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Tashiro D, Oki Y, Nonomura N, Takeyama Y, Osaki T, Morimoto Y. Maximum abdominal excursion assessment using an abdominal excursion measuring device: Reliability and validity of a new device for simple and quantitative assessment of respiratory function. Med Eng Phys 2024; 124:104093. [PMID: 38418023 DOI: 10.1016/j.medengphy.2023.104093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 12/14/2023] [Accepted: 12/21/2023] [Indexed: 03/01/2024]
Abstract
This study aimed to verify the reliability and validity of abdominal expansion and respiratory function measurements. Forty healthy adult males underwent lung capacity, effort lung capacity, respiratory muscle strength, cough strength, diaphragm ultrasound, and abdominal expansion measurements. Abdominal expansion was measured using a device developed to accurately evaluate abdominal movements and calculate maximum abdominal expansion on the ventral side (AE-max: the difference between maximal abdominal contraction at the same time as maximal-effort expiration and maximal abdominal expansion at the same time as maximal-effort inspiration). Intra- and inter-rater reliabilities of the AE-max measurements were examined, the paired t-test was used for assessing the ratios of the expansion and contraction displacement components in AE-max, and regression analysis was used to obtain equations for predicting maximum inspiratory pressure (MIP) based on AE-max. Both intra- and inter-rater reliabilities were high. Criterion-related validity showed that AE-max was associated with all respiratory function parameters, especially MIP, and a high percentage of expansion displacement. Regression analysis showed that AE-max was significantly associated with MIP. Based on its association with MIP, the large proportion of expansion displacement in AE-max, and the results of the multiple regression analysis, we conclude that AE-max is a helpful measure for estimating MIP.
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Affiliation(s)
- Daisuke Tashiro
- Department of Occupational Therapy, Faculty of Rehabilitation, Kobe Gakuin University, Kobe City, Hyogo, Japan.
| | - Yutaro Oki
- Department of Public Health Kobe University Graduate School of Health Sciences, Kobe City, Hyogo, Japan
| | - Natsuha Nonomura
- Department of Occupational Therapy, Faculty of Rehabilitation, Kobe Gakuin University, Kobe City, Hyogo, Japan
| | - Yuki Takeyama
- Department of Occupational Therapy, Faculty of Rehabilitation, Kobe Gakuin University, Kobe City, Hyogo, Japan
| | - Tohmi Osaki
- Department of Occupational Therapy, Faculty of Rehabilitation, Kobe Gakuin University, Kobe City, Hyogo, Japan
| | - Yosuke Morimoto
- Department of Physical Therapy, Faculty of Rehabilitation, Kobe Gakuin University, Kobe City, Hyogo, Japan; Department of Rehabilitation, Nishi-Kinen Port-island Rehabilitation Hospital, Kobe City, Hyogo, Japan
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Lista-Paz A, Langer D, Barral-Fernández M, Quintela-Del-Río A, Gimeno-Santos E, Arbillaga-Etxarri A, Torres-Castro R, Vilaró Casamitjana J, Varas de la Fuente AB, Serrano Veguillas C, Bravo Cortés P, Martín Cortijo C, García Delgado E, Herrero-Cortina B, Valera JL, Fregonezi GAF, González Montañez C, Martín-Valero R, Francín-Gallego M, Sanesteban Hermida Y, Giménez Moolhuyzen E, Álvarez Rivas J, Ríos-Cortes AT, Souto-Camba S, González-Doniz L. Maximal Respiratory Pressure Reference Equations in Healthy Adults and Cut-off Points for Defining Respiratory Muscle Weakness. Arch Bronconeumol 2023; 59:813-820. [PMID: 37839949 DOI: 10.1016/j.arbres.2023.08.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/04/2023] [Accepted: 08/20/2023] [Indexed: 10/17/2023]
Abstract
INTRODUCTION Maximal inspiratory and expiratory pressures (PImax/PEmax) reference equations obtained in healthy people are needed to correctly interpret respiratory muscle strength. Currently, no clear cut-off points defining respiratory muscle weakness are available. We aimed to establish sex-specific reference equations for PImax/PEmax in a large sample of healthy adults and to objectively determine cut-off points for respiratory muscle weakness. METHODS A multicentre cross-sectional study was conducted across 14 Spanish centres. Healthy non-smoking volunteers aged 18-80 years stratified by sex and age were recruited. PImax/PEmax were assessed using uniform methodology according to international standards. Multiple linear regressions were used to obtain reference equations. Cut-off points for respiratory muscle weakness were established by using T-scores. RESULTS The final sample consisted of 610 subjects (314 females; 48 [standard deviation, SD: 17] years). Reference equations for PImax/PEmax included body mass index and a squared term of the age as independent variables for both sexes (p<0.01). Cut-off points for respiratory muscle weakness based on T-scores ≥2.5 SD below the peak mean value achieved at a young age were: 62 and 83cmH2O for PImax and 81 and 109cmH2O for PEmax in females and males, respectively. CONCLUSION These reference values, based on the largest dataset collected in a European population to date using uniform methodology, help identify cut-off points for respiratory muscle weakness in females and males. These data will help to better identify the presence of respiratory muscle weakness and to determine indications for interventions to improve respiratory muscle function.
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Affiliation(s)
- Ana Lista-Paz
- University of A Coruña, Faculty of Physiotherap, Research Group in Psychosocial Intervention and Functional Rehabilitation, Spain.
| | - Daniel Langer
- Department of Rehabilitation Sciences, Research Group or Rehabilitation in Internal Disorders, KU Leuven, Leuven, Belgium; Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department of Chronic Diseases and Metabolism (CHROMETA), KU Leuven, Leuven, Belgium
| | - Margarita Barral-Fernández
- University of A Coruña, Faculty of Physiotherap, Research Group in Psychosocial Intervention and Functional Rehabilitation, Spain
| | | | - Elena Gimeno-Santos
- Hospital Clínic of Barcelona, Spain; Barcelona Institute for Global Health (ISGlobal), Spain; Blanquerna School of Health Sciences, Ramon Llull University, Spain
| | | | - Rodrigo Torres-Castro
- Department of Physical Therapy, University of Chile, Chile; Department of Pulmonary Medicine, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Jordi Vilaró Casamitjana
- Blanquerna School of Health Sciences, Global Research on Wellbeing (GRoW), Ramon Llull University, Barcelona, Spain
| | | | | | | | - Concepción Martín Cortijo
- University Hospital Doce de Octubre, Madrid, Spain; Faculty of Nursing, Physiotherapy and Podiatry, Complutense University, Spain
| | - Esther García Delgado
- University Hospital Doce de Octubre, Madrid, Spain; Faculty of Nursing, Physiotherapy and Podiatry, Complutense University, Spain
| | - Beatriz Herrero-Cortina
- Hospital Clínico Universitario Lozano Blesa, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Spain; Universidad San Jorge, Spain
| | - José Luis Valera
- Hospital Universitari Son Espases, Gabinete de Función Respiratoria, Spain
| | - Guilherme A F Fregonezi
- PneumoCardioVascular Lab/HUOL, Hospital Universitário Onofre Lopes, Empresa Brasileira de Serviços Hospitalares (EBSERH), Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Carolina González Montañez
- University Hospital of Canarias, Spain; School University of Physiotherapy, University of La Laguna, Spain
| | - Rocío Martín-Valero
- Department of Physiotherapy, Faculty of Health Sciences, University of Malaga, Spain
| | | | - Yolanda Sanesteban Hermida
- University of A Coruña, Faculty of Physiotherap, Research Group in Psychosocial Intervention and Functional Rehabilitation, Spain; University Hospital of A Coruña, Spain
| | - Esther Giménez Moolhuyzen
- University of A Coruña, Faculty of Physiotherap, Research Group in Psychosocial Intervention and Functional Rehabilitation, Spain; University Hospital of A Coruña, Spain
| | | | - Antonio T Ríos-Cortes
- General University Hospital Santa Lucía, Spain; Physiotherapy Department, University of Murcia, Spain
| | - Sonia Souto-Camba
- University of A Coruña, Faculty of Physiotherap, Research Group in Psychosocial Intervention and Functional Rehabilitation, Spain
| | - Luz González-Doniz
- University of A Coruña, Faculty of Physiotherap, Research Group in Psychosocial Intervention and Functional Rehabilitation, Spain
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Park TS, Tak YJ, Ra Y, Kim J, Han SH, Kim SH, Shin Y, Shin MJ, Kang JH. Reference Respiratory Muscle Strength Values and a Prediction Equation Using Physical Functions for Pulmonary Rehabilitation in Korea. J Korean Med Sci 2023; 38:e325. [PMID: 37846788 PMCID: PMC10578989 DOI: 10.3346/jkms.2023.38.e325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 06/13/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND In Korea, tests for evaluating respiratory muscle strength are based on other countries' clinical experience or standards, which can lead to subjective evaluations. When evaluating respiratory function based on the standards of other countries, several variables, such as the race and cultures of different countries, make it difficult to apply these standards. The purpose of this study was to propose objective respiratory muscle strength standards and predicted values for healthy Korean adults based on age, height, weight, and muscle strength, by measuring maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and peak cough flow (PCF). METHODS This cross-sectional study analyzed MIP, MEP, and PCF in 360 people, each group comprising 30 adult men and women aged 20-70, diagnosed as healthy after undergoing medical check-ups at a general hospital. Hand grip strength (HGS) and the five times sit-to-stand test (FTSST) results were also recorded. Correlations among respiratory muscle strength, participant demographics, and overall muscle strength were evaluated using Pearson's correlation analysis. The predicted values of respiratory muscle strength were calculated using multiple regression analysis. RESULTS Respiratory muscle strength differed from the values reported in studies from other countries. In the entire samples, both MIP and MEP had the highest correlations with peak HGS (r = 0.643, r = 0.693; P < 0.05), while PCF had the highest correlation with forced expiratory volume in 1 s (r = 0.753; P < 0.05). Age, body mass index, peak HGS, and FTSST results were independent variables affecting respiratory muscle strength. A predictive equation for respiratory muscle strength was developed using the multiple regression equation developed in this study. CONCLUSION Respiratory muscle strength index may differ by country. For more accurate diagnoses, standard values for each country are required. This study presents reference values for Korea, and a formula for estimation is proposed when no respiratory muscle strength measurement equipment is available. TRIAL REGISTRATION Clinical Research Information Service Identifier: KCT0006778.
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Affiliation(s)
- Tae Sung Park
- Department of Convergence Medical Institute of Technology, Pusan National University Hospital, Busan, Korea
- Department of Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
- Department of Physical Therapy, College of Health Sciences, Catholic University of Pusan, Busan, Korea
| | - Young Jin Tak
- Department of Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
- Department of Family Medicine, Pusan National University Hospital, Busan, Korea
- Department of Family Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Youngjin Ra
- Department of Family Medicine, Pusan National University Hospital, Busan, Korea
| | - Jinmi Kim
- Department of Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
- Department of Biostatistics, Clinical Trial Center, Pusan National University Hospital, Busan, Korea
| | - Sang Hun Han
- Department of Rehabilitation Medicine, Pusan National University Hospital, Busan, Korea
| | - Sang Hun Kim
- Department of Rehabilitation Medicine, Pusan National University Hospital, Busan, Korea
| | - YongBeom Shin
- Department of Rehabilitation Medicine, Pusan National University Hospital, Busan, Korea
- Department of Rehabilitation Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Myung-Jun Shin
- Department of Convergence Medical Institute of Technology, Pusan National University Hospital, Busan, Korea
- Department of Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
- Department of Rehabilitation Medicine, Pusan National University Hospital, Busan, Korea
- Department of Rehabilitation Medicine, Pusan National University School of Medicine, Busan, Korea.
| | - Jong Ho Kang
- Department of Physical Therapy, College of Health Sciences, Catholic University of Pusan, Busan, Korea.
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de Sevilla GGP, Sánchez-Pinto B. Associations between muscle strength, dyspnea and quality of life in post-COVID-19 patients. Rev Assoc Med Bras (1992) 2022; 68:1753-1758. [PMID: 36449807 PMCID: PMC9779978 DOI: 10.1590/1806-9282.20220974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 09/08/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Patients with severe coronavirus disease 2019 (COVID-19) develop high muscle weakness. The objective of this study was to analyze the physical fitness of post-COVID-19 patients and its relationship with dyspnea and health-related quality of life (HrQoL). METHODS This observational, retrospective, cross-sectional study was conducted between October and November 2021 in the Universidad Europea de Madrid (Spain), with 32 post-COVID-19 patients aged 63.2 (14.1) years. Muscle strength, aerobic capacity, maximal respiratory mouth pressures, dyspnea, and HrQoL were analyzed 6-12 months after discharge for COVID-19. To analyze the relationship between continuous variables, Spearman's correlation test and Pearson's correlation test were performed. RESULTS The participants had a mean handgrip strength of 22.1 (9.0) kg and very poor HrQoL. Negative moderate correlations were found between handgrip strength and length of hospital and intensive care unit stay (r=-0.37; p=0.002). In addition, muscle strength was negatively correlated with dyspnea (r=-0.37; p=0.008) and HrQoL, and moderate-large negative correlations were found between dyspnea and HrQoL. CONCLUSION Higher handgrip strength was associated with lower COVID-19 severity and less sequelae. Therefore, either the patients with severe COVID-19 suffered greater muscle breakdown, or higher muscle strength acted as a mitigating factor for the disease. It is suggested that post-COVID-19 rehabilitation programs should focus on increasing muscle strength. Also, adequate physical fitness could mitigate the physical and mental post-COVID-19 sequelae.
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Affiliation(s)
| | - Beatriz Sánchez-Pinto
- Hospital de Emergencias Enfermera Isabel Zendal, Rehabilitation Unit – Madrid, Spain
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Hamada R, Oshima Y, Yoshioka Y, Chen-Yoshikawa TF, Nakajima D, Nankaku M, Ikeguchi R, Date H, Matsuda S, Sato S. Comparison of international and Japanese predictive equations for maximal respiratory mouth pressures. Respir Investig 2022; 60:847-851. [PMID: 36038474 DOI: 10.1016/j.resinv.2022.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/16/2022] [Accepted: 07/23/2022] [Indexed: 11/28/2022]
Abstract
Respiratory muscle weakness has attracted attention because sarcopenia and respiratory muscle dysfunction may play a key role in the development of respiratory failure. To evaluate respiratory muscle strength appropriately, individual factors such as sex, age, body size, and ethnicity should be considered. This study aimed to compare equations available in Japan and other countries for predicting respiratory muscle strength. We tested 21 equations for maximal inspiratory pressure (MIP) and 17 for maximal expiratory pressure (MEP) for each sex (76 equations in total) in 159 normal, healthy subjects. We observed wide variations in the overall agreement among the MIP and MEP equations. Some equations showed a proper normal distribution, with median values of almost 100%, and the Japanese equations released in 1997 generally showed the best distributions of both %MIP and %MEP. We can conclude that it is better to use Japanese equations when evaluating respiratory muscle strength in Japanese subjects.
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Affiliation(s)
- Ryota Hamada
- Rehabilitation Unit, Kyoto University Hospital, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
| | - Yohei Oshima
- Rehabilitation Unit, Kyoto University Hospital, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
| | - Yuji Yoshioka
- Rehabilitation Unit, Kyoto University Hospital, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
| | - Toyofumi Fengshi Chen-Yoshikawa
- Department of Thoracic Surgery, Graduate School of Medicine, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan.
| | - Daisuke Nakajima
- Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
| | - Manabu Nankaku
- Rehabilitation Unit, Kyoto University Hospital, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
| | - Ryosuke Ikeguchi
- Rehabilitation Unit, Kyoto University Hospital, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
| | - Hiroshi Date
- Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
| | - Shuichi Matsuda
- Rehabilitation Unit, Kyoto University Hospital, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
| | - Susumu Sato
- Rehabilitation Unit, Kyoto University Hospital, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan; Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
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Maximal Respiratory Pressure Reference Values for Hopi Children Ages 4 to 13. Cardiopulm Phys Ther J 2022; 33:123-129. [DOI: 10.1097/cpt.0000000000000195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Plaza MDL, Sevilla GGPD. Respiratory muscle sequelae in young university students infected by coronavirus disease 2019: an observational study. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2022; 68:245-249. [PMID: 35239890 DOI: 10.1590/1806-9282.20211040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 11/24/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND The infection caused by coronavirus disease 2019 can lead to respiratory sequelae in individuals who have experienced severe or mild symptoms. METHODS An observational, cross-sectional study was developed, following the STROBE guidelines. Maximal inspiratory and expiratory mouth pressures were assessed in 50 healthy young students (26 women, 24 men; age 22.20±2.41 years). The inclusion criteria were as follows: aged between 18 and 35 years; control group: not diagnosed with coronavirus disease 2019; and coronavirus disease 2019 group: diagnosed with coronavirus disease 2019, at least 6 months ago. The exclusion criteria were as follows: obese/overweight; infected with coronavirus disease 2019 or coronavirus disease 2019 symptoms in the last 6 months; smokers; and asthmatics. RESULTS When comparing with groups, the coronavirus disease 2019 group presented statistically significant lower maximal inspiratory pressure values compared with the control group (88.32±16.62 vs. 101.01±17.42 cm H2O; p=0.01). Regarding the maximal expiratory pressure, no significant differences were found. Similar results were found when performing a subgroup analysis by sex and group. CONCLUSIONS Young students who suffered from coronavirus disease 2019 asymptomatically or mildly at least 6 months ago presented a significant decrease in the inspiratory muscle strength as a sequel, so we believe that patients affected by this disease should have a brief postinfection assessment of this musculature to detect the indication for cardiorespiratory rehabilitation.
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Affiliation(s)
- Marta de la Plaza
- Universidad Europea de Madrid, Faculty of Sports Sciences, Department of Physiotherapy - Madrid, Spain
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