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Maximal Inspiratory Pressure (MIP) is considered an effective method to estimate strength of inspiratory muscles, but still leads to false positive diagnosis. Although MIP assessment with unidirectional expiratory valve method has been used in patients undergoing mechanical ventilation, no previous studies investigated the application of this method in subjects without artificial airway.    Objectives  This study aimed to compare the MIP values assessed by standard method (MIP sta ) and by unidirectional expiratory valve method (MIP uni ) in subjects with spontaneous breathing without artificial airway. MIP uni  reproducibility was also evaluated.    Methods  This was a crossover design study, and 31 subjects performed MIP sta  and MIP uni  in a random order. MIP sta  measured MIP maintaining negative pressure for at least one second after forceful expiration. MIP uni  evaluated MIP using a unidirectional expiratory valve attached to a face mask and was conducted by two evaluators (A and B) at two moments (Tests 1 and 2) to determine interobserver and intraobserver reproducibility of MIP values. Intraclass correlation coefficient (ICC [2,1] ) was used to determine intraobserver and interobserver reproducibility.    Results  The mean values for MIP uni  were 14.3% higher (-117.3 ± 24.8 cmH 2 O) than the mean values for MIP sta  (-102.5 ± 23.9 cmH 2 O) (p<0.001). Interobserver reproducibility assessment showed very high correlation for Test 1 (ICC [2,1]  = 0.91), and high correlation for Test 2 (ICC [2,1]  = 0.88). The assessment of the intraobserver reproducibility showed high correlation for evaluator A (ICC [2,1]  = 0.86) and evaluator B (ICC [2,1]  = 0.77).    Conclusions  MIP uni  presented higher values when compared with MIP sta  and proved to be reproducible in subjects with spontaneous breathing without artificial airway.

Unidirectional Expiratory Valve Method to Assess Maximal Inspiratory Pressure in Individuals without Artificial Airway