Sajjadi Elaheh, Mabe Patrick C, Seven Yasin B, Smith Barbara K
Department of Physical Therapy, University of Florida, Gainesville, FL 32610 USA.
Center for Respiratory Research and Rehabilitation, University of Florida, Gainesville, FL 32610 USA.
Cardiopulm Phys Ther J. 2022 Apr;33(2):87-95. doi: 10.1097/cpt.0000000000000183.
The mouthpiece is the standard interface for spirometry tests. Although the use of a mouthpiece can be challenging for patients with orofacial weakness, maintaining a proper seal with a facemask can be an issue for healthy individuals during forceful efforts. We compared respiratory muscle activity and tests using a mouthpiece and facemask in healthy adults to investigate whether they can be used interchangeably.
In this observational study, subjects (n=12) completed forced vital capacity, maximal respiratory pressure, and peak cough flow with a mouthpiece and facemask. Root mean square values of the genioglossus, diaphragm, scalene, and sternocleidomastoid were compared between conditions.
When switching from a mouthpiece to a facemask, significantly higher values were seen for peak cough flow (average bias= -54.36 L/min, p<0.05) and the difference seen with MEP and MIP were clinically significant (average bias: MEP=27.33, MIP=-5.2). Additionally, submental activity was significantly greater when MIP was conducted with a mouthpiece. No significant differences were seen in respiratory muscle activity during resting breathing or spirometry.
There are clinically significant differences with cough and MEP tests and neck muscles are activated differently based on interface. Considering the small sample size, our findings suggest a facemask may be used to complete some PFTs.
咬嘴是肺量计测试的标准接口。尽管对于有口面部肌无力的患者来说，使用咬嘴可能具有挑战性，但在用力时，健康个体使用面罩保持适当密封可能是个问题。我们比较了健康成年人使用咬嘴和面罩时的呼吸肌活动及测试情况，以研究它们是否可以互换使用。
在这项观察性研究中，受试者（n = 12）使用咬嘴和面罩完成用力肺活量、最大呼吸压力和峰值咳嗽流量测试。比较不同条件下颏舌肌、膈肌、斜角肌和胸锁乳突肌的均方根值。
从咬嘴切换到面罩时，峰值咳嗽流量出现显著更高的值（平均偏差 = -54.36 L/分钟，p < 0.05），并且最大呼气压力（MEP）和最大吸气压力（MIP）的差异具有临床意义（平均偏差：MEP = 27.33，MIP = -5.2）。此外，使用咬嘴进行MIP时，颏下活动明显更大。静息呼吸或肺量计测试期间，呼吸肌活动未见显著差异。
咳嗽和MEP测试存在临床显著差异，并且颈部肌肉根据接口的不同而有不同程度地激活。考虑到样本量较小，我们的研究结果表明面罩可用于完成一些肺功能测试（PFT）。
