PT  - JOURNAL ARTICLE
AU  - R Gosselink
AU  - L Kovacs
AU  - M Decramer
TI  - Respiratory muscle involvement in multiple sclerosis
AID  - 10.1183/09031936.99.13244999
DP  - 1999 Feb 01
TA  - European Respiratory Journal
PG  - 449--454
VI  - 13
IP  - 2
4099  - http://erj.ersjournals.com/content/13/2/449.short
4100  - http://erj.ersjournals.com/content/13/2/449.full
SO  - Eur Respir J1999 Feb 01; 13
AB  - Respiratory complications are common in the terminal stages of multiple sclerosis and contribute to mortality in these patients. When respiratory motor pathways are involved, respiratory muscle weakness frequently occurs. Although it is well established that weakness of the respiratory muscles produces a restrictive ventilatory defect, the degree of muscle weakness and pulmonary function are poorly related. Respiratory muscle weakness was observed in patients with normal or near normal pulmonary function. Expiratory muscle weakness is more prominent than inspiratory muscle weakness and may impair performance of coughing. Subsequently, in addition to bulbar dysfunction, respiratory muscle weakness may contribute to ineffective coughing, pneumonia, and sometimes even acute ventilatory failure may ensue. Respiratory muscle weakness may also occur early in the course of the disease. Recent studies suggest that the respiratory muscles can be trained for both strength and endurance in multiple sclerosis patients. Whether respiratory muscle training delays the development of respiratory dysfunction and subsequently improves exercise capacity and cough efficacy, prevents pulmonary complications or prolongs survival in the long-term remains to be determined.