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Test of incremental respiratory endurance (TIRE) in patients with cardiovascular disease: agreement, reliability and
Amanda Moreira Ferreira1, Carolina Barbosa Neres1, Cássia da Luz Goulart2
1Graduate Program of Rehabilitation Sciences, University of Brasília, Brasília, Distrito Federal, Brazil.
Purpose:
To assess agreement among three instruments for maximal inspiratory pressure (MIP) measurement; evaluate intra- and inter-rater reliability of inspiratory performance measures using Test of Incremental Respiratory Endurance (TIRE); examine their convergent validity; and analyze associations between inspiratory performance and peak oxygen consumption (VO2peak) in individuals with CVD.
Materials And Methods:
This cross-sectional study included 51 individuals with CVD (mean age 62.0 ± 9.9 years; 56% male; 70% ischemic etiology). Participants underwent clinical evaluation, body composition via dual-energy X-ray absorptiometry, transthoracic echocardiography, cardiopulmonary exercise testing, spirometry, and inspiratory muscle performance testing. Agreement, reliability, and validity analyses were conducted using standardized rest intervals.
Results:
No significant differences in MIP mean values were observed among the three devices (p = 0.22). Agreement analysis demonstrated good concordance between devices, with intraclass correlation coefficients(ICC) ranging from 0.84 to 0.88 across device pairs (p < 0.001). TIRE showed good to excellent intra- and inter-rater reliability (ICC: 0.76-0.97) and strong convergent validity (r = 0.66-0.88, p < 0.001). SMIP showed a stronger correlation with VO2peak (r = 0.60, p = 0.001) than MIP.
Conclusions:
TIRE is a reliable and valid tool for assessing inspiratory muscle strength and performance. SMIP may serve as a functional marker of aerobic capacity in individuals with CVD.
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