Journal of Applied Physiology Journal of Applied Physiology
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J Appl Physiol 64: 2215-2219, 1988;
8750-7587/88 $5.00
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Journal of Applied Physiology, Vol 64, Issue 5 2215-2219, Copyright © 1988 by American Physiological Society

ARTICLES

Assessment of maximal expiratory pressure in healthy adults

I. Rubinstein, A. S. Slutsky, A. S. Rebuck, P. A. McClean, R. Boucher, A. Szeinberg and N. Zamel
Department of Medicine, University of Toronto, Ontario, Canada.

Maximal static expiratory pressure developed at the mouth (PEmax) provides a useful clinical index of expiratory muscle function; however, the range of normal values among laboratories shows considerable variation. We examined the hypothesis that the wide variability could be attributable to the differences in technique among laboratories. We measured PEmax at functional residual capacity (PEmax FRC) in 28 healthy subjects using the following five techniques: 1) using a scuba-type mouthpiece with the cheeks supported by the hands ("hands on"), 2) without supporting the cheeks ("no hands"), 3) using a rigid, circular mouthpiece (2.8 cm ID, "tube"), 4) using the scuba-type mouthpiece but with the cheeks supported by an observer ("other hands"), and 5) using a large-bore circular mouthpiece (4.1 cm ID, "new tube"). Mean PEmax FRC obtained with hands on was significantly higher than no-hands and tube methods. PEmax FRC values obtained by the other-hands and new-tube maneuvers were similar to the hands-on maneuver. We conclude that the technique used to measure PEmax FRC can significantly affect the results and suggest that it should be measured using a large-bore circular mouthpiece or a scuba-diving mouthpiece with the cheeks supported.


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