Which strategy is effective for a patient with limited coughing ability due to a neuromuscular disorder?

Mechanical insufflation-exsufflation (MIE) is particularly effective for patients with limited coughing ability due to neuromuscular disorders. This technique is designed to assist patients in clearing secretions from their airways, which can be a challenge for individuals who are unable to generate an effective cough due to muscle weakness or dysfunction.

The MIE device delivers a positive pressure breath to the patient, followed by a rapid shift to negative pressure. This combination creates a forceful exhalation equivalent to a strong cough, helping to mobilize and expel secretions from the lungs. By mimicking the natural cough mechanism, MIE assists patients in managing their respiratory health more effectively.

Other strategies, while potentially beneficial in different contexts, may not provide the same level of efficacy for clearing secretions in individuals with compromised muscle control. For instance, gentle secretion mobilization may not generate sufficient force for effective clearance, while the Active Cycle of Breathing (ACB) relies on the patient's ability to initiate and participate in the breathing techniques. Positive airway pressure (PAP) can aid in maintaining lung volumes and preventing atelectasis but does not specifically address the need for effective secretion clearance in the same manner as MIE.