Clinical assessment of the respiratory muscles

Pulmonary and Critical Care Division, Ohio State University College of Medicine, Columbus 43210, USA.

This review examines approaches to evaluation of the respiratory muscles and describes new techniques that may be more quantitative, less effort dependent, and less invasive than conventional methods. To evaluate strength of the respiratory muscles, maximum inspiratory and expiratory pressures remain useful measures. Potential methodologic errors, however, necessitate careful technique. Evaluation of the twitch response to direct phrenic nerve stimulation may ultimately prove more quantitative and less effort dependent than measurements of maximum pressure. Many techniques are also available to measure endurance of respiratory muscles, but most are less than satisfactory outside the research environment because of poor reproducibility and other procedural difficulties. The maximum incremental resistive loading test, however, has proven to be practical and well tolerated. There is little substitute for careful clinical observation of respiratory muscle coordination and movement, particularly in the patient with suspected respiratory muscle weakness or chest wall distortion. In conclusion, though the respiratory muscles are difficult to evaluate, techniques are available that can be quite helpful for assessment, particularly in response to interventions such as rehabilitation.

This article has been cited by other articles:

				E. H. J. Hulzebos, P. J. M. Helders, N. J. Favie, R. A. De Bie, A. Brutel de la Riviere, and N. L. U. Van Meeteren Preoperative Inspiratory Muscle Training and Postoperative Complications--Reply JAMA, February 21, 2007; 297(7): 698 - 699. [Full Text] [PDF]

				E. H. Hulzebos, N. L. van Meeteren, B. J. van den Buijs, R. A de Bie, A B. de la Riviere, and P. J. Helders Feasibility of preoperative inspiratory muscle training in patients undergoing coronary artery bypass surgery with a high risk of postoperative pulmonary complications: a randomized controlled pilot study Clinical Rehabilitation, November 1, 2006; 20(11): 949 - 959. [Abstract] [PDF]

				E. H. Hulzebos, N. L. Van Meeteren, R. A De Bie, P. C Dagnelie, and P. J. Helders Prediction of Postoperative Pulmonary Complications on the Basis of Preoperative Risk Factors in Patients Who Had Undergone Coronary Artery Bypass Graft Surgery Physical Therapy, January 1, 2003; 83(1): 8 - 16. [Abstract] [Full Text] [PDF]