Applications of a specific pulmonary exercise to improve functional vital capacity

By S. McKeever and R. Miller

Glossopharyngeal breathing (GPB), a maneuver for maximizing insufflations, was initially utilized in the 1950's for polio patients dependent on iron lungs. Over the past five decades, GPB has predominately been used with polio patients and spinal cord injury populations (Affeldt, Dail, Collier, & Farr, 1955). In recent literature, it has been proposed that GPB be used for treating pulmonary insufficiency with patients who have tetraplegic neuromuscular disorders (Pryor, 1999). In this presentation, GPB was applied as an exercise for a patient with bilateral medullary infarcts resulting in restrictive ventilatory changes that included poor breath support for speech. Over a six-month period, this patient demonstrated an increase in forced vital capacity (FVC) measures from 2.5L to 3.8L. He improved his words per breath (WPB) in conversation from 3.8 to 6.2 WPB. His WPB during reading improved from 3.8 to 6 WPB. His maximum phonation time improved from 8 to 18 seconds. These results suggest that GPB may be effective for increasing FVC and related motor speech parameters. This case presentation demonstrates the potential for GPB as an exercise that may be useful in the treatment of pulmonary insufficiency for speech.