
Cerebral palsy (CP) is a functional neurological disorder characterized by impaired motor coordination. Classic CP is attributed to neonatal or early infancy brain injury arising from a variety of causes. It is the leading cause of childhood physical disability. Among the more than 600,000 Americans living with the disorder, one-third are classified as severely impaired and are at-risk for the serious or fatal respiratory complications.
In severe CP, ineffective cough, uncoordinated swallowing, episodes of seizure, weak respiratory muscle function and immobility all contribute to a high incidence of pulmonary aspiration.
A weakened pulmonary defense system requires therapeutic intervention. Aggressive attention to removal of retained secretions is central to breaking a cycle of recurrent infection and progressive pulmonary deterioration. Managing threats to respiratory health is a fundamental component of CP care.
Many physicians prescribe high frequency chest compression (HFCC) airway clearance therapy (ACT) for a subset of at-risk CP patients who cannot mobilize airway secretions without therapeutic intervention. Methods requiring active participation are generally unsuitable. In patients with ineffective cough, additional techniques or devices to clear secretions from central airways are also required.