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Glossopharyngeal and Neck Accessory Muscle Breathing in a Young Adult With C2 Complete Tetraplegia Resulting in Ventilator Dependency

VC Warren, PT, is Physical Therapist II, Rancho Los Amigos National Rehabilitation Center, 7601 E Imperial Hwy, Downey, CA 90242 (vwarren{at}dhs.co.la.ca.us)

Background and Purpose. This case report describes the use of glossopharyngeal breathing (GPB) and neck accessory muscle breathing (NAMB) in the treatment of an individual who was dependent on a ventilator secondary to a spinal cord injury. Case Description. The patient was a 19-year-old man with C2 complete tetraplegia. He received a 5-week inpatient program of GPB training 3 to 4 times per week. A 4-week NAMB training program followed. Outcome. Following GPB training, forced vital capacity increased 35-fold, time off the ventilator improved from 0 to 30 minutes, and a nonfunctional cough became a weak functional cough. After NAMB training, the patient was able to be off the ventilator for 2 minutes. Discussion. Increased ventilatory capability has the potential to affect patients' quality of life by improving cough function and decreasing dependence on a ventilator in the event of accidental disconnection.

Key Words: Emergency breathing techniques • Glossopharyngeal breathing • Neck accessory muscle breathing