Résumé :
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Background : In patients with neuromuscular disorders or kyphoscoliosis respiratory failure may lead to microatelectases and respiratory infections. As air stacking may improve peak cough flow and prevent stiffening of the chest wall, it may play an important role in the prevention of pulmonary morbidity in patients with (imminent) respiratory failure. They aim of this study was to investigate the feasibility and applicability of air stacking in patients with neuromuscular disorders or kyfoscoliosis. Methods : 29 consecutive patients were instructed to stack air and asked to continue this at home three times a day for three months. After three months the Peak Cough Flow (PCF), PCF following air stacking (PCFAS), Vital Capacity (VC) and Maximal Insufflation Capacity (MIC) were measured. The applicability and feasibility were assessed by these measurements and a questionnaire. Results : Twenty-three patients (79%)were able to stack air at least two times a day at home. Complaints from air stacking were myalgia, aerophagy, chest pain and coughing. For non of the patients these complaints were a reason to stop air stacking. Almost half of the patients experienced a subjective improvement in cough strength. The difference between MIC and the VC was significant both at the start and after 3 months. This also applied to the difference between the PCF and PCFAS. There was a training effect of air stacking on the MIC as well as on the PCF. MIC and PCFAS improved particularly in patients who had a better VC at the start of the study. Conclusions : Air stacking is applicable and feasible for patients with neuromuscular disorders or kyfoscoliosis. It seems important, however, to start air stacking before the disease too advanced.
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