title: Cough augmentation in Duchenne muscular dystrophy.
abstract: OBJECTIVE
  The purpose of this work was to compare the relative importance of deep lung insufflation with the abdominal thrust and their combination in augmenting cough peak flows (CPF).
  
  
  METHODS
  Unassisted CPF and CPF assisted by air stacking to deep lung volumes (CPFair), assisted by abdominal thrusts (CPFthrust), and assisted by both air stacking and abdominal thrusts (aCPF) were measured for 61 patients with Duchenne muscular dystrophy (DMD).
  
  
  RESULTS
  Overall, mean unassisted CPF were 138 +/- 70 liters/min, CPFthrust were 204 +/- 75 liters/min, CPFair were 236 +/- 68 liters/min, and aCPF were 302 +/- 78 liters/min. The differences between each were statistically significant (P < 0.0001).
  
  
  CONCLUSIONS
  Thus, air stacking was significantly more effective than abdominal thrust in increasing CPF, but the combination was the most effective. The CPF of the quartile of patients with the lowest unassisted CPF were also significantly (P < or = 0.04) more augmented by air stacking and thrusting than for the milder quartiles of patients. Thus, the greatest improvements in CPF were for patients with the weakest coughs.
authors: Department of Pediatrics, Yakumo Byoin National Sanatorium, Hokkaido, Japan.
authors: Yuka
authors: Y
authors: Ishikawa
authors: John R
authors: JR
authors: Bach
authors: Eugene
authors: E
authors: Komaroff
authors: Toshihiko
authors: T
authors: Miura
authors: Roseanna
authors: R
authors: Jackson-Parekh
mesh_terms: D000293:Adolescent; D000328:Adult; D001945:Breathing Exercises; D002648:Child; D003371:Cough / Q000503:physiopathology*; D006801:Humans; D007327:Insufflation; D008297:Male; D020388:Muscular Dystrophy, Duchenne / Q000503:physiopathology* / Q000534:rehabilitation*; D015656:Respiratory Mechanics / Q000502:physiology; D013147:Spirometry