Inspiratory Muscle Rehabilitation Training in Pediatrics: What Is the Evidence?

Table 1

Causes of respiratory muscle weakness or fatigue.

Common classes	Examples/comments
Injury to spinal cord/diaphragmatic innervation	Trauma affecting spinal nerves C3–5
Arnold–Chiari malformations	Types I–IV
Guillain–Barre syndrome	Following acute infections, rarely vaccines
Myasthenic syndromes
Muscular dystrophies	Duchenne, Becker, Myotonic, Limb-girdle
Spinal muscular atrophy	Types 1 (infantile onset), 2 (intermediate), 3/4 (mild, adult onset)
Multiple sclerosis
Metabolic myopathy	Pompe, McArdle, mitochondrial
Airway diseases	COPD, asthma
Diaphragmatic disorders	Congenital diaphragmatic hernia, eventration
Cerebral vascular accidents (stroke)
Critical illness	Prolonged ECMO, chronic mechanical ventilation
Inflammatory myopathy	Polymyositis, dermatomyositis
Iatrogenic (steroid myopathy, radiation injury)
Poisoning/toxins	Botulism, narcotics
Infections	Polio, polio-like viruses, acute flaccid myelitis
Obesity	Restricted diaphragmatic motion and thoracic expansion

Note. COPD – chronic obstructive pulmonary disease and ECMO – extracorporeal membrane oxygenation.