[Home respiratory management--an attempt at respiratory physical therapy for neuromuscular diseases].

In home respiratory management, an important issue to consider is for patients at home with neuromuscular diseases. Under the current condition, however, a technical support is not offered sufficiently. In evaluating the effect of respiratory physical therapy, we have found significant differences in both between peak cough flow (PCF) and assisted peak cough flow (a-PCF) and between vital capacity (VC) and maximum inspiratory capacity (MIC) for patients with spontaneous ventilation and those with non-invasive positive pressure ventilation (NPPV). Since in neuromuscular diseases, it is not rare that the patients fall into acute respiratory insufficiency due to the difficulty of sputum expectoration, the respiratory physical therapy to strengthen the ability of coughing is considered useful. In the case of rapidly worsening amyotrophic lateral sclerosis (ALS), the effect of this therapy lasts only briefly, but it is considered necessary to popularize this technique, because neuromuscular diseases require a different approach in respiratory physical therapy, compared to other pulmonary diseases such as chronic obstructive pulmonary diseases.