Glossopharyngeal pistoning for lung insufflation in children with spinal muscular atrophy type II.
OBJECTIVE
To evaluate whether children with spinal muscular atrophy (SMA) type II were able to learn glossopharyngeal pistoning for lung insufflation (GI), and to evaluate the effects of GI on pulmonary function and chest expansion.


METHODS
Eleven children with SMA type II were recruited. They performed 10 cycles of GI, four times per week, for 8 weeks. Lung function and chest expansion were measured before and after the 8-week period.


RESULTS
Five of the 11 children learned the technique. The median GI volume was 0.28 (range 0.15-0.98) L. Four of the children who completed the study showed a mean increase in inspiratory vital capacity (IVC) of 0.13 L (95% confidence interval (CI) 0.03-0.23) and peak expiratory flow (PEF) of 116 L/min (95% CI 60-173). They also had an increased chest expansion with GI at the level of the xiphoid process of 1.50 cm (95% CI 0.16-2.84) and at the level of the fourth costa of 1.79 cm (95% CI 0.85-2.73). The children reported temporary symptoms of dizziness and tension in the chest.


CONCLUSIONS
Five of the 11 children were able to learn the technique of GI and for the four who fulfilled the training, it had positive effects on IVC, PEF and chest expansion. GI did not cause major discomfort.
Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska University Hospital, SE-14183 Huddinge, Stockholm, Sweden. malin.nygren-bonnier@karolinska.se
Malin
M
Nygren-Bonnier
Agneta
A
Markström
Peter
P
Lindholm
Eva
E
Mattsson
Brita
B
Klefbeck
D000293:Adolescent; D001945:Breathing Exercises; D002648:Child; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D007320:Inspiratory Capacity; D007327:Insufflation; D007858:Learning; D008168:Lung / Q000503:physiopathology*; D008297:Male; D010366:Peak Expiratory Flow Rate; D012129:Respiratory Function Tests; D015656:Respiratory Mechanics; D014897:Spinal Muscular Atrophies of Childhood / Q000503:physiopathology / Q000534:rehabilitation*; D018709:Statistics, Nonparametric