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BACKGROUND: Chest wall mobility is often measured in clinical practice, but the correlations between chest wall mobility and respiratory muscle strength and lung volumes are unknown. We investigate the associations between chest wall mobility, axillary and thoracic cirtometry values, respiratory muscle strength (maximum inspiratory pressure and maximum expiratory pressure), and lung volumes (expiratory reserve volume, FEV 1 , inspiratory capacity, FEV 1 /FVC), and the determinants of chest mobility in healthy subjects. METHODS: In 64 healthy subjects we measured inspiratory capacity, FVC, FEV 1 , expiratory reserve volume, maximum inspiratory pressure, and maximum expiratory pressure, and chest wall mobility via axillary and thoracic cirtometry. We used linear regression to evaluate the influence of the measured variables on chest wall mobility. RESULTS: The subjects' mean ؎ SD values were: age 24 ؎ 3 years, axillary cirtometry 6.3 ؎ 2.0 cm, thoracic cirtometry 7.5 ؎ 2.3 cm; maximum inspiratory pressure 90.4 ؎ 10.6% of predicted, maximum expiratory pressure 92.8 ؎ 13.5% of predicted, inspiratory capacity 99.7 ؎ 8.6% of predicted, FVC 101.9 ؎ 10.6% of predicted, FEV 1 98.2 ؎ 10.3% of predicted, expiratory reserve volume 90.9 ؎ 19.9% of predicted. There were significant correlations between axillary cirtometry and FVC (r ‫؍‬ 0.32), FEV 1 (r ‫؍‬ 0.30), maximum inspiratory pressure (r ‫؍‬ 0.48), maximum expiratory pressure (r ‫؍‬ 0.25), and inspiratory capacity (r ‫؍‬ 0.24), and between thoracic cirtometry and FVC (r ‫؍‬ 0.50), FEV 1 (r ‫؍‬ 0.48), maximum inspiratory pressure (r ‫؍‬ 0.46), maximum expiratory pressure (r ‫؍‬ 0.37), inspiratory capacity (r ‫؍‬ 0.39), and expiratory reserve volume (r ‫؍‬ 0.47). In multiple regression analysis the variable that best explained the axillary cirtometry variation was maximum inspiratory pressure (R 2 0.23), and for thoracic cirtometry it was FVC and maximum inspiratory pressure (R 2 0.32). CONCLUSIONS: Chest mobility in healthy subjects is related to respiratory muscle strength and lung function; the higher the axillary cirtometry and thoracic cirtometry values, the greater the maximum inspiratory pressure, maximum expiratory pressure, and lung volumes in healthy subjects.

Previous studies have proposed only one prediction equation for respiratory muscle strength without taking into consideration differences between ages in pediatric population. In addition, those researches were single-center studies. The objective of this study was to establish reference equations for maximal inspiratory pressure (PImax) and maximal expiratory pressure (PEmax) in children and teenagers. In a multicenter study, 450 healthy volunteers were evaluated (aged 6–18yrs). There were included volunteers with normal lung function. We excluded volunteers who could not perform the tests; participated in physical activity more than twice a week; were born prematurely; smokers; chronic respiratory, cardiologic, and/or neurologic diseases; had acute respiratory disease during the prior three weeks. The volunteers were divided into two groups: Group 6–11 (6–11yrs) and Group 12–18 (12–18yrs). PImax and PEmax were measured according to statement. The mean PImax value was 85.6 (95%IC 83.6–87.6 cmH2O), and PEmax 84.6 (95%IC 85.5–86.2 cmH2O). The prediction equations for PImax and PEmax for Group 6–11 were 37.458–0.559 + (age * 3.253) + (BMI * 0.843) + (age * gender * 0.985); and 38.556 + 15.892 + (age * 3.023) + (BMI * 0.579) + (age * gender * 0.881), respectively (R2 = 0.34 and 0.31, P<0.001). The equations for Group 12–18 were 92.472 + (gender * 9.894) + 7.103, (R2 = 0.27, P = 0.006) for PImax; and 68.113 + (gender * 17.022) + 6.46 + (BMI * 0.927), (R2 = 0.34, P<0.0001) for PEmax. This multicenter study determined the respiratory muscle strength prediction equations for children and teenagers.

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HighlightsHome-based pulmonary rehabilitation (HBPR) has been used in several chronic pulmonary obstructive diseases.HBPR has never been investigated in patients with bronchiectasis.Short- and long-term effects of HBPR will be investigated in this population.The study will provide evidence to guide recommendations about HBPR for bronchiectasis.