Tests of respiratory muscle strength
- John Moxham, MD
John Moxham, MD
- Professor of Respiratory Medicine
- King's College London School of Medicine
Respiratory muscle strength can be assessed by measuring the maximal inspiratory pressure (MIP or PImax), and the maximal expiratory pressure (MEP or PEmax). The MIP reflects the strength of the diaphragm and other inspiratory muscles, while the MEP reflects the strength of the abdominal muscles and other expiratory muscles. An alternative or additional test of inspiratory muscles strength is maximal sniff nasal inspiratory pressure (SNIP). Common indications for measurement of the MIP, SNIP, and MEP include:
●Respiratory muscle weakness is suspected, such as a patient with unexplained dyspnea, a weak cough, or known neuromuscular disease
●Lung function tests show reduced vital capacity (VC) or an increased diffusion capacity of unknown etiology
●Evaluation of whether known respiratory muscle weakness has improved, remained stable, or worsened
Measurement, interpretation, quality assurance, and clinical applications of the MIP, SNIP, and MEP are discussed in this topic review. Assessments of other aspects of respiratory function (eg, airflow, lung volumes, gas exchange) are described separately. (See "Overview of pulmonary function testing in adults" and "Diffusing capacity for carbon monoxide" and "Reference values for pulmonary function testing" and "Flow-volume loops" and "Office spirometry".)
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- Maximal inspiratory pressure (MIP)
- Maximal expiratory pressure (MEP)
- Sniff nasal inspiratory pressure (SNIP)
- Reference range
- Detecting change
- QUALITY ASSURANCE
- CLINICAL APPLICATION
- Clinical course
- - Comparing measures
- ADDITIONAL TESTS (INVASIVE)
- SUMMARY AND RECOMMENDATIONS