking, successful in adults, offers a potential method to enhance lung volumes.
Purpose of the Study:
- To evaluate the effectiveness of involuntary breath stacking (IBS) in children with NMD.
- To compare IBS with voluntary breath stacking (VBS) and supported breath stacking (SBS) in a subset of patients.
Main Methods:
- Twenty-three children with NMD were studied, with 15 verbally communicative.
- Involuntary breath stacking (IBS) involved a face mask with a one-way valve and pneumotachograph.
- Tidal volumes and minute ventilation were measured before and after expiratory valve closure.
Main Results:
- IBS increased average tidal volumes by 599 ml, achieving volumes up to three times the baseline.
- Minute ventilation increased by 18% (P < 0.05) after IBS.
- Supported breath stacking (SBS) was more effective in subjects with severe muscle weakness compared to IBS and VBS.
Conclusions:
- IBS is a viable technique to increase lung volumes in children with NMD, especially those who are non-cooperative or have mild weakness.
- VBS achieved similar volumes to IBS in cooperative subjects.
- SBS demonstrated greater efficacy in individuals with pronounced respiratory muscle weakness.
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