Paralytic conditionにおける呼吸リハビリテーション

抄録

Paralytic condition is a kind of respiratory impairment, which mainly features global alveolar hypoventilation. This condition comprises spinal cord disorders and motor unit diseases, and may also include patients undergoing sedation. Although patients with paralytic and obstructive conditions are both candidates for comprehensive pulmonary rehabilitation, the approach used to treat either condition differs considerably. Patients with paralytic condition often lose their inspiratory and expiratory muscle strength. They need physical medicine respiratory aids, and they should be managed to maintain lung and chest wall compliance, cough ability sufficient enough to clear secretions, and ventilation. Noninvasive positive pressure ventilation and related aids are widespread in the treatment of these conditions. Appropriate use of these methods is very important in order to prolong and maintain quality of life. Impairment of bulbar function and intelligence, and disease progression should also be considered in rehabilitation for such individuals. Although establishing a system for the rehabilitation team is important, the present conditions locally are insufficient to provide this care. Several clinical guidelines have been published to spread information on the methods to treat patients. We are planning to develop new guidelines that include the necessary care required for paralytic condition patients, thereby hoping to spread this rehabilitation system.