Hardin, in Encyclopedia of Sleep, 2013 Restrictive Lung Disease 100,108,109 Mild reductions in strength and endurance may be related to intercostal muscle atrophy secondary to decreased rib cage mobility 101 or to poor coordination of the respiratory muscles. P i max and P e max may be mildly reduced and respiratory muscle endurance may be impaired even in individuals with normal respiratory muscle strength.
Respiratory muscle strength and endurance may be reduced in AS. 107 Patients with AS are also at risk for respiratory failure if cervical spine fractures (typically C6 or C7) cause tetraplegia. 106 Kyphosis may be worsened and respiratory function further impaired by fractures involving the rigid spine ( Fig. 100,105 Kyphosis may develop in up to 50% of patients with long-standing AS due to either advanced disease or osteoporosis. Mild reductions in TLC and VC may be related to disease activity and duration, to spinal and rib cage immobility, or to concomitant kyphosis. Restrictive lung disease may be seen in patients with AS. Dennis McCool MD, in Murray and Nadel's Textbook of Respiratory Medicine (Sixth Edition), 2016 Pulmonary and Respiratory Muscle Function
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