Usually boys do not have trouble breathing or coughing while they are still walking. Because the breathing muscles become affected, as boys with DMD get older they are at risk of chest infections, often due to an ineffective cough. Later on they develop problems with their breathing when sleeping. When they are older, they may require help with breathing during the day as well. As this is a staged progression of problems, a planned and proactive approach to respiratory care is possible based around appropriate surveillance, prophylaxis and interventions. The team must include a physician and therapist with skill in looking after the delivery of non-invasive ventilation and associated techniques for increasing the amount of air that can enter the lungs (lung volume recruitment), and manual and mechanically assisted cough.
Information based on consensus statement (published in January 2010)