Abstract
Individuals with paralytic or restrictive pulmonary syndromes usually require particular attention to more than one bodily system. Patients with myopathies often have complicating cardiomyopathies and smooth muscle involvement. Bulbar muscle dysfunction can result in pulmonary complications, impaired communication, and malnutrition, which can exacerbate respiratory dysfunction by itself. Because the survival of patients with functional bulbar musculature can be prolonged greatly without resorting to tracheostomy by using physical medicine respiratory muscle aids, complications not associated directly with the primary pathology increasingly need to be addressed.