Reference Values for Maximal Inspiratory Pressure: A Systematic Review

Pessoa, Isabela M. B. S.; Parreira, Verônica Franco; Fregonezi, Guilherme A. F.; Sheel, A. William; Chung, Fu‐Tsai; Reid, W. Darlene

doi:10.1155/2014/982374

Cited by 122 publications

(64 citation statements)

References 34 publications

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“…It is known, for example, that subjects with chronic lower back pain and sacroiliac joint pain have abnormal diaphragm movement [19,20]. However, it seems very likely that the relationship between height and diaphragm excursion in QB reflects the one between height and tidal volume (volume-related rib cage biomechanic properties and optimized muscle fiber's length-tension ratio), while gender affects the DP excursion due to greater maximal inspiratory and expiratory pressures produced by males (more abundant inspiratory muscle mass and physiologically higher maximal inspiratory pressures) [21].…”

Section: Discussionmentioning

confidence: 99%

Reproducibility and Clinical Correlates of Supine Diaphragmatic Motion Measured by M-Mode Ultrasonography in Healthy Volunteers

et al. 2018

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Background: Assessing diaphragm mobility is important to detect malfunctions or impending exhaustion and to evaluate the effects of many chest and abdominal conditions on respiratory mechanics. Amongst several imaging methods, ultrasonography represents the only noninvasive, nonionizing imaging technique widely available for the direct assessment of diaphragm excursion. Objectives: the aim of this study is to prospectively assess the supine diaphragmatic motion amplitude, intra- and inter-observer agreement, and anthropometric correlates of diaphragm motion variability, measured through M-mode ultrasonography, in a sample of healthy volunteers. Methods: One-hundred healthy volunteers were considered eligible for the study. Instead of B-mode imaging, the M-mode technique was used to achieve a more accurate measurement of diaphragm motion. To assess intra-observer variability, 3 consecutive measurements (M-mode and B-mode) of the right dome motion were obtained at every session. To test for inter-rater reliability, the subjects were asked to provide 2 more diaphragm motion measurements every week, each performed by 2 experienced operators, and 42 subjects accepted. Results: Diaphragmatic motion was positively correlated with height and weight both at quiet (Spearman’s coefficient = 0.514, p < 0.001 and 0.314, p = 0.038) and deep breathing (Spearman’s coefficient = 0.342, p = 0.001 and 0.225, p = 0.024, respectively) and negatively correlated with age, but only during deep breathing (Spearman’s coefficient = –0.272, p = 0.006). Intra-observer agreement degree on all 3 measurements was excellent during both quiet and deep breathing, with a Cronbach’s alpha of 0.793 and 0.901, respectively, and an intra-class coefficient of 0.797 and 0.900, respectively. Similarly, the degree of inter-observer agreement achieved a Cronbach’s alpha of 0.638 and 0.776, and an inter-class coefficient of 0.632 and 0.778, respectively. Deep breathing was associated with sex only in linear multivariable models (B = –10.14; 95% confidence interval [CI] –17.86, –2.41; p = 0.011), while quiet breathing resulted to be affected by height only (B = 30.05; 95% CI 0.79–59.31; p = 0.044). Conclusions: Diaphragm excursion measurements using the M-mode technique were accurate and could be reproduced also when obtained in recumbent patients. After adjustments, the main predictors of diaphragmatic motion were sex and height, which should be considered to design a specifically tailored study and to develop normality reference equations.

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Section: Discussionmentioning

confidence: 99%

Reproducibility and Clinical Correlates of Supine Diaphragmatic Motion Measured by M-Mode Ultrasonography in Healthy Volunteers

et al. 2018

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“…The issue of the existence of several benchmarks for MIP measures was confirmed in a recently published systematic review28, in which the low methodological quality of the existing articles was noted, contributing to an appreciation of the difficulty, in research and especially in clinical situations, of choosing an appropriate prediction equation. …”

Section: Discussionmentioning

confidence: 99%

Predictive equations for respiratory muscle strength according to international and Brazilian guidelines

Pessoa

Neto

Montemezzo³

et al. 2014

Braz. J. Phys. Ther.

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Background: The maximum static respiratory pressures, namely the maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP), reflect the strength of the respiratory muscles. These measures are simple, non-invasive, and have established diagnostic and prognostic value. This study is the first to examine the maximum respiratory pressures within the Brazilian population according to the recommendations proposed by the American Thoracic Society and European Respiratory Society (ATS/ERS) and the Brazilian Thoracic Association (SBPT). Objective:To establish reference equations, mean values, and lower limits of normality for MIP and MEP for each age group and sex, as recommended by the ATS/ERS and SBPT. Method:We recruited 134 Brazilians living in Belo Horizonte, MG, Brazil, aged 20-89 years, with a normal pulmonary function test and a body mass index within the normal range. We used a digital manometer that operationalized the variable maximum average pressure (MIP/MEP). At least five tests were performed for both MIP and MEP to take into account a possible learning effect. Results:We evaluated 74 women and 60 men. The equations were as follows: MIP=63.27-0.55 (age)+17.96 (gender)+0.58 (weight), r2 of 34% and MEP= - 61.41+2.29 (age) - 0.03(age2)+33.72 (gender)+1.40 (waist), r2 of 49%. Conclusion: In clinical practice, these equations could be used to calculate the predicted values of MIP and MEP for the Brazilian population.

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“…Recently peak inspiratory flow (PIF) measurement has been of interest as a reliable and accessible tool for assessment of respiratory muscle strength in older adults (14). Maximal inspiratory pressure (MIP) is the most commonly used measure for assessment of inspiratory muscle function (15). Subjective factors which may influence MIP include proper test performance, weight, age, sex, height, fitness level and smoking status (15, 16).…”

Section: Discussionmentioning

confidence: 99%

“…Maximal inspiratory pressure (MIP) is the most commonly used measure for assessment of inspiratory muscle function (15). Subjective factors which may influence MIP include proper test performance, weight, age, sex, height, fitness level and smoking status (15, 16). There is no agreement regarding which of these variables have a significant influence on MIP (15).…”

Section: Discussionmentioning

confidence: 99%

“…Subjective factors which may influence MIP include proper test performance, weight, age, sex, height, fitness level and smoking status (15, 16). There is no agreement regarding which of these variables have a significant influence on MIP (15). Although studies on the effects of Ramadan fasting on weight change have had conflicting results, in a recent systematic review, it was concluded that fasting during Ramadan could result in relatively small but significant weight loss in both genders and most of the weight lost was regained within a few weeks after Ramadan (17).…”

Section: Discussionmentioning

confidence: 99%

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Effects of Ramadan Fasting on Inspiratory Muscle Function

et al. 2016

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BackgroundRamadan fasting is a major challenge for exercising Muslims especially in warm seasons. There is some evidence to indicate that Ramadan fasting causes higher subjective ratings of perceived exertion (RPE) in fasting Muslims. The mechanisms of this phenomenon are not known exactly. The role of respiratory muscle strength in this regard has not been studied yet.ObjectivesThe aim of this study was investigation of the effects of Ramadan fasting on respiratory muscle strength.Patients and MethodsIn a before-after study, from 35 fasting, apparently healthy, male adults who had fasted from the beginning of Ramadan, maximal inspiratory muscle pressure (MIP) and peak inspiratory flow (PIF) were measured in the last week of Ramadan month in summer. At the time of test, there was not any sleep problem in participants and all of them had good cooperation. Three months later, after exclusion of incompatible persons mainly because of change in their physical activity level, smoking behavior or drug consumption, the measurements were repeated in 12 individuals.ResultsWeight, MIP and PIF data had normal distribution (Kolmogorov-Smirnov Test). There was a significant increase in MIP (mean 8.3 cm H2O with 95% confidence interval of 2.2 - 14.3) and PIF (mean 0.55 lit/s with 95% confidence interval of 0.02 - 1.07) and weight (mean 3.4 Kg with 95% confidence interval of 2.2 - 4.5) after Ramadan (Paired t test with P < 0.05). When weight difference was used as a covariate in repeated measure ANOVA test, there was no further significant difference between MIP and PIF measurements.ConclusionsRamadan fasting may cause reduction of respiratory muscle strength through reduction of body weight.

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Reference Values for Maximal Inspiratory Pressure: A Systematic Review

Abstract: The present meta-analysis provides normative MIP values that are reflective of a large sample (n=840) and likely represents the broadest representation of participant characteristics compared with previous reports of normative data.

Cited by 122 publications

References 34 publications

Reproducibility and Clinical Correlates of Supine Diaphragmatic Motion Measured by M-Mode Ultrasonography in Healthy Volunteers

Reproducibility and Clinical Correlates of Supine Diaphragmatic Motion Measured by M-Mode Ultrasonography in Healthy Volunteers

Predictive equations for respiratory muscle strength according to international and Brazilian guidelines

Effects of Ramadan Fasting on Inspiratory Muscle Function

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