Which is included in pulmonary hygiene measures for teens with DMD?

• A. Chest physiotherapy
• B. Lung volume recruitment
• C. Assistive cough device and breath stacking
• D. Nebulized antibiotics

Answer: (C)

In Duchenne muscular dystrophy, airway clearance is crucial because weakening respiratory muscles make it hard to cough and clear secretions. Pulmonary hygiene aims to keep airways clear by improving how much air you can take in and how forcefully you can cough.

The best choice combines an assistive cough device with breath stacking. An assistive cough device provides a rapid, strong cough by delivering positive pressure and then exhaling quickly, which helps push secretions out. Breath stacking, or lung volume recruitment, increases inspiratory volume before that cough, boosting the peak cough flow and making it easier to mobilize mucus. Using these together directly enhances the effectiveness of the cough and secretion clearance, which is central to pulmonary hygiene in teens with DMD.

Nebulized antibiotics are treatments for active infection rather than routine airway clearance. Chest physiotherapy and other methods can be helpful, but the combination of an assistive cough device and breath stacking specifically targets cough effectiveness and mucus clearance.