Effective airway clearance is essential for persons with neuromuscular disease. Airway clearance prevents infection and optimizes respiratory function and ventilation. The use of mechanical insufflation-exsufflation (MI-E) to promote airway clearance in persons with neuromuscular disorders is well documented. The aim of this scoping review was to identify and map the available evidence relating to physiological effects of MI-E in patients with neuromuscular disease. Electronic databases, including MEDLINE, CINAHL, EMBASE, EMCARE, SCOPUS, COCHRANE, and Web of Science, were searched from inception to November 2024. Inclusion criteria were studies involving spontaneous breathing, adult or pediatric participants with a neuromuscular diagnosis, English/translated to English articles, full-text articles, and studies involving MI-E with clear strategies. Data were extracted by 2 authors using a bespoke extraction form. A Mixed Methods Appraisal Tool was used to assess quality. Of 1,176 abstracts identified, 25 records were included. The review data suggested MI-E was well tolerated in persons with neuromuscular disease and proposed improved cough compared with participants' baseline. Studies predominately used cough peak flow to assess MI-E effectiveness, with emerging evidence looking at upper airway dynamics. Studies specifically focused on a pediatric neuromuscular cohort are vital, as this remains an under-researched area.
Edel et al. (Thu,) studied this question.