Proposal for a more effective chest physiotherapy treatment in the neuromuscular patient with copious secretions, bulbar dysfunction and ineffective cough: a case report

摘要

We describe a less conventional form of physiotherapy management of a patient with severe neuromuscular disease, bulbar dysfunction with ineffective cough and copious airway secretions resulting in respiratory failure and lobar collapse. Contrary to standard recommendations for practice, optimal secretion clearance was achieved by initially avoiding the side-lying position and using two therapists for cough augmentation and suctioning. This case report should generate ideas for further research.