Automatic air-leak compensation in neuromuscular patients: a feasibility study.

Air leaks often result in alveolar hypoventilation in mechanically ventilated patients with neuromuscular disease. The primary objective of this study was to assess the feasibility, efficacy and tolerance of a ventilator equipped with an automated air-leak compensation system in a clinical situation. Fourteen neuromuscular patients with nocturnal air leaks during home ventilation were included in a prospective randomised crossover study.

Evaluation of a stair-climbing power wheelchair in 25 people with tetraplegia.

Objective: To compare the performance of a power wheelchair with stair-climbing capability (TopChair) and a conventional power wheelchair (Storm3).

Design: A single-center, open-label study.

Setting: A physical medicine and rehabilitation hospital.

Intermittent positive-pressure breathing effects in patients with high spinal cord injury.

Objective: To determine whether intermittent positive-pressure breathing (IPPB) improved lung compliance, work of breathing, and respiratory function in patients with recent high spinal cord injury (SCI).

Design: An unblinded randomized crossover trial.

Setting: Rehabilitation hospital.

Home trials of a speech synthesizer in severe dysarthria: patterns of use, satisfaction and utility of word prediction.

Objective: The aim of this study was to evaluate a speech synthesizer with respect to patterns of use and satisfaction, during a 2-month trial at home, and the usefulness of the word prediction function.

Design: Prospective study.

Participants: Of the 24 patients with severe dysarthria recruited, 10 completed the study.

Hand versus mouth for call-bell activation by DMD and Becker patients.

Severe hand dysfunction is common in patients with Duchenne muscular dystrophy (DMD) and may preclude the use of conventional call-bells. We prospectively evaluated a call-bell with two hand-controlled interfaces (push-button and key-pinch) and two mouth-controlled interfaces (sip-or-puff) in 32 consecutive DMD and Becker patients. Patients called intentionally 348 times, using the sip-or-puff device 237 times and the hand-controlled interfaces 147 times.

Breathing-swallowing interaction in neuromuscular patients: a physiological evaluation.

Rationale: Malnutrition and aspiration are major problems in patients with neuromuscular disease. Because impaired swallowing contributes to malnutrition, means of improving swallowing are needed.

Objectives: To investigate interactions between breathing and swallowing in neuromuscular disorders and to evaluate the impact of mechanical ventilation (MV) on swallowing in tracheostomized patients.

Assessing inspiratory muscle strength by sniff nasal inspiratory pressure.

The sniff nasal inspiratory pressure (SNIP) consists in the measurement of pressure through an occluded nostril during sniffs performed through the controlateral nostril. It is an accurate and noninvasive approximation of esophageal pressure swing during sniff maneuvers. However SNIP can underestimate esophageal pressure swing in subjects with nasal obstruction, patients with chronic obstructive pulmonary disease and severe neuromuscular patients.