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How Many Maneuvers Should We Do for Maximal Inspiratory and Expiratory Muscle Pressure Testing in Children: A Retrospective Review in Children with Cystic Fibrosis

  • CYSTIC FIBROSIS
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Abstract

Objectives

Maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) could be useful clinical parameters in monitoring many conditions including cystic fibrosis (CF). However, current protocols for undertaking the measurements lack standardization including the number of repeated attempts to achieve best values. We aimed to (a) determine the optimum number of attempts to achieve best MIP/MEP values, and (b) evaluate if the number of attempts is consistent across two different test days.

Methods

We analyzed data of a previous randomized controlled trial involving the effect of singing on respiratory muscle strength in 35 children with CF. On two different days (T1, T2) children performed MIP/MEP with at least ten attempts each to achieve < 10% repeatability.

Results

All children achieved repeatable MIP/MEP values within 10–11 attempts with 24 (68.6%) and 26 (74.3%) of these achieving best values of MIP and MEP, respectively, at attempts 6–11. Median values of the pressures by three, five, eight and all attempts significantly increased with more attempts (all p < 0.05). At T2, 56% required fewer attempts to achieve best values, but 32% required more attempts, indicating that the number of attempts required was inconsistent between test days.

Conclusion

It is likely that at least ten attempts (best two within < 10% variability) is required to achieve best and reliable MIP/MEP in children with CF. A larger sample size in children with CF and various conditions is required to consolidate these findings.

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Data Availability

All data and materials support this study claims and comply with field standards.

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Funding

This study was not funded. WB is supported by an Asia–Pacific Society of Respirology short-term research/training scholarship (ID 2959) and a Charles Darwin University PhD scholarship. AC is supported by an Australian National Health and Medical Research Council (NHMRC) Practitioner Fellowship (APP1058213) and a top-up fellowship from the Children’s Hospital Foundation (Grant 50286). JM is supported by an Early Career Fellowship Grant from Queensland Children’s Hospital Foundation (RPC0772019).

Author information

Authors and Affiliations

  1. Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia

    Wicharn Boonjindasup & Anne B. Chang

  2. Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, QLD, Australia

    Wicharn Boonjindasup, Anne B. Chang, Julie M. Marchant & Margaret S. McElrea

  3. Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand

    Wicharn Boonjindasup

  4. Department of Respiratory and Sleep Medicine, Queensland Children’s Hospital, Brisbane, QLD, Australia

    Anne B. Chang, Julie M. Marchant & Margaret S. McElrea

  5. Health and Social Care Research Centre, University of Derby, Derby, UK

    J. Yoon Irons

  6. Cough, Asthma & Airways Research Group, Centre for Children’s Health Research, Level 7, 62 Graham Street, South Brisbane, QLD, 4101, Australia

    Wicharn Boonjindasup

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  1. Wicharn Boonjindasup
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  2. Anne B. Chang
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  4. J. Yoon Irons
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  5. Margaret S. McElrea
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by WB and MM. The children in the original RCT were recruited by JYI. The first draft of the manuscript was written by WB. MM, AC and JM were involved in preparation of manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Wicharn Boonjindasup.

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Conflict of Interest

The author declares that they have no conflict of interest to disclose.

Ethical Approval

The questionnaire and methodology for this study was approved by the Human Research Ethics committee of Children’s Health Queensland (CHQ HREC 2007/104) for the original RCT and this current study.

Informed Consent

Written informed consent was obtained from the parents or legal guardians, and assent was obtained from children aged over 12 years. No identifiable information of participants.

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Boonjindasup, W., Chang, A.B., Marchant, J.M. et al. How Many Maneuvers Should We Do for Maximal Inspiratory and Expiratory Muscle Pressure Testing in Children: A Retrospective Review in Children with Cystic Fibrosis. Lung 199, 213–222 (2021). https://doi.org/10.1007/s00408-021-00422-0

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  • DOI: https://doi.org/10.1007/s00408-021-00422-0

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