Respiratory Function Assessment in Multiple Sclerosis

Multiple sclerosis (MS) is an immune-mediated disorder characterised by demyelination and axonal loss within the central nervous system, leading not only to sensory and motor deficits but also to impairments in respiratory function. As the disease progresses, weakening of the inspiratory and expiratory muscles may result in reduced lung volumes, diminished cough efficacy and an elevated risk of pulmonary complications. Assessment of respiratory function in MS typically encompasses spirometric measures such as forced vital capacity (FVC) and forced expiratory volume in one second (FEV1), static measurements of maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP), and evaluation of peak cough flow (PCF). Techniques such as lung volume recruitment can augment maximal insufflation capacity and enhance cough performance. Early detection of subclinical respiratory muscle weakness enables timely introduction of rehabilitative interventions—including targeted breathing exercises and assisted ventilation strategies—to preserve pulmonary health, reduce morbidity and improve quality of life across diverse clinical settings worldwide.

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Respiratory Function Assessment in Multiple Sclerosis publication trend

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Technical terms

Forced Vital Capacity (FVC): The maximum volume of air exhaled forcefully after a full inhalation, measured by spirometry.

Forced Expiratory Volume in 1 second (FEV1): The volume of air expelled in the first second of the FVC manoeuvre, indicating airway patency.

Maximum Inspiratory Pressure (MIP): The greatest negative pressure generated during inhalation against a closed airway, reflecting inspiratory muscle strength.

Maximum Expiratory Pressure (MEP): The highest pressure achieved during forceful exhalation against a closed airway, reflecting expiratory muscle strength.

Peak Cough Flow (PCF): The maximal airflow reached during a cough, indicating the effectiveness of airway clearance.

Lung Volume Recruitment: A technique that uses assisted inflation manoeuvres to increase maximal lung insufflation capacity and enhance cough flow.

References

1. Effectiveness of Respiratory Exercises on Perceived Symptoms of Fatigue among Multiple Sclerosis Patients: A Systematic Review. Sustainability (2023).
2. Associations between respiratory function, balance, postural control, and fatigue in persons with multiple sclerosis: an observational study. Frontiers in Public Health (2024).
3. Respiratory issues in patients with multiple sclerosis as a risk factor during SARS-CoV-2 infection: a potential role for exercise. Molecular and Cellular Biochemistry (2022).
4. Lung Volume Recruitment in Multiple Sclerosis. PLOS ONE (2013).