Neuromuscular diseases, such as Parkinson's disease, myasthenia gravis, or muscular dystrophy, are often accompanied by peripheral and respiratory muscle weakness. Peripheral muscle weakness and respiratory muscle weakness may gradually worsen during the course of the disease. Depending on the disease, respiratory muscle weakness can lead to speech and swallowing difficulties, reduced speech intensity, and dyspnea.
Rehabilitation therapy using "breathing dumbbells" improves speech, swallowing, and cough function, reduces saliva penetration and aspiration, and strengthens respiratory muscles. Please note that people with muscular dystrophy should only use RMT under the guidance of a doctor to avoid overtraining.
Purpose of usage
- Strengthen the inspiratory muscles (diaphragm, external intercostal muscles, accessory neck muscles) and expiratory muscles (internal intercostal muscles, abdominal muscles)
- Improve movement of glossopharyngeal complex
- Improve airflow through the vocal cords
- Improve respiratory support and achieve safe swallowing function
- Improve protective cough and help clear the airway
- Promote diaphragmatic breathing
- Reduce shortness of breath
- Can slow down the progression of respiratory myopathy
Specific clinical benefits
- Increase maximum inspiratory and expiratory pressure (PImax, PEmax)
- Reduce dyspnea (BORG scale)
- Improve exercise tolerance (6MWT) and improve postural control
- Reduce hyperinflation and improve inspiratory fraction and volume (IC, IF)
- Peak inspiratory and expiratory flows (PIF, PEF) increase
- Increase blood oxygen saturation
- Improve laryngeal function and facilitate speaking and swallowing
- Improve reflex cough and improve lung hygiene
- Improve diaphragm function and support breathing and speech quality and strength
Other benefits
- Improve quality of life(QOL)
- Reduce hospitalization and healthcare needs
- Reduce the risk of death
Training Programs:
Note: These are program recommendations based on clinical evidence from RMT. These recommendations should not replace the therapist's clinical judgment and will still need to be adapted to each patient's case, condition, and preferences.
RMT Goals:
5 sets of 10 breaths per set, 2 times per day (morning and evening), 6 days per week. Or as tolerated.
Intensity:
Approximately 60% of MIP/MEP. The correct setting should allow you to tolerate a set of 10 breaths without fatigue. Please note that inhalation and exhalation settings need to be determined and set up separately.
Continuous Therapy:
Increase settings according to increasing respiratory muscle strength, but do not increase intensity (i.e., keep the intensity at 60% of MIP/MEP).
Record progress:
Prepare an RMT diary to record respiratory pressure values and number of sessions, settings and other comments.