Reliability of Chest Wall Mobility and Its Correlation with Lung Functions in Healthy Nonsmokers, Healthy Smokers, and Patients with COPD

Abstract

Chest wall circumference measurements are common evaluation methods in clinical settings by therapists in order to obtain chest wall mobility. Previous published results have been conflicting, and there is a lot of variability in the method of testing, which needs testing in different conditions. Seventy subjects (25 healthy nonsmokers, 25 healthy smokers, and 20 COPD) aged between 18 and 70 years participated in the study. Upper and lower chest expansion (CE) measurements (2 levels) are performed with cloth inch tape. Intrarater (between day) and interrater (within-day) reliability of CE measurements was evaluated by two examiners. Lung function parameters, forced expiratory volume in first second (FEV1), forced vital capacity (FVC), FEV1/FVC, and vital capacity (VC) were measured using a computerized spirometer (Spiro lab 3). The intrarater reliability for upper and lower CE showed very good agreement with intraclass correlation (ICC) values between 0.90 and 0.93 for upper CE and 0.85 to 0.86 for lower CE. The interrater reliability for upper CE showed good to very good agreement with ICC values ranging between 0.78 and 0.83, and lower CE showed very good agreement with ICC values ranging between 0.82 and 0.84. Upper and lower CE showed a significant and positive correlation with all lung function parameters, with strong correlation with FEV1/FVC (r = 0.68). Upper and lower CE measurements with inch tape showed good intra- and interrater reliability and reproducibility in healthy nonsmokers, healthy smokers, and COPD subjects. Compared to upper, lower CE correlated well with the lung function parameters. Upper and lower CE may be more useful in clinical practice to evaluate chest mobility and to give indirect information on lung function but interpretation with caution is required when considering implementation into clinical setting.

Correlating Spirometric Parameters with Breath-Holding Time and Maximum Chest Expansion in Healthy Young Adults

“…20 Reddy et al also found very strong correlation of CE at upper thoracic level with FVC (r=0.678, p<0.001) and FEV 1 (r=0.595, p<0.001) in healthy controls. 13 The correlations in our study were weaker, and significantly strong only for males (FVC and FEV 1 ). In one study in COPD patients, chest wall mobility was found to be highly reliable and associated with inspiratory capacity, yet not found to infer pulmonary function to satisfactory level.…”

“…The mean CE is lower in patients of ankylosing spondylitis (3.05±1.63 cms) 20 and chronic obstructive pulmonary disease (3.7±0.8 cms). 13,14 Fisher et al found a very strong correlation (r= 0.71, p<0.001) between CE and VC in the patients with ankylosing spondylitis. 20 Reddy et al also found very strong correlation of CE at upper thoracic level with FVC (r=0.678, p<0.001) and FEV 1 (r=0.595, p<0.001) in healthy controls.…”

“…10,11 Owing to their simplicity and cost effectiveness, the CE and BHT have been suggested as reasonable alternatives to spirometry in resource-poor settings with the advantage of independence from technician and machine. 12,13 This study aims to verify this claim.…”

“…Studies conducted on wider range of age or on patients would find variable measurments. Reddy et al (2019) have reported higher FVC (5.1±0.8 l) and FEV 1 (5.1±0.6 l) values in an all male study (n=25, mean age = 23.6±5.3 years) 13.…”

Effect of Passive Stretching of Respiratory Muscles on Chest Expansion and 6-Minute Walk Distance in COPD Patients

“…Chest expansion was measured in centimeters at the level of the axilla and the xiphisternum using a tape. Each measurement was obtained after maximal expiration followed by maximum inspiration [ 39 , 40 ]. The 6MWD was calculated according to American Thoracic Society guidelines.…”