title: Mechanical insufflation-exsufflation for an individual with Duchenne muscular dystrophy and a lower respiratory infection.
abstract: Duchenne muscular dystrophy (DMD) is an X-linked recessive myopathy associated with progressive muscle weakness and wasting, loss of ambulation, respiratory insufficiency, weak cough, repeated respiratory infections, and ultimately death from respiratory failure in early adulthood. Mechanical insufflation-exsufflation (MI-E) devices, such as the CoughAssist®, are used in individuals with neuromuscular weakness to augment cough and help clear secretions; however, there is no consensus on the optimal treatment regimen. We present the challenging case of a patient with DMD admitted to a tertiary hospital with a severe lower respiratory infection, and discuss how MI-E was used by physiotherapists to assist secretion clearance and prevent further deterioration.
authors.affiliation: Physiotherapy Department Sir Charles Gairdner Hospital Nedlands Australia.
authors.forename: Emma
authors.initials: E
authors.lastname: Koenig
authors.affiliation: Department of Pulmonary Physiology and Sleep Medicine Sir Charles Gairdner Hospital  Nedlands Australia; West Australian Sleep Disorders Research Institute Nedlands Australia; Faculty of Science University of Western Australia Nedlands Australia.
authors.forename: Bhajan
authors.initials: B
authors.lastname: Singh
authors.affiliation: Physiotherapy Department Sir Charles Gairdner Hospital Nedlands Australia; Institute for Respiratory Health Nedlands Australia.
authors.forename: Jamie
authors.initials: J
authors.lastname: Wood
keywords: CoughAssist; Duchenne muscular dystrophy; mechanical insufflation–exsufflation; physiotherapy; respiratory infection