Reliability of maximal respiratory pressures in multiple sclerosis

Area of Science:

• Respiratory Medicine
• Neurology
• Clinical Physiology

Background:

• Maximal respiratory pressures, including maximal inspiratory pressure (P(I)max) and maximal expiratory pressure (P(E)max), are crucial indicators of respiratory muscle strength.
• Assessing these pressures in individuals with multiple sclerosis (MS) presents challenges due to potential variability in performance.
• Establishing reliable measurement protocols is essential for accurate clinical assessment and monitoring of disease progression in MS patients.

Purpose of the Study:

• To determine the number of testing sessions and measurements required for reliable P(I)max and P(E)max values in subjects with MS.
• To compare the reliability of these measurements between MS patients and healthy control subjects.
• To identify optimal protocols for obtaining consistent respiratory pressure data.

Main Methods:

• A descriptive, comparative design with repeated measures was employed.
• Four weekly sets of 10 P(I)max and 10 P(E)max measurements were collected from 72 MS patients in their homes.
• The same protocol was followed by 61 healthy control subjects in a private setting.

Main Results:

• MS patients showed significant differences in mean P(E)max and P(I)max across the first three of four testing sessions.
• Healthy controls exhibited significant differences only when comparing the first session to the subsequent three sessions.
• For MS patients, respiratory pressures increased between the first and tenth trial within the initial session, but not in subsequent sessions.

Conclusions:

• Multiple practice sessions are recommended to achieve reliable P(I)max and P(E)max measurements in individuals with MS.
• Healthy control subjects require at least one practice session to establish a reliable baseline.
• These findings inform the development of standardized protocols for respiratory muscle strength testing in clinical populations.