title: Active lung volume recruitment to preserve vital capacity in Duchenne muscular dystrophy.
abstract: OBJECTIVE
  To consider the effect of active lung volume recruitment ("air stacking") on rate of decline in vital capacity.
  
  
  METHODS
  Retrospective cross-sectional design.
  
  
  METHODS
  People with Duchenne muscular dystrophy.
  
  
  METHODS
  Vital capacity was measured at every patient visit and then graphed. Air stacking using volume-preset ventilation or manual resuscitator bag was introduced to all patients after their vital capacity plateaued (reached a lifetime maximum).
  
  
  RESULTS
  For 151 consecutive patients with multi-year data, the 1-year rate of greatest decline in post-plateau vital capacity was 104 ml (8.8%)/year and occurred from age 20 to 21 years. For 53 patients with multi-visit data for whom air stacking was begun at the immediate post-plateau visit, the 1-year rate of greatest decline in vital capacity was 118 ml (8.5%) and occurred from age 20 to 21 years. Between annual visits, vital capacity and maximum insufflation capacity increased 26.4% and 43.3% of the time, respectively. The peak of maximal vital capacity decline occurred more than 5 years later than previously reported without air stacking.
  
  
  CONCLUSIONS
  For patients with Duchenne muscular dystrophy, active lung volume recruitment may help to preserve vital capacity. Effects on post-plateau vital capacity may be a useful outcome measure for therapeutic trials.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, 07103 Newark, USA. chioumi@njms.rutgers.edu.
authors.forename: Michael
authors.initials: M
authors.lastname: Chiou
authors.forename: John R
authors.initials: JR
authors.lastname: Bach
authors.forename: Lavina
authors.initials: L
authors.lastname: Jethani
authors.forename: Michael F
authors.initials: MF
authors.lastname: Gallagher
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008168:Lung / Q000473:pathology*; D008297:Male; D020388:Muscular Dystrophy, Duchenne / Q000628:therapy*; D012189:Retrospective Studies; D013990:Tidal Volume / Q000502:physiology*; D014797:Vital Capacity / Q000502:physiology*; D055815:Young Adult