Spirometry is essential for the diagnosis and management of common respiratory diseases. However, its use and quality are low in primary care. An important reason for this is the technical difficulty in performing conventional spirometry. If high-quality spirometry could be performed online, from the pulmonary function laboratory in hospitals, most of the technical problems could be solved. The aim of the present study was to compare spirometries performed online by remote technicians with conventional spirometry.This was a controlled, randomised crossover study of 261 patients referred from primary care centres for pulmonary consultation. They were randomised to undergo either conventional or online spirometry. The technician, located remotely, controlled the spirometer computer. Using a teleconference link, the technician guided the patient through the spirometry. The comparison between conventional and online spirometries was performed on intention to treat and per protocol bases for spirometric values and quality criteria. Agreement between the two spirometric methods was assessed with a Bland-Altman plot. A subpopulation of off-range patients was also characterised. Finally, intra-and interobserver agreement was evaluated using the intraclass correlation coefficient.No clinically significant differences were seen between the online and conventional spirometric values in both the intention to treat and per protocol analyses. The agreement in Bland-Altman analysis was poorer for intention to treat than for the per protocol analysis. The latter had a lower percentage of off-range patients and high agreement to determine abnormal spirometry in the offrange group. Conventional spirometry had a higher percentage of patients with spirometric quality criteria although the quality criteria difference was only 5.9%, when both procedures were the first to start. Very good agreement was found between intra-and interobserver reliability.Spirometry performed online from a hospital can be an adequate alternative to conventional spirometry for primary care centres.

Abstract--The respiratory system has been described as a limiting factor in the performance of athletes. Therefore, the objective of this study was to evaluate the relationship between the respiratory muscle strength (RMS) and aerobic performance of wheelchair basketball players (WCBPs). We evaluated 19 male WCBPs who were divided into two groups: trunk control group (TCG) and without trunk control group (WTCG). All participants underwent a pulmonary function test, evaluation of maximal inspiratory (MIP) and expiratory (MEP) pressures, and an aerobic performance test. The MIP of both groups and the MEP values of TCG exceeded the predicted values for age and gender. No differences were observed in the MIP and aerobic performance between the groups although a difference was observed in the MEP values. Positive correlations were observed between MIP/MEP and the aerobic performance for both groups. These results suggested that the overall RMS of this group of WCBPs fell within or above the predicted values. Hence, the study concluded that RMS can positively influence the aerobic performance of WCBP.