List key nonpharmacologic management strategies for SMA.

Respiratory support and airway clearance techniques, physical and occupational therapy, scoliosis management, nutrition and assistive devices.

Only respiratory therapy.

Only physical therapy.

No interventions.

Nonpharmacologic management of SMA is a holistic, multidisciplinary approach that targets respiration, mobility, posture, and nutrition to sustain function and quality of life. Respiratory support and airway clearance techniques address weakness in the chest muscles and diminished cough, helping keep airways clear and reducing infection risk; many individuals rely on devices to augment cough and may need ventilatory support as the disease progresses. Physical and occupational therapy help maintain joint range of motion, prevent contractures, and preserve independence through adaptive strategies as strength declines. Scoliosis management aims to preserve chest wall mechanics and breathing capacity, often starting with bracing and advancing to surgery if needed. Nutrition and feeding support ensure adequate growth and energy, with plans for optimizing oral intake and, when necessary, feeding tubes and electrolyte or caloric management. Assistive devices and home adaptations enable safer mobility, communication, and daily activities. These components work best when tailored to the person’s stage and needs, providing a coordinated plan to optimize function and quality of life.

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