Bulbar Dysfunction and Associated Cardiopulmonary Considerations in Polio and Neuromuscular Disease

John R. Bach, Donna C. Tippett, Mercedes M. McCrary

Research output: Contribution to journalArticlepeer-review


Many individuals with progressive neuromuscular conditions, including post-poliomyelitis, develop severe bulbar dysfunction, which adversely affects quality of life and can indirectly exacerbate cardiopulmonary insufficiency. The incidence of dysarthria and dysphagia appears to increase as patients advance to the point of requiring ventilatory assistance. In a study of post-poliomyelitis ventilator users, the incidence of dysphagia was found to be 50 percent by contrast to approximately 21 percent in non-ventilator users. The incidence of dysarthria and dysphagia is even higher for patients with some advanced neuromuscular conditions. Various therapeutic interventions, including prevention of the fatigue and hypoventilation associated with inspiratory muscle insufficiency, can improve communication, swallowing, and nutrition. The use of noninvasive expiratory muscle aids can eliminate aspirated food and airway secretions. Quality of life can be significantly improved and life itself can be prolonged for some ventilator users by maintaining effective communication and good nutrition. Surgical methods for managing dysphagia may be used as a last resort.

Original languageEnglish (US)
Pages (from-to)121-128
Number of pages8
JournalNeurorehabilitation and neural repair
Issue number2
StatePublished - Jun 1992


  • Cardiopulmonary failure
  • Duchenne muscular dystrophy
  • Dysarthria
  • Dysphagia
  • Mechanical ventilation
  • Neuromuscular disease
  • Poliomyelitis

ASJC Scopus subject areas

  • Rehabilitation
  • Neurology
  • Clinical Neurology


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