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Suzanne C. Smeltzer, EdD, RN; Mark J. Utell, MD; Richard A. Rudick, MD; Robert M. Herndon, MD

Arch Neurol. 1988;45(11):1245-1249.

Abstract
• Pulmonary function was studied in 25 patients with clinically definite multiple sclerosis with a range of motor impairment. Forced vital capacity (FVC), maximal voluntary ventilation (MVV), and maximal expiratory pressure (MEP) were normal in the ambulatory patients (mean 80% predicted) but reduced in bedridden patients (mean, 38.5%, 31.6%, and 36.3% predicted; FCV, MVV, and MEP, respectively) and wheelchair-bound patients with upper extremity involvement (mean, 69.4%, 50.4%, and 62.6% predicted; FVC, MVV, and MEP, respectively). Forced vital capacity, MVV, and MEP correlated with Kurtzke Expanded Disability Status scores ( = —0.72, —0.70, and —0.65) and expiratory muscle weakness occurred most frequently. These findings demonstrate that marked expiratory weakness develops in severely paraparetic patients with multiple sclerosis and the weakness increases as the upper extremities become increasingly involved.

Author Affiliations
From Rutgers—the State University of New Jersey, College of Nursing, Newark (Dr Smeltzer); the University of Rochester (NY) Medical Center (Dr Utell); the Mellen Center, Cleveland Clinic (Dr Rudick); and the Department of Neurology, University of Rochester (NY) Medical Center (Dr Herndon).

Footnotes
Accepted for publication March 21, 1988.

Reprint requests to Rutgers—the State University of New Jersey, College of Nursing, 180 University Ave, Newark, NJ 07102 (Dr Smeltzer).

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