Acute Effects of Air Stacking Versus Glossopharyngeal Breathing in Patients with Neuromuscular Disease

Objective: To compare the effects of Air Stacking (AS) and Glossopharyngeal Breathing (GPB) on the Maximum Insufflation Capacity (MIC) in patients with Neuromuscular Disease (NMD).

Methods: We design a randomized cross-over study. Children and adolescents with NMD who were users of non-invasive mechanical ventilation were recruited. Vital capacity (VC) and MIC were measured before and after the intervention with AS and GPB. Values were compared pre- and post-intervention and were considered statistically significant if p <0.05.

Results: We selected 14 patients with a median age of 12.5 years (range 9-18) with the following diagnoses: Duchenne Muscular Dystrophy (7), Spinal Muscular Atrophy Type II (3), Spinal Cord Injury (1) and Congenital Myopathies (3). The median baseline VC was 1325 ml (CI 1084-1594 ml). AS improved the VC to 1930 mL (CI 1630-2434 mL, p<0.001), and GPB increased the VC to 1600 mL (CI 1370-1960 mL, p=0.001). There was a significant difference of 290 mL (CI 168-567 mL, p<0.002) between both techniques.

Conclusion: The air stacking and glossopharyngeal breathing were both effective in increasing the maximum insufflation capacity, but air stacking resulted in a greater increase in MIC.