J Korean Med Sci.  2023 Oct;38(40):e325. 10.3346/jkms.2023.38.e325.

Reference Respiratory Muscle Strength Values and a Prediction Equation Using Physical Functions for Pulmonary Rehabilitation in Korea

• Park TS
• Tak YJ
• Ra Y
• Kim J
• Han SH
• Kim SH
• Shin Y
• Shin MJ
• Kang JH

• KMID: 2546933
• DOI: http://doi.org/10.3346/jkms.2023.38.e325

Abstract

Background
In Korea, tests for evaluating respiratory muscle strength are based on other countries’ clinical experience or standards, which can lead to subjective evaluations. When evaluating respiratory function based on the standards of other countries, several variables, such as the race and cultures of different countries, make it difficult to apply these standards. The purpose of this study was to propose objective respiratory muscle strength standards and predicted values for healthy Korean adults based on age, height, weight, and muscle strength, by measuring maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and peak cough flow (PCF).
Methods
This cross-sectional study analyzed MIP, MEP, and PCF in 360 people, each group comprising 30 adult men and women aged 20–70, diagnosed as healthy after undergoing medical check-ups at a general hospital. Hand grip strength (HGS) and the five times sitto-stand test (FTSST) results were also recorded. Correlations among respiratory muscle strength, participant demographics, and overall muscle strength were evaluated using Pearson’s correlation analysis. The predicted values of respiratory muscle strength were calculated using multiple regression analysis.
Results
Respiratory muscle strength differed from the values reported in studies from other countries. In the entire samples, both MIP and MEP had the highest correlations with peak HGS (r= 0.643, r = 0.693; P < 0.05), while PCF had the highest correlation with forced expiratory volume in 1 s (r = 0.753; P < 0.05). Age, body mass index, peak HGS, and FTSST results were independent variables affecting respiratory muscle strength. A predictive equation for respiratory muscle strength was developed using the multiple regression equation developed in this study.
Conclusion
Respiratory muscle strength index may differ by country. For more accurate diagnoses, standard values for each country are required. This study presents reference values for Korea, and a formula for estimation is proposed when no respiratory muscle strength measurement equipment is available. Trial Registration: Clinical Research Information Service Identifier: KCT0006778

Keyword

Hand Strength; Maximal Respiratory Pressures; Muscle Strength; Pulmonary Ventilation; Respiratory Function Tests; Respiratory Muscles

Figure

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  Fig. 1 Research progress flow.MIP = maximal inspiratory pressure, MEP = maximal expiratory pressure, PCF = peak cough flow, FTSST = five times sit-to-stand test.

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  Fig. 2 Correlation between maximal inspiratory pressure and HGS (A) and FTSST result (B).HGS = hand grip strength, FTSST = five times sit-to-stand test, MIP = maximal inspiratory pressure.

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