Reliability in the measurement of maximum inspiratory pressure and inspiratory capacity of a physiotherapist in training

Authors

  • Rodrigo Muñoz Cofré Universidad de La Frontera. Chile
  • Mariano del Sol Calderón Universidad de La Frontera. Chile
  • Paul Medina González Medina González Universidad de La Frontera. Chile
  • Nicolás Martínez Saavedra Universidad Católica del Maule. Facultad de Ciencias de la Salud
  • Máximo Escobar Cabello Universidad de La Frontera. Chile

DOI:

https://doi.org/10.1590/1809-2950/18007825042018

Keywords:

Maximal Respiratory Pressures, Data Accuracy, Physical Therapists

Abstract

The objective of this study was to explore the impact of clinical experience on the reliability and concordance of maximal inspiratory pressure (MIP) and inspiratory capacity (IC) measurements in a period of clinical training. For convenience, 37 participants in a body plethysmograph were evaluated by an experienced physiotherapist (EF) and a novice physiotherapist (NF). Intra-Class Correlation Coefficient (ICC) was used to analyze the reliability of the MIP and IC tests; to explore the individual differences, the Bland-Altman (gB/A) graphs were used. ICC analysis in three trials showed excellent inter-rater reliability (ICC 1st: 0.914; ICC 2nd: 0.915; ICC 3rd: 0.925) for the MIP test and (ICC 1st: 0.955; ICC 2nd: 0.965; ICC 3rd: 0.970) for the IC test. However, concordance according to gB/A among the evaluators showed a systematic trend with higher absolute scores for EF of 9.2 cmH2O in MIP, and of 0.06 L in IC, respectively. The results suggest that NF acquired reliable technical and discriminative skills for the MIP and IC test, but patients tended to improve performance with an experienced assessor. The evaluator’s experience influences the results obtained from the measurement of the MIP in the subjects; the formation of a NF requires incorporating more skills to recognize a sincere and maximum effort.

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Author Biographies

  • Rodrigo Muñoz Cofré, Universidad de La Frontera. Chile

    Programa de Doctorado en Ciencias Morfológicas, Universidad de La Frontera

  • Mariano del Sol Calderón, Universidad de La Frontera. Chile

    Programa de Doctorado en Ciencias Morfológicas, Universidad de La Frontera

  • Paul Medina González Medina González, Universidad de La Frontera. Chile

    Departamento de Kinesiología. Facultad de Ciencias de la Salud, Universidad Católica del Maule

  • Nicolás Martínez Saavedra, Universidad Católica del Maule. Facultad de Ciencias de la Salud

    Estudiante, Escuela de Kinesiología, Facultad de Ciencias de la Salud, Universidad Católica del Maule

  • Máximo Escobar Cabello, Universidad de La Frontera. Chile

    Programa de Doctorado en Educación en Red, Universidad del Bío-Bío

References

Clancy C, Eisenberg J. Outcomes research: measuring the end

results of health care. Ciencia. 1998;282:246-47. doi: 10.1126/

science.282.5387.245.

Bangdiwala S, Muñoz S. Medición de confiabilidad y validez

en instrumentos clínicos. Rev Med Chile. 1997;125:446-73.

Streiner DL. Starting at the beginning: An introduction to

coefficient alpha and internal consistency. J Pers Assess.

;80:99-103. doi.org/10.1207/S15327752JPA8001_18.

Alarcón A, Muñoz S. Medición en salud: Algunas consideraciones

metodológicas. Rev Med Chile. 2008;136:125-130. doi.

org/10.4067/S0034-98872008000100016.

Bonagamba GH, Coelho DM, Oliveira AS. Confiabilidade

interavaliadores e intra-avaliador do escoliômetro.

Rev Bras Fisioter. 2010;14(5):432-7. doi.org/10.1590/

S1413-35552010005000025.

Côté P, Kreitz BG, Cassidy JD, Dzus AK, Martel J. A study of

the diagnostic accuracy and reliability of the Scoliometer and

Adam’s forward bend test. Spine. 1998;23(7):796-802.

Onate J, Cortes N, Welch C, Van Lunen B. Expert versus novice

interrrater reliability and criterion validity of the landing error

scoring system. J Sport Rehabil. 2010;19(1):41-56.

Mc Gaghie W, Issenberg B, Petrusa E, Scalese R. A critical review

of simulation-based medical education research: 2003-2009.

Med Educ. 2010;44:50-63. doi: 10.1111/j.1365-2923.2009.03547.x.

Black L, Hyatt R. Maximal Respiratory Pressure. Normal

values and relationship to age and sex. Am Rev Respir Dis.

;99:669-702. doi: 10.1164/arrd.1969.99.5.696.

Mc Cool F, Tzelepis G. Inspiratory muscle training in the patient

with neuromuscular disease. Phys Ther. 1995;75:1006-114.

Smith P, Coakley JM, Edward R. Respiratory muscles training in

Duchenne muscular dystrophy. Muscle Nerve. 1998;11:784-85.

doi: 10.1002/mus.880110716.

Escobar J. Entrenamiento muscular inspiratorio en pacientes

con distrofia muscular de Duchenne. Una visión controversial.

REEM. 2015;2:7-16.

Wen AS, Woo MS, Keens TG. How many maneuvers are required

to measure maximal inspiratory pressure accurately. Chest.

;111:802-07. doi.org/10.1378/chest.111.3.802.

Volianitis S, McConnell A, Jones D. Assessment of maximum

inspiratory pressure. Prior submaximal respiratory muscle

activity (‘warm-up’) enhances maximum inspiratory activity

and attenuates the learning effect of repeated measurement.

Respiration. 2001;68(1):22-7. doi: 10.1159/000050458.

Sclauser P, Franco P, Fregonezi G, Sheel A, Chung F, Reid W.

Reference values for maximal inspiratory pressure: A systematic

review. Can Respir J. 2014;21:43-50. doi.org/10.1155/2014/982374.

American Thoracic Society / European Respiratory Society.

ATS/ERS Statement on Respiratory Muscle Testing. Am J Respir

Crit Care Med. 2002;166:518-624. doi:10.1164/rccm.166.4.518.

Aldrich T, Spiro P. Maximal inspiratory pressure: does

reproducibility indicate full effort? Thorax. 1995;50:40-3.

Lechner D, Bradbury S, & Bradley L. Detecting sincerity of

effort: a summary of methods and approaches. Phys Ther.

;75(8):867-88.

FND. Fundación neumológica Colombiana. Laboratorio de

función pulmonar. Neumologica.org. 2008; [Online]; 2008

[Visitada con fecha 22 Febrero 2018]. Disponible en: http://

www.neumologica.org/pruebas.htm.

Miranda M, Muñoz R. Confiabilidad y Validez del Incentivador

de Volumen en la medición de la capacidad inspiratoria. REEM.

;1(1):27-31.

Lisboa C, Leiva A, Pinochet R, Repetto P, Borzone G, Díaz O.

Valores de referencia de la capacidad inspiratoria en sujetos

sanos no fumadores mayores de 50 años. Arch Bronconeumol.

;43(9):485-89.

Casanova C, Celli B. ¿Debemos tener en cuenta la capacidad

inspiratoria? Arch Bronconeumol. 2007;43(5):245-47.

Oliveira V, Figueiredo A, Dos Santos S, Almeida J, Dos Santos,

H. Reliability of the measures inter and intra-evaluators

with universal goniometer and fleximeter. Fisioter Pesqui.

;21(3):229-35. doi.org/10.590/1809-2950/52921032014.

Sachs M, Enright P, Hinckley K, Jiang R, Barr R. Performance of

maximum inspiratory pressure tests and maximum inspiratory

pressure reference equations for 4 race/ethnic groups. Respir

Care. 2009;54(10):1321-8.

Ruppel G, Enright P. Pulmonary function testing. Respir Care.

;57(1):165-75. doi.org/10.4187/respcare.01640.

Knudson R, Slatin R, Lebowitz M, Burrows B. The Maximal

Expiratory Flow-Volume Curve: Normal Standards, Variability,

and effects of age. Am Rev Respir Dis. 1976;113:587-99. doi:

1164/arrd.1976.113.5.587.

Gotelli N, Ellison A. A primer of ecological statistics 2ed.

Massachusetts, Sinauer Associates Inc. Publishers Sunderland,

Ju Lin, Zwei J, Hsu T, Liu Y, Yu H, Tsai S, et al. Correlation of rater

training and reliability in performance assessment: Experience

in a school of dentristry. J Dental Scienc. 2013;8:256-60. doi.

org/10.1016/j.jds.2013.01.002.

Rodríguez, I. Confiabilidad de la fuerza muscular respiratoria

y flujos espiratorios forzados en adolescentes sanos.

Rev Chil Enferm Respir. 2015;31:86-93. doi.org/10.4067/

S0717-73482015000200003.

Garrido F, Muñoz R. Estudio transversal de confiabilidad interevaluador para la evaluación de peak del flujo expiratorio,

capacidad inspiratoria y presión inspiratoria máxima. REEM.

;1(2):25-32.

Adaos C, González A, Slater D, Medina P, Muñoz R, Escobar M.

Análisis de presión inspiratoria máxima según tres protocolos

en estudiantes voluntarios asintomáticos de la Universidad

Católica del Maule, Chile. Rev Chil Enferm Respir. 2017;33:21-

doi.org/10.4067/S0717-73482017000100004.

Figueiredo K, De Lima K, Cavalcanti M, Guerra RO. Interobserver

reproducibility of the Berg Balance Scale by novice and

experienced physiotherapists. Physiother Theory Pract.

;25(1):30-6. doi: 10.1080/09593980802631330.

Wainwright S, Shepard K, Harman L, Stephens J. Factors that

influence the clinical decision making of novice and experienced

physical therapists. Phys Ther. 2010;90(1):75-88. doi: 10.2522/

ptj.20100161.

Fuentes J, Armijo-Olivo S, Funabashi M, Miciak M, Dick B,

Warren S, et al. Enhanced therapeutic alliance modulates pain

intensity and muscle pain sensitivity in patients with chronic

low back pain: an experimental controlled study. Phys Ther.

;94:477-89. doi: 10.2522/ptj.20130118.

Cipriany-Dacko LM, Innerst D, Johannsen J, Rude V.

Interrater reliability of the Tinetti Balance Scores in novice

and experienced physical therapy clinicians. Arch Phys Med

Rehabil. 1997;78:1160-4.

Published

2018-11-12

Issue

Section

Investigação

How to Cite

Reliability in the measurement of maximum inspiratory pressure and inspiratory capacity of a physiotherapist in training. (2018). Fisioterapia E Pesquisa, 25(4), 444-451. https://doi.org/10.1590/1809-2950/18007825042018