Abstract
Purpose
This study aimed to develop a digital manometer capable of measuring the maximal respiratory pressures at functional residual capacity level—pulmonary volume where the pressures related to the elastic recoil of the respiratory system are minimized—and to validate its functionally in healthy individuals.
Methods
The proposed device was built based on three main components: the hardware, electronic part; the firmware, computational part; and the mechanics, composed of the device housing, connections, and filters used. Also, the software was updated to allow measurements at functional residual capacity. Functional validation was performed with 30 healthy individuals (15 men), aged between 20 and 40 years. The intraclass correlation coefficient (ICC) verified concurrent validity and test-retest reliability reproducibility, and pressures at functional residual capacity were compared to pressures at residual volume and total lung pulmonary capacity, by paired t test.
Results
The developed device met the desired functional and non-functional requirements. The volume calculated from the acquired flow values showed variability of less than 2%. There was total agreement between the expected and obtained pressures. Regarding functional validation, an ICC ≥ 0.84; p < 0.001 was observed for both concurrent validity and test-retest reliability. Measurements at functional residual capacity were significantly lower than measurements performed at residual volume and total lung capacity (p < 0.05).
Conclusion
The TrueForce can be considered a valid and reliable instrument for measures of maximum respiratory pressures performed in the functional residual capacity, and it can be used in clinical trial research.
Similar content being viewed by others
References
Agostoni E, Mead J. Statics behavior of the respiratory system. In: Fenn WO, Rahn H, editors. Handbook of Physiology. Washington: American physiological society; 1964. p. 387–409.
Aldrich TK, Spiro P. Maximal inspiratory pressure: does reproducibility indicate full effort? Thorax. 1995;50:40–3.
ATS/ERS. Statement on respiratory muscle testing. Am J Respir Crit Care Med. 2002;166:518–624.
Cook CD, Mead J, Orzalesi MM. Static volume-pressure characteristics of the respiratory system during maximal efforts. J Appl Physiol. 1964;19:1016–22.
Culver BH, Graham BL, Coates AL, Wanger J, Berry CE, Clarke PK, et al. Recommendations for a standardized pulmonary function report. Am J Respir Crit Care Med. 2017;196:1463–72.
Dimitriadis Z, Kapreli E, Konstantinidou I, Oldham J, Strimpakos N. Test/retest reliability of maximum mouth pressure measurements with the microRPM in healthy volunteers. Respir Care. 2011;56:776–82.
Ferreira EVM. Respiratory muscles: myths and secrets. J Bras Pneumol. 2015;41:107–9.
Flenady T, Dwyer T, Applegarth J. Accurate respiratory rates count: so should you! Australas Emerg Nurs J. 2017;20:45–7.
Graham BL, Steenbruggen I, Miller MR, Barjaktarevic IZ, Cooper BG, Hall GL, et al. Standardization of Spirometry 2019 update. An official American Thoracic Society and European Respiratory Society technical statement. Am J Respir Crit Care Med. 2019;200:e70–88.
Guyton AC, Hall JE. Tratado de Fisiologia Médica. 11th ed. Rio de Janeiro: Elsevier Editora; 2006.
Halliday D, Resnick R, Walker J. Fundamentos de Física: Gravitação, Ondas e Termodinâmica. 10th ed. Rio de Janeiro: LTC; 2016.
Hamnegard CH, Wragg S, Kyroussis D, Aquilina R, Moxham J, Green M. Portable measurement of maximum mouth pressures. Eur Respir J. 1994;7:398–401.
Honeywell. TruStability™ SSC Pressure Sensors. 2020. https://sensing.honeywell.com/sensors/amplified-board-mount-pressure-sensors/TruStability-SSC-series. Accessed 20 Aug 2020.
Jardim JR, Camelier A, Corso SD, Rodrigues JE. Strength and endurance of the respiratory and handgrip muscles after the use of flunisolide in normal subjects. Respir Med. 2007;101:1594–9.
Karvonen MJ, Kental E, Mustala O. The effects of training on heart rate; a longitudinal study. Ann Med Exper Fenn. 1957;35:307–15.
Koch GG. Intraclass correlation coefficient. Encyclopedia of statistical sciences. Hoboken: Wiley; 2006.
Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med. 2016;15:155–63.
Kuratomi Y, Okazaki N, Ishihara T, Arai T, Kira S. Variability of breath-by-breath tidal volume and its characteristics in normal and diseased subjects ventilatory monitoring with electrical impedance pneumography. Jpn J Med. 1985;24:141–9.
Larson JL, Kim MJ. Reliability of maximal inspiratory pressure. Nurs Res. 1987;36:317–9.
Laveneziana P, Albuquerque A, Aliverti A, Babb T, Barreiro E, Dres M, et al. ERS statement on respiratory muscle testing at rest and during exercise. Eur Respir J. 2019;53:1801214.
Linear Technology. LT1512 Product Info. 2020. http://www.linear.com/LT1512. Accessed 4 Jan 2021.
Maillard JO, Burdet L, Van Melle G, Fitting JW. Reproducibility of twitch mouth pressure, sniff nasal inspiratory pressure, and maximal inspiratory pressure. Eur Respir J. 1998;11:901–5.
Miller MR, Lloyd J, Bright P. Recording flow in the first second of a maximal forced expiratory manoeuvre: influence of frequency content. Eur Respir J. 2002;19:530–3.
Pereira C. Diretrizes para Testes de Função Pulmonar: Espirometria. J Bras Pneumol. 2002;28:S1–S82.
Pereira C, Sato T, Rodrigues SC. New reference values for forced spirometry in white adults in Brazil. J Bras Pneumol. 2007;33:397–406.
Pessoa IMBS, Neto MH, Montemezzo D, Silva LAM, Andrade AD, Parreira VF. Predictive equations for respiratory muscle strength according to international and Brazilian guidelines. Braz J Phys Ther. 2014;18:410–8.
Pessoa IMBS, Coelho CM, Mendes LPS, Montemezzo, Pereira DAG, Parreira VF. Comparison of three protocols for measuring the maximal respiratory pressures. Fisioter Mov. 2015;28:31–3.
Rahn H, Otis AB. The pressure-volume diagram of the thorax and lung. Am J Phys. 1946;146:161–78.
Ratnovsky A, Elad D, Halpern P. (2008). Mechanics of respiratory muscles. Respir Physiol Neurobiol. 2008;163:82–9.
Ringqvist T. The ventilatory capacity in healthy subjects. An analysis of causal factors with special reference to the respiratory forces. Scand J Clin Lab Investig Suppl. 1966;88:5–179.
Rohrer F. Der Zusammenhang der Atemkräfte und ihre Abhängigkeit vom Dehnungszustand der Atmungsorgane. Pflugers Arch. 1916;165(8–10):419–44.
Salazar E, Knowles JH. An analysis of pressure-volume characteristics of the lungs. J Appl Physiol. 1964;19:97–104.
Sensirion. SFM3000 - Mass Flow Meter. 2020. https://www.sensirion.com/en/flow-sensors/mass-flow-meters-for-high-precise-measurement-of-gases/low-pressure-drop-mass-flow-meter/. Accessed 20 Ago 2020.
Severino FG, Resqueti VR, Bruno SS, Azevedo IG, Vieira RHG, Fregonezi GAF. Comparison between a national and a foreign manovacuometer for nasal inspiratory pressure measurement. Rev Bras Fis. 2010;14:426–31.
Souza RB. Pressões respiratórias estáticas máximas. J Bras Pneumol. 2002;28:S155–65.
Stewart J. Cálculo Vol. I. 6th ed.. Cengage Learning Edições Ltda. 2010.
STMicroelectronics. STM32F765VI - High-performance and DSP with FPU, ARM Cortex-M7 MCU with 2 Mbytes Flash, 216 MHz CPU, Art Accelerator, L1 cache, SDRAM, DFSDM. 2020. https://www.st.com/en/microcontrollers-microprocessors/stm32f765vi.html. Accessed 20 Aug 2020.
WHO/Europe. Nutrition - Body mass index - BMI. 2020. https://www.euro.who.int/en/health-topics/disease-prevention/nutrition/a-healthy-lifestyle/body-mass-index-bmi. Accessed 20 Aug 2020.
Windisch W, Hennings E, Sorichter S, Hamm H, Criée CP. Peak of plateau maximal inspiratory mouth pressure: which is best? Eur Respir J. 2004;23:708–13.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Pereira, M.C.B., Silveira, B.M.F., Pereira, H.L.A. et al. TrueForce: a new digital manometer to measure maximal respiratory pressures at functional residual capacity. Res. Biomed. Eng. 37, 181–191 (2021). https://doi.org/10.1007/s42600-021-00139-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s42600-021-00139-2