Objective: To investigate the effect of deep lung
insufflations on maximum insufflation capacities (MICs) and peak cough
flows (PCFs) for patients with neuromuscular disease.
Method: Forty-three patients with neuromuscular disease
were trained in stacking delivered volumes of air to deep lung
insufflation and were prescribed a program of air stacking once their
vital capacities (VCs) were noted to be < 2,000 mL. VC, MIC, and
unassisted and assisted PCF were monitored. The initial data were
compared with the highest MICs subsequently achieved. For those
patients whose MICs only decreased, we compared the initial data with
the most recent data.
Results: The MICs increased from
(mean ± SD) 1,402 ± 530 mL to 1,711 ± 599 mL (p < 0.001)
for 30 patients and only decreased for 13 patients. Patients for whom
the MICs increased also had a significant increase in assisted PCF from
3.7 ± 1.4 to 4.3 ± 1.6 L/s (p < 0.05) despite having
somewhat decreasing VCs and unassisted PCFs.
Conclusion: With training, the capacity to stack air to
deep insufflations can improve despite progressive neuromuscular
disease. This can result in increased cough