COMPUTERIZED RESPIRATORY MUSCLE TRAINING IN CHILDREN WITH DUCHENNE MUSCULAR-DYSTROPHY

The present study describes the use of simple video games for a 5-week regimen of respiratory muscle training in 15 patients with Duchenne m uscular dystrophy (DMD) at various stages of the disease. The games we re re-arranged to be operated and driven by the respiratory efforts of the patient and to incorporate accurate ventilation and time measurem ents. Improvement in respiratory performance was determined by maximum voluntary ventilation (MVV), maximal achieved ventilation (V,max) dur ing a progressive isocapnic hyperventilation manoeuvre (PIHV) and the PIHV duration. The actual training period was 23 +/- 4 days (mean +/- S.D.) at ventilatory effort of 46 +/- 6% MVV, for 10 +/- 3 min day(-1) . Patients with moderate impairment of lung function tests (LFT) showe d an improvement in MW, V,max, and duration of PIHV of 12 +/- 7% (p < 0.02), 53 +/- 25% (p < 0.001) 57 +/- 21% (p < 0.01), respectively. Imp rovements correlated with actual training time and ventilation level, %MVV, but negatively correlated with years of immobilization and with the initial MVV. We conclude that computerized respiratory games may b e applied for breathing exercises and may improve respiratory performa nce in recently immobilized children with DMD who have moderate impair ment of LFT.