Practical problems in the respiratory care of patients with muscular dystrophy.

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THE muscular dystrophies comprise several groups of inherited disorders with a wide variation between the groups in the distribution and severity of muscle involvement.1 The respiratory muscles, in common with other skeletal muscles, are affected in all types of muscular dystrophy, so that patients have an increased risk of respiratory complications and premature death.2 Respiratory insufficiency often remains covert because impaired skeletal-muscle function prevents patients from exceeding their limited ventilatory capacity; however, it can easily be detected with routine pulmonary-function tests. The case for regular pulmonary assessment in neuromuscular disease has recently been cogently argued in the Journal.3 The . . .