Simple artificial training device for respiratory muscle strength and lung volumes in healthy young male and female subjects: A pilot study

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

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.

The R168G heterozygous mutation of tropomyosin 3 (TPM3) was identified in three family members and has manifestations ranging from asymptotic to serve scoliosis and respiratory complications

According to existing reports, mutations in the slow tropomyosin gene (TPM3) may lead to congenital fiber-type disproportion (CFTD), nemaline myopathy (NM) and cap myopathy (CD). They are all congenital myopathies and are associated with clinical, pathological and genetic heterogeneity. A ten-year-old girl with scoliosis was unable to wean from mechanical ventilation after total intravenous anesthesia. The girl has scoliosis, respiratory insufficiency, motion delay and muscle weakness; her younger brother has a similar physiology but does not have scoliosis or respiratory insufficiency, and her parents are healthy. We conducted genetic testing and found a c.502C > G (p.R168G) heterozygous mutation in the family. This mutation originated from the father and was autosomal dominant. Muscle biopsy results indicated that no special structures were present, and the type I fiber ratio was not notably high compared to previous reports. Although the family members have the same mutations, their clinical manifestations are quite different.