Barnes Nicola, Walsh Bronagh, Samuel Dinesh
Faculty of Environmental and Life Sciences, University of Southampton, Highfield Campus, Southampton SO17 1BJ, UK.
Geriatrics (Basel). 2020 Sep 21;5(3):59. doi: 10.3390/geriatrics5030059.
Peak inspiratory flow (PIF) is a portable, relatively new method for measuring respiratory function and indirect muscle strength; the feasibility of its routine clinical measurement is unknown. To investigate the acceptability, reliability and short-term stability of PIF, alongside the established measures of peak expiratory flow (PEF) and grip strength in community dwelling case management patients. Patients were tested in a sitting position, initially on two occasions, one week apart; seven patients having repeated measures taken on a further four occasions over a seven-week period. The best of three attempts for all measures were recorded. Reliability was tested using intra-class correlation coefficient (ICC), standard error of measurement (SEM), minimal detectable change (MDC) and Bland-Altman analysis. Eight patients aged 69-91 years (mean age 81.5 ± 7.7 years; 5 males) participated. For between-day reliability using the first two time points, one week apart the ICCs (3,1) were 0.97, 0.98 and 0.99 for PIF, PEF and grip strength respectively; using all five time points resulted in ICCs of 0.92, 0.99 and 0.99 respectively. Bland-Altman plots also illustrated a good level of agreement across days. Feedback on the acceptability of the measures was gathered from patients. PIF, PEF and grip strength showed excellent reliability and acceptability. Whilst excellent reliability was observed over the seven-week period, the occurrence of clinically significant symptoms and adverse events in the presence of unchanging PIF, PEF and grip strength, suggests that the measures may not be suitable to identify patients with multiple health conditions entering a period of acute decline.
吸气峰流速（PIF）是一种用于测量呼吸功能和间接肌肉力量的便携式且相对较新的方法；其在常规临床测量中的可行性尚不清楚。为了研究PIF的可接受性、可靠性和短期稳定性，同时对比社区居家病例管理患者中已确立的呼气峰流速（PEF）和握力测量方法。患者采取坐姿进行测试，最初测试两次，间隔一周；七名患者在七周内又进行了四次重复测量。记录所有测量中三次尝试中的最佳结果。使用组内相关系数（ICC）、测量标准误差（SEM）、最小可检测变化（MDC）和布兰德-奥特曼分析来测试可靠性。八名年龄在69 - 91岁（平均年龄81.5±7.7岁；5名男性）的患者参与了研究。对于使用前两个时间点（间隔一周）的日间可靠性，PIF、PEF和握力的ICC（3,1）分别为0.97、0.98和0.99；使用所有五个时间点时，ICC分别为0.92、0.99和0.99。布兰德-奥特曼图也显示出不同日期之间具有良好的一致性水平。从患者那里收集了关于这些测量方法可接受性的反馈。PIF、PEF和握力显示出极好的可靠性和可接受性。虽然在七周期间观察到了极好的可靠性，但在PIF、PEF和握力不变的情况下出现了具有临床意义的症状和不良事件，这表明这些测量方法可能不适用于识别进入急性衰退期的多种健康状况患者。
