Validity, intra and inter‐reliability of manual evaluation of the respiratory muscle strength in asthmatic patients

• Published in: Physiotherapy research international : the journal for researchers and clinicians in physical therapy 2020-10, Vol.25 (4), p.e1852-n/a
• Main Authors: Luz Goulart, Cassia, Trimer, Renata, Garcia‐Araujo, Adriana Sanches, Caruso, Flavia Rossi, Ricci, Paula Angélica, Santos, Polliana Batista, Mendes, Renata Gonçalves, Borghi‐Silva, Audrey
• Format: Article
• Language: English
• Subjects: Adult; asthma; Asthma - physiopathology; Diaphragm - physiopathology; Female; Humans; Male; manual evaluation; maximal respiratory pressures; Middle Aged; Muscle Strength - physiology; Reproducibility of Results; Respiratory Mechanics; respiratory muscle strength; Respiratory Muscles - physiology; Respiratory Muscles - physiopathology
• ISSN: 1358-2267; 1471-2865
• DOI: 10.1002/pri.1852

Objective This study investigated the concurrent validity, inter and intra‐reliability of manual evaluation in Asthma patients. Methods Twenty six asthma patients were assessed. Maximal respiratory muscle strength (Mrms) was tested by inspiratory and expiratory pressure (MIP and MEP, respectively) trough manovacuometer. In addition, Mrms of diaphragm (anterior and posterior), Intercostals (lower and upper portion) and Rectus abdominal were obtained manually, according to Medical Research Council (MRC) scale. Two independents evaluators, previously trained, made both measurements. Results Reproducibility of Mrms intra‐evaluators: anterior diaphragm (ICCs, 0.79 and 0.67); Posterior portion of the diaphragm (ICCs, 0.43 and 0.51); Upper intercostals (ICCs, 0.47 and 0.40); Lower intercostals (ICCs, 0.81 and 0.51) and rectus abdominal (ICCs, 1.0). Inter‐reproducibility of anterior diaphragm was low to moderate, while intercostals (upper and lower portion) was relatively low. However, rectus abdominal presented high reproducibility reflecting in almost perfect agreement. In addition, we found positive correlations between MIP versus Lower Intercostals (r = .60, p = .007) and MEP versus rectus abdominal (r = .41, p = .04). Conclusion In asthmatic patients, manual evaluation of the respiratory muscles is reliable. In addition, maximal respiratory pressures using manometer assessment were related to manual evaluation, in special to diaphragm and rectus abdominal muscles.