Chest
Clinical Investigations: Neuromuscular DiseaseAssessing Inspiratory Muscle Strength in Patients With Neurologic and Neuromuscular Diseases: Comparative Evaluation of Two Noninvasive Techniques
Section snippets
Subjects
We studied 30 white patients (21 men [age range, 14 to 59 years] and 9 women [age range, 22 to 72 years]) with a number of NNMD (Table 1) referred to our laboratory because of suspected respiratory muscle weakness, and a group of 41 age-matched and sex-matched normal subjects (23 men [age range, 15 to 51 years] and 18 women [age range, 16 to 52 years]). In patients with quadriplegia, a high-level spinal lesion (C3 to C6) was found; spasticity was also present in quadriplegics and in multiple
Results
Demographic, clinical, and pulmonary function data, and Pmosn values of the 30 patients and means of control subjects are shown in Table 1. The values of MIP and Pmosn in male and female control subjects are shown in Table 2. In the control subjects as a whole, MIP tended to be higher than Pmosn (p < 0.06). In male control subjects (130.8 ± 25.3 cm H2O) but not in female control subjects (86.7 ± 23.8 cm H2O), MIP was significantly higher than Pmosn (110.0 ± 21.1 cm H2O in male subjects, 92.8 ±
Discussion
The main findings of the present study can be summarized as follows: (1) in control subjects, the variation coefficients for MIP and Pmosn were similar, and the Pmosn/MIP ratio was inversely related to MIP; and (2) the majority of patients were between the prediction limits calculated for control subjects, and most patients with Duchenne dystrophy were below them.
Before commenting on these findings, it is important to raise some methodologic considerations. First, differences in training and
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Cited by (22)
Pompe disease: A neuromuscular disease with respiratory muscle involvement
2009, Respiratory MedicineCitation Excerpt :Sniff inspiratory nasal pressure and maximum inspiratory mouth pressure are both complementary techniques that are non-invasive volitional maneuvres. These techniques give a measurement of inspiratory muscle strength; predicted normal values adjusted for age and sex are available for both adults and children.26,32 Transdiaphragmatic pressure measurement requires esophageal pressure and gastric pressure measurements, but it has the advantage of directly quantifying diaphragmatic weakness.15,26,28
Sniff and Muller manoeuvres to measure diaphragmatic muscle strength
2008, Respiratory MedicineCitation Excerpt :Our data indicate, as previously suggested with non-invasive global inspiratory muscle assessment,23,26 that Pdi sniff and Pdi max (and Poes sniff and Poes max) are complementary rather than interchangeable and should therefore be used in combination with non-volitional tests for a complete sequential assessment of diaphragmatic strength in patients with suspected diaphragmatic dysfunction and/or inspiratory muscle disease.
Evaluation of inspiratory pressure in children with enlarged tonsils and adenoids
2005, Revista Brasileira de OtorrinolaringologiaCitation Excerpt :Iandelli assessed patients with neuromuscular diseases and verified several factors that may influence the IP value, such as: different techniques, personal motivation, cooperation and facial muscular weakness. However, despite these variations, this parameter may be applied in the evolution process of disease, as well as in the response to therapy. 15 In myasthenia gravis, the evaluation of 23 patients demonstrated that respiratory muscle strength remained normal, with no restrictive standard; however, the strength of respiratory muscles was reduced. 16
Respiratory muscle strength: 1998-2004 Update
2004, Revue des Maladies RespiratoiresInspiratory muscle training in a child with nemaline myopathy and organ transplantation
2011, Pediatric Critical Care MedicineCitation Excerpt :The patient completed MIP maneuvers from a sitting position. MIP has been used extensively to estimate inspiratory strength in healthy adults and children, as well as people with neuromuscular impairments (8, 9). We assessed MIP upon initial examination and weekly thereafter, according to American Thoracic Society testing guidelines (10).
Evaluation of respiratory muscle strength by randomized controlled trial comparing thoracoscopy, transaxillary thoracotomy, and posterolateral thoracotomy for lung biopsy
2006, European Journal of Cardio-thoracic Surgery