neum onia . ▁M obil izing ▁and ▁clear ing ▁secret ions ▁involve ▁manual ▁or ▁mechanical ▁ch est ▁phys i other apy ▁with ▁post ural ▁d rain age , ▁and ▁manual ▁or ▁mechanical ▁c ough ▁assistance ▁device . ▁To ▁assist ▁in ▁breath ing , ▁Non - in vas ive ▁vent ilation ▁( Bi P AP ) ▁is ▁frequently ▁used ▁and ▁tra che ost omy ▁may ▁be ▁sometimes ▁performed ▁in ▁more ▁severe ▁cases ; ▁both ▁methods ▁of ▁vent ilation ▁prolong ▁surv ival ▁to ▁a ▁compar able ▁degree , ▁although ▁tra che ost omy ▁prevents ▁speech ▁development . ▁ ▁N ut r ition ▁ ▁The ▁more ▁severe ▁the ▁type ▁of ▁S MA , ▁the ▁more ▁likely ▁to ▁have ▁nut r ition ▁related ▁health ▁issues . ▁Health ▁issues ▁can ▁include ▁difficulty ▁in ▁feed ing , ▁j aw ▁opening , ▁che wing ▁and ▁sw allow ing . ▁Ind ividual s ▁with ▁such ▁difficulties ▁can ▁be ▁at ▁increase ▁risk ▁of ▁over ▁or ▁und ern ut r ition , ▁failure ▁to ▁th rive ▁and ▁asp iration . ▁Other ▁nut r itional ▁issues , ▁especially ▁in ▁individuals ▁that ▁are ▁non - amb ul atory ▁( more ▁severe ▁types ▁of ▁S MA ), ▁include ▁food ▁not ▁passing ▁through ▁the ▁st om ach ▁quickly ▁enough , ▁g astr ic ▁re fl ux , ▁const ip ation , ▁vom iting ▁and ▁blo ating . ▁There in , ▁it ▁could ▁be ▁necessary ▁in ▁S MA ▁type ▁I ▁and ▁people ▁with ▁more ▁severe ▁type ▁II ▁to ▁have ▁a ▁feed ing ▁t ube ▁or ▁g ast rost