LATE-BREAKING ABSTRACT: Effects of air stacking versus glossopharyngeal breathing on maximum insufflation capacity in children and adolescents with neuromuscular disease

Abstract

Background: Neuromuscular diseases (NMD) are characterized by a reduced maximum insufflation capacity (MIC), which contributes to increased morbidity and mortality from respiratory diseases. Techniques such as glossopharyngeal breathing (GPB) and insufflation using a manual resuscitation bag, or “air stacking (AS)”, can be used to increase the MIC. These techniques employ different mechanisms, and the ability to learn the technique plays a key role in its proper implementation and effectiveness. Objective: To compare the effects of AS and GPB on the MIC in patients with NMD. Method: Children and adolescents with NMD who were users of non-invasive mechanical ventilation were recruited. Vital capacity (VC) and MIC were measured prior to and after the intervention with AS and GPB. Values were compared pre- and post-intervention and were considered statistically significant if p Results: We selected 15 patients with a median age of 12 years (range 5-18 years) with the following diagnoses: Duchenne Muscular Dystrophy (7), Spinal Muscular Atrophy Type II (3), Spinal Cord Injury (2) and Congenital Myopathies (3). The median baseline VC was 1320 ml (CI 1102-1659 ml). AS improved the VC to 2000 mL (CI 1584-2228 mL, p Conclusion: The insufflation techniques air stacking and glossopharyngeal breathing were both effective in increasing the maximum insufflation capacity, but air stacking resulted in a greater increase of MIC.