Inspiratory muscle testing in stable COPD patients. 1994

T Similowski, and J P Derenne
Laboratoire de Physio-Pathologie Respiratoire, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.

Exploration of inspiratory muscles in stable chronic pulmonary disease patients can be important in the investigation of a respiratory handicap unsatisfactorily explained by alterations of the passive respiratory system, or in the follow-up of patients undergoing treatments that can interfere with muscle function. Compensatory mechanisms tend to counterbalance the deleterious effects of hyperinflation in these patients, and precise clinical data are needed in order to avoid mistakes due to underverified hypotheses. Investigation of inspiratory muscle function requires the study of output data under various states of activity of the system. As outputs, volume displacement lacks specificity, pressure measurements can be more specific but are at times invasive and should be associated with lung volume measurements, electromyography is methodologically complex, nonquantitative and of poor reproducibility. Voluntary manoeuvres depend upon subject co-operation, and do not allow partitioning of output between the action of different muscle groups. Transcutaneous electrical phrenic nerve stimulation is devoid of these inconveniences, but it explores only one muscle (the diaphragm) under conditions that are not "natural" (relaxed rib cage). Recently, perspectives for easier clinical assessment of inspiratory muscle function in chronic obstructive pulmonary disease patients have been opened by cervical magnetic stimulation, better understanding of the meaning of mouth pressure in relationship to phrenic stimulation, and development of noninvasive tests, such as nostril pressure during sniff or phonomyography. If validated, such tests should provide a reasonably limited panel of clinical tools to better appreciate muscle function in this setting.

UI MeSH Term Description Entries
D008173 Lung Diseases, Obstructive Any disorder marked by obstruction of conducting airways of the lung. AIRWAY OBSTRUCTION may be acute, chronic, intermittent, or persistent. Obstructive Lung Diseases,Obstructive Pulmonary Diseases,Lung Disease, Obstructive,Obstructive Lung Disease,Obstructive Pulmonary Disease,Pulmonary Disease, Obstructive,Pulmonary Diseases, Obstructive
D010791 Phrenic Nerve The motor nerve of the diaphragm. The phrenic nerve fibers originate in the cervical spinal column (mostly C4) and travel through the cervical plexus to the diaphragm. Nerve, Phrenic,Nerves, Phrenic,Phrenic Nerves
D012129 Respiratory Function Tests Measurement of the various processes involved in the act of respiration: inspiration, expiration, oxygen and carbon dioxide exchange, lung volume and compliance, etc. Lung Function Tests,Pulmonary Function Tests,Function Test, Pulmonary,Function Tests, Pulmonary,Pulmonary Function Test,Test, Pulmonary Function,Tests, Pulmonary Function,Function Test, Lung,Function Test, Respiratory,Function Tests, Lung,Function Tests, Respiratory,Lung Function Test,Respiratory Function Test,Test, Lung Function,Test, Respiratory Function,Tests, Lung Function,Tests, Respiratory Function
D012132 Respiratory Muscles These include the muscles of the DIAPHRAGM and the INTERCOSTAL MUSCLES. Ventilatory Muscles,Respiratory Muscle,Muscle, Respiratory,Muscle, Ventilatory,Muscles, Respiratory,Muscles, Ventilatory,Ventilatory Muscle
D003964 Diaphragm The musculofibrous partition that separates the THORACIC CAVITY from the ABDOMINAL CAVITY. Contraction of the diaphragm increases the volume of the thoracic cavity aiding INHALATION. Respiratory Diaphragm,Diaphragm, Respiratory,Diaphragms,Diaphragms, Respiratory,Respiratory Diaphragms
D004558 Electric Stimulation Use of electric potential or currents to elicit biological responses. Stimulation, Electric,Electrical Stimulation,Electric Stimulations,Electrical Stimulations,Stimulation, Electrical,Stimulations, Electric,Stimulations, Electrical
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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