Dr. John R. Bach prepares to examine a client with Spinal Muscular Atrophy (SMA). (In addition to Lou, Dr. Bach's Respiratory Therapist, during this visit to the clinic, a Resident doctor from Philadelphia is assisting and learning Dr. Bach's protocols.)
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Vital Capacity (VC) is measured by taking a deep breath and blowing out completely through a spirometer that measures the VC in liters.
Maximal Insuffilation Capacity (MIC) measures the maximum amount of air that can be held in the lungs. This requires "air stacking" with the use of an Ambubag.
After accepting as many breaths as he can possible, the client holds his breath while the Resident and RT switch from pumping with the Ambubag to measuring VC-MIC with a spirometer.
A brace (visible under this boy's shirt) is commonly worn in hopes of controlling or slowing scoliosis, the collapsing curvature of the spine. For most boys with Duchenne muscular dystrophy, a brace may be of little value. It rarely prevents severe scolosis in Duchenne, can restrict VC and the ability to cough, and can mask the need for surgery until too late.