New method for evaluating maximal respiratory pressures: Concurrent validity, test-retest, and inter-rater reliability

Braz J Phys Ther. 2021 Nov-Dec;25(6):741-748. doi: 10.1016/j.bjpt.2021.04.012. Epub 2021 May 14.

Abstract

Background: Maximal respiratory pressures (MRP) obtained at functional residual capacity (FRC) may reflect the real respiratory muscle pressure.

Objectives: To evaluate concurrent validity, test-retest, and inter-rater reliability of MRP performed with a new instrument in healthy individuals, and to compare values obtained at different volumes in healthy individuals and individuals with COPD.

Methods: MRP of 100 healthy individuals were obtained using the TrueForce and the MicroRPM® at residual volume (RV) and total lung capacity (TLC) to evaluate concurrent validity. MRP were obtained at FRC using the TrueForce to evaluate reliability. Comparisons of inspiratory pressure values (FRC compared to RV) and expiratory pressure values (FRC compared to TLC) were performed with 100 healthy individuals and 15 individuals with COPD.

Results: The intraclass correlation coefficient (ICC) was 0.77 and 0.86 for concurrent validity for inspiratory and expiratory pressures, respectively. Test-retest reliability showed an ICC of 0.87 for inspiratory pressure, and 0.78 for expiratory pressure; inter-rater reliability showed an ICC of 0.91 for inspiratory pressure, and 0.84 for expiratory pressure. Measurements performed at RV and TLC were higher when compared to FRC [mean difference (95%CI)= -8.30 (-11.82, -4.78) cmH2O; -37.29 (-42.63, -31.96) cmH2O] in healthy individuals, and -11.09 (-15.83, -6.35) cmH2O; -57.14 (-71.05, -43.05) cmH2O in COPD, for inspiratory and expiratory pressures, respectively.

Conclusion: MRP performed with the TrueForce presented good concurrent validity, good test-retest reliability, excellent inter-rater reliability for inspiratory pressure and good inter-rater reliability for expiratory pressure. MRP were lower when obtained at FRC for healthy individuals and with COPD.

Keywords: Chronic obstructive pulmonary disease; Functional residual capacity; Measurement properties; Physical therapy; Respiratory muscles.

MeSH terms

  • Humans
  • Maximal Respiratory Pressures*
  • Reproducibility of Results
  • Respiratory Function Tests
  • Respiratory Muscles*