Which muscular dystrophy commonly requires respiratory support and airway clearance strategies as part of standard care?

• A. Duchenne muscular dystrophy
• B. Becker muscular dystrophy
• C. Facioscapulohumeral muscular dystrophy
• D. Myotonic dystrophy type 2

Answer: (A)

Duchenne muscular dystrophy commonly progresses with early and severe weakness of the respiratory muscles, including the diaphragm and intercostals. As these muscles weaken, effective coughing declines and nighttime (and sometimes daytime) ventilation becomes inadequate, leading to hypoventilation, atelectasis, and pneumonia risk. Because of this, respiratory support and airway clearance strategies are a standard part of care—examples include noninvasive ventilation at night and devices or techniques to help clear secretions (cough-assist devices, chest physiotherapy, and regular airway clearance routines).

Becker muscular dystrophy can involve breathing difficulties, but it typically starts later and progresses more slowly, so respiratory support is not as universally required as in Duchenne. Facioscapulohumeral muscular dystrophy mainly affects shoulder and facial muscles, with respiratory involvement being less common and not routinely part of standard care. Myotonic dystrophy type 2 can have respiratory weakness in some individuals, especially with advanced disease, but again it's not as consistently addressed with routine respiratory support as in Duchenne.

So the best answer is Duchenne muscular dystrophy because its pattern of rapid, early respiratory muscle decline makes airway clearance and respiratory support a standard part of management.