Pulmonary physical medicine interventions for elderly patients with muscular dysfunction.
The respiratory consequences of respiratory muscle impairment, with or without bulbar muscle weakness, usually involve inadequate ventilation and airway secretion encumbrance and may progress to respiratory failure. This article focuses on muscular dysfunction of the bulbar and respiratory musculature in elderly patients with neuromuscular diseases or central nervous system disorders. In addition, the article discusses application of pulmonary physical medicine principles for patients with predominantly restrictive pulmonary disorders caused primarily by muscular dysfunction. Diagnostic evaluation, respective clinical courses and responses to therapy, and the use of noninvasive ventilatory support outside of an acute care setting are also reviewed.
Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, 5601 Loch Raven Boulevard, Suite 403-6, Baltimore, MD 21239, USA.
Rosemarie A
RA
Filart
John R
JR
Bach
D000368:Aged; D006801:Humans; D006935:Hypercapnia / Q000503:physiopathology; D007040:Hypoventilation / Q000503:physiopathology; D008170:Lung Compliance; D009136:Muscular Dystrophies / Q000150:complications / Q000503:physiopathology; D010092:Oximetry; D010300:Parkinson Disease / Q000150:complications / Q000503:physiopathology; D012129:Respiratory Function Tests; D012131:Respiratory Insufficiency / Q000503:physiopathology / Q000628:therapy*; D015656:Respiratory Mechanics; D012132:Respiratory Muscles / Q000503:physiopathology*