CLINICAL BOTTOM LINE
“How could I apply this information?”
This study presents values for maximal inspiratory and expiratory pressure for children 7 to 11 years old who are healthy. These values may assist therapists working with individuals with respiratory muscle weakness, fatigue, or dyspnea with activity. The authors question the reliability of existing predictive equations for determining maximal respiratory pressures, indicating these equations should be used with caution. Instead, normative values from performance of maximal pressures should be considered. Normative values will provide a comparison for therapists to determine the level of impairment should they assess maximal inspiratory and expiratory pressures in their population. These pressures are important outcome measures in individuals with respiratory muscle weakness and fatigue.
“What should I be mindful about in applying this information?”
The measurements taken in this study were made on a limited number of children who are healthy; approximately 5 boys and 5 girls in each age group, and within a limited age range, even though the samples in the 2 groups are larger than previous studies. Therapists must use caution in comparing these measurements with children who may be at the extremes of height or weight for their age category. In addition, as this study was completed on children who are healthy, data on children with known cardiopulmonary impairments or neuromotor impairments that affect respiratory musculature are needed. Because these types of respiratory measures can provide great benefit as outcome measures, therapists may need additional training to perform these measures clinically. Consideration for identifying measures that result in more consistent normative values and more easily performed may also be warranted. This might increase awareness of respiratory strength and endurance deficits in the pediatric population as well as encourage inclusion of interventions to improve respiratory impairments.
Alyssa LaForme Fiss, PT, PhD, PCS
Ellen Hillegass, PT, EdD, CCS, FAACVPR, FAPTA
Cardiopulmonary Specialists Inc and Mercer University