Reliability of SNIP test and optimal number of maneuvers in 6-11 years healthy children

Marcelino, Ana Aline; Fregonezi, Guilherme; Marques, Layana; Lista-Paz, Ana; Torres‐Castro, Rodrigo; Resqueti, Vanessa

doi:10.1371/journal.pone.0252150

Cited by 4 publications

(6 citation statements)

References 26 publications

(50 reference statements)

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“…They also showed good reliability and reported that 42% of the highest SNIP values were among the 6th and 10th maneuvers; 3% of participants achieved the same performance over 12 maneuvers. Corroborating Lofaso et al [ 7 ] and Marcelino et al [ 28 ], we found that 75% (24 maneuvers) of the highest SNIP values and 69% (22 maneuvers) of the reproducible maneuvers were obtained in the last ten maneuvers. Also, 65% of the highest SNEP values and 62% of the reproducible maneuvers were achieved among the 11th and 20th maneuvers.…”

Section: Discussionsupporting

confidence: 88%

“…Moreover, SNIP is a widely used test [3,10,23], that is recommended to assess individuals with respiratory diseases (e.g., chronic obstructive pulmonary disease and neuromuscular diseases) [24,26]. Other studies confirmed the good reliability of SNIP for assessing healthy adults [25][26][27] and children aged 8 to 11 years [28].…”

Section: Discussionmentioning

confidence: 95%

“…Although most studies presented ten maneuvers as sufficient for obtaining satisfactory results, previous studies predicted that more maneuvers could be required [7]. Marcelino et al PLOS ONE [28] concluded that twelve SNIP maneuvers were enough to obtain the highest peak pressure value in children up to 11 years old. They also showed good reliability and reported that 42% of the highest SNIP values were among the 6th and 10th maneuvers; 3% of participants achieved the same performance over 12 maneuvers.…”

Section: Discussionmentioning

confidence: 99%

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Reliability of maximal respiratory nasal pressure tests in healthy young adults

de Lima,

Resqueti,

Marcelino

et al. 2023

PLoS ONE

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Introduction Sniff nasal inspiratory (SNIP) and expiratory pressure (SNEP) may complement the assessment of respiratory muscle strength. Thus, specifying their reliability is relevant to improving the clinical consistency of both tests. Objective To assess the reliability of SNIP and SNEP in healthy young adults. Methods This cross-sectional study included self-reported healthy aged 18 to 29 years. SNIP was performed using a plug to occlude one nostril, while SNEP was conducted using a facemask. Participants performed 20 SNIP and SNEP maneuvers with 30-second intervals in between. The intraclass correlation coefficient (ICC), standard error of measurement (SEM), and minimum detectable change (MDC) assessed the reliability of SNIP and SNEP. Analyses were conducted between the highest peak pressure and the first reproducible maneuver in men and women. Results The total sample comprised 32 participants: 16 men and 16 women. The ICC, SEM, and MDC for SNIP maneuvers were 0.994 (95%CI 0.988 to 0.997), 1.820 cmH2O, and 5.043 cmH2O, respectively. For SNEP, these parameters were 0.950 (95%CI 0.897 to 0.976), 6.03 cmH2O, and 16.716 cmH2O. The SNIP and SNEP in men showed ICC of 0.992 (95%CI 0.977 to 0.997) and 0.877 (95%CI 0.648 to 0.957), SEM of 2.07 and 7.66 cmH2O, and MDC of 5.74 and 21.23 cmH2O. In women, SNIP and SNEP presented ICC of 0.992 (95%CI 0.977 to 0.997) and 0.957 (95%CI 0.878 to 0.985), SEM of 1.15 and 6.11 cmH2O, and MDC of 3.19 and 16.95 cmH2O. Also, 60% of the highest SNIPs occurred among the 11th and 20th maneuvers in men and women. In men, 55% of the highest SNEPs occurred among the 11th and 20th maneuvers; this value was 50% in women. Conclusion SNIP and SNEP showed excellent reliability. The reliability of SNIP and SNEP in men was good and excellent, respectively, whereas both tests had excellent reliability in women. Also, women reached the highest peak pressure faster than men in both tests.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

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Reliability of maximal respiratory nasal pressure tests in healthy young adults

de Lima,

Resqueti,

Marcelino

et al. 2023

PLoS ONE

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“…Taking this into account and the fact the investigator needed to record the measurement, it would have been difficult to complete this process within an interval less than 30 s. As the present study included only healthy subjects, we cannot conclude whether 30 s is an appropriate rest interval for patients who may be prone to fatigue, such as those with NMDs. However, our findings are supported by the fact that 30 s intervals have previously been used in NMD and lung disease patients, with no adverse events or significant impact on SNIP values reported [ 11 , 19 ] and in healthy children [ 25 ].…”

Section: Discussionsupporting

confidence: 80%

Optimization of sniff nasal inspiratory pressure (SNIP) measurement methodology in healthy subjects

2023

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Background Maximal inspiratory pressure (MIP) is currently the most commonly used measure for respiratory muscle strength (RMS) estimation, however, requires significant effort. Falsely low values are therefore common, especially in fatigue-prone subjects, such as neuromuscular disorder patients. In contrast, sniff nasal inspiratory pressure (SNIP) requires a short, sharp sniff; this is a natural manoeuvre, decreasing required effort. Consequently, it has been suggested that use of SNIP could confirm the accuracy of MIP measurements. However, no recent guidelines regarding the optimal method of SNIP measurement exist, and varied approaches have been described. Objectives We compared SNIP values from three conditions, namely with 30, 60 or 90 s time intervals between repeats, the right (SNIPR) and left (SNIPL) nostril, and the contralateral nostril occluded (SNIPO) or non-occluded (SNIPNO). Additionally, we determined the optimal number of repeats for accurate SNIP measurement. Method 52 healthy subjects (23 males) were recruited for this study, of which a subset of 10 subjects (5 males) completed tests comparing the time interval between repeats. SNIP was measured from functional residual capacity via a probe in one nostril, while MIP was measured from residual volume. Results There was no significant difference in SNIP depending on the interval between repeats (P = 0.98); subjects preferred the 30 s. SNIPO was significantly higher than SNIPNO (P < 0.00001) but SNIPL and SNIPR did not significantly differ (P = 0.60). There was an initial learning effect for the first SNIP test; SNIP did not decline during 80 repeats (P = 0.64). Conclusions We conclude that SNIPO is a more reliable RMS indicator than SNIPNO, as there is reduced risk of RMS underestimation. Allowing subjects to choose which nostril to use is appropriate, as this did not significantly affect SNIP, but may increase ease of performance. We suggest that twenty repeats is sufficient to overcome any learning effect and that fatigue is unlikely after this number of repeats. We believe these results are important in aiding the accurate collection of SNIP reference value data in the healthy population.

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“…The test was carried out in a sitting position, with the use of three to five repetitions for each nostril. The plug was sterilized after use [24,25].…”

Section: Outcome Measuresmentioning

confidence: 99%

Respiratory Muscle Function in Older Adults with Chronic Respiratory Diseases after Pulmonary Rehabilitation in Subterranean Salt Chambers

Mętel,

Kostrzon,

Adamiak

et al. 2023

JCM

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Training the respiratory muscles is a crucial aspect of pulmonary rehabilitation. The purpose of this study was to assess the function of respiratory muscles in older adults both before and after a period of pulmonary rehabilitation and treatment stay within the underground chambers of a salt mine. A total of 50 patients aged 65 years and older with chronic respiratory conditions was enrolled in the study. These participants underwent a 3-week subterranean pulmonary rehabilitation (PR) program in the “Wieliczka” Salt Mine. Levels of sniff nasal inspiratory pressure (SNIP), maximum inspiratory pressure (MIP), and maximum expiratory pressure (MEP) were measured using the MicroRPM both before and after the outpatient PR program conducted 135 m underground. A total of 44 patients with a mean age of 68.8 ± 2.9 years who completed the PR program and tests were included in the analysis. The average changes in the parameters of pulmonary function before and after the PR were: MIP 8.8 cmH2O, MEP 7.1 cmH2O, and SNIP 11.2 cmH2O (for p < 0.05). For patients older than 70 years, beneficial changes were only observed for MEP, which increased by 9.3 cmH2O (for p < 0.05). Speleotherapy combined with pulmonary rehabilitation improves respiratory muscle function in older adults with chronic respiratory diseases, mainly in terms of MEP. Therefore, a greater emphasis on inspiratory muscle training in the rehabilitation program should be considered.

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Reliability of SNIP test and optimal number of maneuvers in 6-11 years healthy children

Cited by 4 publications

References 26 publications

Reliability of maximal respiratory nasal pressure tests in healthy young adults

Reliability of maximal respiratory nasal pressure tests in healthy young adults

Optimization of sniff nasal inspiratory pressure (SNIP) measurement methodology in healthy subjects

Respiratory Muscle Function in Older Adults with Chronic Respiratory Diseases after Pulmonary Rehabilitation in Subterranean Salt Chambers

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