title: Effect of home mechanical in-exsufflation on hospitalisation and life-style in neuromuscular disease: a pilot study.
abstract: OBJECTIVE
  Mechanical in-exsufflation (MI-E) augments the weakened cough of patients with neuromuscular disease (NMD), clearing secretions and overcoming atelectasis. Little has been published on the impact of MI-E alone on rates of hospitalisation and quality of life (QOL). The aim of this study was to assess the impact of home MI-E on hospital admissions and life-style in children with NMD.
  
  
  METHODS
  A retrospective chart review was performed on children using MI-E, including data on the number of admissions to hospital, length of stay and hours of ventilation. A parental survey was used to gather information on the impact of MI-E on life-style for the child and family.
  
  
  RESULTS
  Ten children with NMD (seven spinal muscular atrophy, two Duchenne muscular dystrophy and one centronuclear myopathy) using MI-E at home were identified. MI-E use commenced at mean age of 8.5 years (range 1.1-16.9) with 1.4 years of use (range 0.3-3.8). MI-E pressures ranged from +/-30 to 40 cmH2 O with no complications reported. There was a significant reduction in hospital days at 6 (P = 0.036) and 12 (P = 0.028) months following commencement of home MI-E compared with the same period preceding MI-E use. The survey highlighted positive benefits of MI-E use, in particular the ability to treat many pulmonary exacerbations at home.
  
  
  CONCLUSIONS
  Home MI-E use by children with NMD can reduce hospitalisation and benefit families by maintaining their child at home.
authors: Department of Physiotherapy, Royal Children's Hospital, Melbourne, Victoria, Australia. fiona.moran@rch.org.au
authors: Fiona C E
authors: FC
authors: Moran
authors: Alicia
authors: A
authors: Spittle
authors: Clare
authors: C
authors: Delany
authors: Colin F
authors: CF
authors: Robertson
authors: John
authors: J
authors: Massie
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006699:Home Care Services; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007327:Insufflation; D007902:Length of Stay / Q000706:statistics & numerical data*; D008019:Life Style; D008297:Male; D009468:Neuromuscular Diseases / Q000150:complications / Q000628:therapy*; D010865:Pilot Projects; D011788:Quality of Life; D012189:Retrospective Studies; D016896:Treatment Outcome