Neuromuscular disease is an umbrella term that covers multiple diseases. It results in muscle weakness, which may affect a person's breathing and therefore may make a person's cough weaker. Cough is an essential defence mechanism used to clear mucus from the lungs and airways.  Patients with neuromuscular disease can get more frequent chest infections, regular and prolonged hospital admissions and a reduced quality of life.

Treatment techniques that help to strengthen cough are really important for this patient group. Less frequent infections, and shorter and less frequent hospital admissions can contribute to an improved quality of life and additionally reduced cost for the healthcare provider.

Mechanical insufflation-exsufflation (MI-E) is one such cough treatment used by Physiotherapists in this patient group. The machine works by giving the patient a big breath in, which is then quickly followed by a big sucking breath out. To date research has focused on the use of this device in the prevention of respiratory infections. There are gaps in the literature regarding the most effective set up of the device. Furthermore recent NICE Guidelines have highlighted a lack of information regarding the cost effectiveness for the use of this device in the neuromuscular patient group.