Ventilatory muscle training in kyphoscoliosis

Cardiorespiratory failure is the usual cause of death in severe kyphoscoliosis. The pathophysiology of this mechanism will be reviewed. Ventilatory muscle training (VMT), a relatively new respiratory technique, has been shown to improve the strength and endurance of the ventilatory muscles. It is known that stronger, endurance trained ventilatory muscles will guard against ventilatory muscle fatigue which may lead to respiratory failure. The actual technique is described with documentation of two representative cases. Case 1 showed a 63% increase in maximum inspiratory mouth pressure (PiMax) and an increased ability to walk and climb stairs with comfort. Case 2 used VMT as an adjunct to her weaning protocol from a portable ventilator. She progressed from full-time to nocturnal ventilator assistance in 1 month.