Koshiro Haruyama, Yosuke Yamaha, Miyuki Ito, Tomoyoshi Otsuka, Michiyuki Kawakami
Department of Rehabilitation Medicine, National Hospital Organization Higashisaitama National Hospital, Hasuda city, Japan. E-mail: koshiroharuyama@gmail.com
DOI: 10.2340/16501977-2729

Objective: To propose alternative learning strategies for glossopharyngeal breathing in patients with Duchenne muscular dystrophy (DMD) and healthy men.
Design: A feasibility study with small case series.
Subjects: Five boys with DMD and 7 male physical therapists as healthy controls who had not learned glossopharyngeal breathing.
Methods: Participants were instructed in a glossopharyngeal breathing protocol, including induction methods comprising sucking motions and phonation with inhalation. The protocol consisted of 1–6 sessions (10–15 min each; total 60 min). Criteria for glossopharyngeal breathing mastery were vital capacity with glossopharyngeal insufflation (VCGI)/VC ratio > 1. 10 for the DMD group and > 1. 05 for the Healthy group. Feasibility outcomes were time required for mastering glossopharyngeal breathing, self-reported outcomes, adverse events and drop-outs.
Results: All participants learned glossopharyngeal breathing within the allocated 60 min. Mean VCGI/VC ratio was 1. 31 for the DMD group and 1. 09 for the Healthy group. No adverse events or drop-outs were encountered during the protocol. In most cases, self-reported outcomes showed that motivation increased and difficulty decreased.
Conclusion: Induction methods for sucking motions and phonation with inhalation for glossopharyngeal breathing learning are feasible. This paper proposes alternative strategies for glossopharyngeal breathing learning in boys with DMD and their instructors.

Glossopharyngeal breathing is an active breathing manoeuvre that involves the subject autonomously pistoning boluses into their lungs without the use of any device, providing a form of positive-pressure breathing. A strategy for learning glossopharyngeal breathing has not yet been established and the manoeuvre is often difficult to learn for patients with Duchenne muscular dystrophy (DMD). All subjects in this study (5 boys with DMD and 7 healthy men) were able to master glossopharyngeal breathing. Two types of guidance, regarding sucking motions and phonation with inhalation, might facilitate boys with DMD and healthy controls in learning glossopharyngeal breathing. This paper proposes a glossopharyngeal breathing strategy to help clinicians by setting out a novel protocol for learning glossopharyngeal breathing more effectively.

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