What is respiratory muscular weakness? According to Tecklin, respiratory muscular weakness is a condition or disorder affecting any part in the chain of command in the neuromuscular process that produces a contraction of the respiratory musculature. This process can vary in severity from mild to irreversible. The mild and transient conditions can be treated with physical therapy interventions. The more serve cases include irreversible damage to the respiratory musculature leading to the patient being dependent on a ventilator to breath.
Which muscles are respiratory muscles? The muscles of inspiration are the diaphragm, external intercostal muscles, and other accessory muscles that ...view middle of the document...
Tecklin talks about neurological conditions such as Guillain-Barre Syndrome, lesions in the medullary centers of the brain, and Werdnig-Hoffmann Syndrome (progressive loss of anterior horn cells) that reduce to respiratory stimuli and cause muscle weakness (Site Source). Other conditions such as degenerative muscular diseases (Duchenne myopathy) and musculoskeletal disorders such as scoliosis can lead to reduce respiratory muscular strength.
Research done by Hadjikoutis and Wiles look at bulbar dysfunction and respiratory complications. Hadjikoutis and Wiles state that brainstem motor neuron degeneration is one of the most common clinical problems creating respiratory muscle weakness that leads to respiratory muscle failure. Motor neuron disease leads to abnormalities in the signals from the corticobulbar pathways and the brainstem that increases the risk for respiratory muscle weakness, dysphagia, potential aspiration, decreased forced vital capacity, and impaired volitional respiratory control (Cite Source). Motor neuron disease a progressive degenerative disorder (Cite Source). Hadjikouttis and Wiles discuss how swallowing and breathing share neuroanatomical pathways and disruptions to these pathways lead to respiratory muscle failure and in severe cases death. This article did a good job of explaining the higher centers for breath control in the brain and the respiratory system on the neurological level. The article did a good job of addressing the issues that Tecklin describes of how neurological conditions such as stoke, CP, and ALS can lead to respiratory muscle failure and cause other cardiopulmonary conditions.
Physical Therapy Examination
Physical therapy examination and intervention should always be patient centered. Cardiopulmonary conditions such as respiratory muscle weakness create challenges for the physical therapist. The book uses 7 goals developed by Mallory and Stillwell that are for physical therapist and treating patients with respiratory muscular weakness. These seven goals are important to consider when examining patients with respiratory muscle weakness and developing their specific plan of care (Cite Source).
“The goals are as follows: 1. Increase muscular strength, 2. Increase attention and cognition, 3. Decrease spasticity, 4. Increase chest wall movement, 5. Use assessor muscle breathing while in the upright position, 6. Use diaphragmatic breathing while upright, and 7. Assisted cough. “
The physical therapy examination according to Tecklin should include: the patient’s medical history, current lab values, chest imaging (X-ray, CT, MRI, etc…), complete systems review of the integumentary, cardiopulmonary system, musculoskeletal, and neuromuscular systems. Tecklin describes the specific tests and measures that should include in the physical therapy examination. Tecklin lists the following information: respiratory muscular strength, chest and shoulder mobility, breathing patterns,...