In spinal-bulbar muscular atrophy, swallowing and chewing muscle weakness pose a choking hazard.
A swallowing specialist should be consulted to determine the safest ways of swallowing, and to learn ways to alter food consistency. A feeding tube can be considered in cases of extreme weakness.
Weakness in the throat muscles also can make breathing during sleep difficult. Noninvasive ventilation aids such as a bilevel positive air pressure device (such as BiPAP by Respironics), which pushes in air under pressure, can help with this.
As the disease progresses over many years, a scooter or wheelchair may eventually be needed for longer distances.