Predicting maximum voluntary ventilation in normal healthy individuals using indirect inspiratory muscle strength measurements: a correlation study

Rohit Sontakke, Mangesh Deore, Dhara Kothari

.

DOI: 10.4236/health.2010.24043                

Abstract

Maximum Voluntary Ventilation (MVV), one of the components of Pulmonary Function Testing (PFT), has multiple uses. Various factors including the inspiratory muscle strength (IMS) influence its magnitude. Our aim was to quantify the IMS indirectly using an economical and non invasive bedside assessment tool, determine its association with MVV and then develop a predictive equation for MVV. 41 healthy non-athletic physical therapy students participated in the study. IMS measurement was performed with a sphygmomanometer. Average of the three net deflections in sphygmomanometer following deepest possible breaths was taken as indirect measurement of IMS in mm of Hg. MVV was measured according to ATS guidelines using a spirometer. Results from the data analysis revealed a significant correlation between IMS and MVV(r = 0.83, p < 0.001) and the coefficient of determination = 0.68. So, we developed a regression equation: Y = 1.9669(X) + 49.838 with SEE: 13.02L/min and ANOVA for the equation was (F=68.9, p < 0.001). Hence, it can be concluded that a strong correlation between the indirect IMS and MVV was established and a predictive equation to estimate MVV was developed. This equation proved to have a high predictive value with a small error of estimation. This indicates that the value of the indirect IMS measurement obtained using the sphygmomanometer can be used to estimate MVV in normal healthy individuals without the use of a conventional spirometer.

Keywords

Healthy Physical Therapy Students; Maximum Voluntary Ventilation; Inspiratory Muscle Strength; Regression Equation; Sphygmomanometer

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Von Leupoldt, A., Hahn, E., Taube, K., Schubert-Heu- keshoven, S., Magnussen and H., Dahme, B. (2008) Effects of 3-week outpatient pulmonary rehabilitation on exercise capacity, dyspnea, and quality of life in COPD. Lung, 186(6), 387-391.
[2]	Güell, R., Resqueti, V., Sangenis, M., Morante, F., Martorell, B., Casan, P., et al. (2006) Impact of pulmonary rehabilitation on psychosocial morbidity in patients with severe COPD. Chest, 129(4), 899-904.
[3]	Verrill, D., Barton, C., Beasley, W. and Lippard, W.M. (2005) The effects of short-term and long-term pulmo- nary rehabilitation on functional capacity, perceived dyspnea, and quality of life. Chest, 128(2), 673-683.
[4]	Cecins, N., Geelhoed, E. and Jenkins, S.C. (2008) Re- duction in hospitalization following pulmonary rehabili- tation in patients with COPD. Australian Health Review, 32(3), 415-422.
[5]	Kyung, K.A. and Chin, P.A. (2008) The effect of a pul- monary rehabilitation programme on older patients with chronic pulmonary disease. Journal of Clinical Nursing, 17(1), 118-125.
[6]	Hui, K.P., Alison, B. and Hewitt, A.B. (2003) Simple pul- monary rehabilitation program improves health outcomes and reduces hospital Utilization in patients with COPD. Chest, 124, 94-97.
[7]	Nici, L., Donner, C., Wouters, E., Zuwallack, R., Am- brosino, N., Bourbeau, J., et al. (2006) American thoracic society/European respiratory society statement on pulmonary rehabilitation. American Journal of Respiratory and Critical Care Medicine, 173, 390-1413.
[8]	Hill, K., Jenkins, S.C., Hillman, D.R. and Eastwood, P.R. (2004) Dyspnea in COPD: Can inspiratory muscle train- ing help? Australian Journal of Physiotherapy, 50(3), 169-180.
[9]	Rochester, D. (1993) Respiratory muscles and ventilatory failure. American Journal of Medical Science, 305, 394- 402.
[10]	Altose, M.D. (1992) Respiratory muscles and dyspnea. Seminars in Respiratory Medicine, 13, 1-6.
[11]	Killian, K.J. and Jones, N.L. (1988) Respiratory muscles and dyspnea. Clinics in Chest Medicine, 9, 237-248.
[12]	Weiner, P., Magadle, R., Beckerman, M., Weiner, M. and Berar-Yanay, N. (2004) Maintenance of inspiratory muscle training in COPD patients: One year follow-up. European Respiratory Journal, 23(1), 61-65.
[13]	Battaglia, E., Fulgenzi, A., Bernucci, S., Giardini, M.E. and Fererro, M.E. (2006) Home respiratory muscle training in patients with chronic obstructive pulmonary disease. Respirology. 11(6), 799-804.
[14]	Smith, L., Cook, D., Guyatt, G., Madhavan, J. and Ox- man, A. (1992) Respiratory muscle training in chronic airflow limitation: 8 meta-analyses. American Review of Respiratory Disease, 145, 533-539.
[15]	Padula, C.A. and Yeaw, E. (2006) Inspiratory muscle training: Integrative review. Research and Theory for Nursing Practice, 20(4), 291-304.
[16]	Lötters, F., van Tol, B., Kwakkel, G. and Gosselink, R. (2002) Effects of controlled inspiratory muscle training in patients with COPD: A meta-analysis. European Respiratory Journal, 20(3), 570-576.
[17]	Harver, A., Mahler, D.A. and Daubenspeck, J.A. (1989) Targeted inspiratory muscle training improves respiratory muscle function and reduces dyspnea in chronic obstructive pulmonary disease. Annals of Internal Medicine, 111, 117-124.
[18]	Kim, M., Larson, J., Covey, M., Vitalo, C., Alex, C. and Patel, M. (1993) Inspiratory muscle training in patients with chronic obstructive pulmonary disease. Nursing Research, 42, 356-362.
[19]	McConnell, A.K. and Romer, L.M. (2004) Dyspnoea in health and obstructive pulmonary disease: The role of respiratory muscle function and training. Sports Medicine, 34(2), 117-132.
[20]	American Thoracic Society. (1999) Dyspnea: Assessment, mechanism and management: A consensus statement. American Journal of Respiratory and Critical Care Medicine, 159, 321-340.
[21]	Gibson, G.J., Whitelaw, W. and Nikolaos, S.N. (2002) Tests of over all respiratory function. ATS/ERS state- ment on respiratory muscle testing. American Journal of Respiratory and Critical Care Medicine, 166, 521-526.
[22]	Green, M., Road, J. and Sieck, G.C. (2002) ATS/ERS statement on respiratory muscle testing. American Jour- nal of Respiratory and Critical Care Medicine, 166, 528-542.
[23]	Clanton, T., Calverly, P.M. and Celli, B.R. (2002) Tests of respiratory muscle endurance. ATS/ERS statement on respiratory muscle testing. American Journal of Respiratory and Critical Care Medicine, 166, 559-569.
[24]	Supinski, G.S., Fitting, J.W. and Bellemare, F. (2002) Assessment of Respiratory Muscle fatigue. ATS/ERS statement on respiratory muscle testing. American Journal of Respiratory and Critical Care Medicine, 166, 571-578.
[25]	Loring, S.H., Troyer, A. and Grassino, A,E. (2002) As- sessment of Chest Wall Function. ATS/ERS statement on respiratory muscle testing. American Journal of Respi- ratory and Critical Care Medicine, 166, 580-586.
[26]	Sheldon, R.L. (2000) Pulmonary Function Testing. In Wilkins, R.L., Krider, Susan, J., Clinical assessment in respiratory care. 4th Edition, Mosby, St. Louis, 141-160.
[27]	Millre, M.R., Hankinson, J. and Brusasco, V. (2005) Maximum voluntary ventilation. Standardisation of spi- rometry: SERIES ‘‘ATS/ERS task force: Standardization of lung function testing’’. European Respiratory Journal, 26, 331-334.
[28]	Portney, L.G. and Watkins, M.P. (2009) Foundations of clinical research applications to practice. 3rd Editon, Prentice Hall, New Jersey, 539-567.
[29]	Fulton, J.E., Pivarnik, J.M., Taylor, W.C., Snider, S.A., Tate, A.L. and Frankowski, R.F. (1995) Prediction of ma- ximum voluntary ventilation (MVV) in African-Ameri- can adolescent girls. Pediatric Pulmonology, 20(4), 225- 233.
[30]	Pride, N.B. (2001) Tests of forced inspiration and expira- tion. Clinics in Chest Medicine, 22(4), 599-622.
[31]	Aggarwal, A.N., Gupta, D., Behera, D. and Jindal, S.K. (2005) Applicability of commonly used Caucasian prediction equations for spirometry interpretation in India. Indian Journal of Medical Research, 122(2), 153-164.