Whether you have a disability, or someone you know has one, disability impacts everyone, at all ages and stages of life. According to the Centers for Disease Control and Prevention, up to one in four (27%) adults in the U.S. have some type of disability, and 12.1% of U.S. adults have a mobility disability with serious difficulty walking or climbing stairs.
Involuntary movement disabilities can present significant challenges for both patients and their providers during airway management and treatment. It’s important that all providers are familiar with different disabilities and their symptoms, to offer the safest, most effective and reliable care to their patients.
Types of involuntary movement disabilities
Involuntary movement occurs when a person moves their body in an unintended or uncontrollable way. These movements can be anything from quick, jerking tics to longer tremors and seizures, and can occur in almost any part of the body, including the face, neck and limbs.
Parkinson’s disease is a brain disorder that triggers unintended or uncontrollable movements, such as shaking, stiffness and difficulty with balance and coordination.
Common Parkinson’s symptoms include:
- Tremors in hands, arms, legs, jaw or head
- Muscle stiffness, where muscles remain contracted for a long time
- Slowness of movement
- Impaired balance and coordination, sometimes leading to falls
Cerebral Palsy (CP), the most common motor disability in childhood, refers to a group of disorders that involve abnormal brain development or damage to the developing brain that affects one’s ability to control their muscles. CP presents differently in different individuals depending on the part of the brain impacted. One or more of the following movement disorders can occur based on which parts of the brain are affected by CP:
- Stiff muscles (spasticity)
- Uncontrollable movements (dyskinesia)
- Poor balance and coordination (ataxia)
Involuntary movement and the airway
Involuntary movement disabilities such as Parkinson’s and cerebral palsy can present various challenges for patients and providers when it comes to navigating airway management and respiratory health. Providers must carefully and regularly monitor airway health in patients to identify healthy vs. unhealthy breathing patterns and prevent emergencies like aspiration and deadly infections. When assessing any patient’s condition, it’s critical that providers identify whether the patient can cough up mucus, as an inability to cough may lead to airway obstruction, lung infections and bacterial colonization.
Airway clearance therapy (ACT) is considered a highly effective airway management method for patients with involuntary movement disorders, as it helps to minimize the effects of airway obstruction, infection and inflammation from mucus stasis on the airways and lungs.
Ventilation and airway management
Respiratory muscle weakness can present tremendous obstacles when treating patients with involuntary movement and neurological disorders, but many providers have found success using noninvasive ventilation (NIV) methods to mitigate airway symptoms, reduce hospitalization and improve quality of life for patients. NIV devices or respiratory assist devices, such as nasal cannulas, simple masks or continuous positive airway pressure (CPAP), are generally more portable, less expensive alternatives to mechanical ventilators, and have often been found to reduce risks during intubation, compared to more invasive tools that bypass the upper airway.
There are many unique needs and symptoms to be mindful of when treating patients with involuntary movement disabilities, and a lack of knowledge and preparedness can result in dangerous, sometimes fatal consequences for patients. Providers must continue learning about the risks and complications that go along with performing airway management on patients with these disorders, in order to better advocate for and address patients’ needs at all times.