Diaphragm neuromechanical coupling (NMC), which reflects the efficiency of conversion of neural activation to transdiaphragmatic pressure (P di), is increasingly recognized to be a useful clinical index of diaphragm function and respiratory mechanics in neuromuscular weakness and cardiorespiratory disease. However, the current gold standard assessment of diaphragm NMC requires invasive measurements of P di and crural diaphragm electromyography (oesEMG di), which complicates the measurement of diaphragm NMC in clinical practice. This is the first study to compare invasive measurements of diaphragm NMC (iNMC) using the relationship between P di and oesEMG di , with noninvasive assessment of NMC (nNMC) using surface mechanomyography (sMMG lic) and electromyography (sEMG lic) of lower chest wall inspiratory muscles. Both invasive and noninvasive measurements were recorded in twelve healthy adult subjects during an inspiratory threshold loading protocol. A linear relationship between noninvasive sMMG lic and sEMG lic measurements was found, resulting in little change in nNMC with increasing inspiratory load. By contrast, a curvilinear relationship between invasive P di and oesEMG di measurements was observed, such that there was a progressive increase in iNMC with increasing inspiratory threshold load. Progressive recruitment of lower ribcage muscles, serving to enhance the mechanical advantage of the diaphragm, may explain the more linear relationship between sMMG lic and sEMG lic (both representing lower intercostal plus costal diaphragm activity) than between P di and crural oesEMG di. Noninvasive indices of NMC derived from sEMG lic and sMMG lic may prove to be useful indices of lower chest wall inspiratory muscle NMC, particularly in settings that do not have access to invasive measures of diaphragm function. INDEX TERMS Electromyography, inspiratory threshold loading, mechanomyography, neuromechanical coupling, respiratory muscles. The associate editor coordinating the review of this manuscript and approving it for publication was Venkata Rajesh Pamula .