Abstract
Chest wall circumference measurements are common evaluation methods in clinical settings by therapists in order to obtain chest wall mobility. Previous published results have been conflicting, and there is a lot of variability in the method of testing, which needs testing in different conditions. Seventy subjects (25 healthy nonsmokers, 25 healthy smokers, and 20 COPD) aged between 18 and 70 years participated in the study. Upper and lower chest expansion (CE) measurements (2 levels) are performed with cloth inch tape. Intrarater (between day) and interrater (within-day) reliability of CE measurements was evaluated by two examiners. Lung function parameters, forced expiratory volume in first second (FEV1), forced vital capacity (FVC), FEV1/FVC, and vital capacity (VC) were measured using a computerized spirometer (Spiro lab 3). The intrarater reliability for upper and lower CE showed very good agreement with intraclass correlation (ICC) values between 0.90 and 0.93 for upper CE and 0.85 to 0.86 for lower CE. The interrater reliability for upper CE showed good to very good agreement with ICC values ranging between 0.78 and 0.83, and lower CE showed very good agreement with ICC values ranging between 0.82 and 0.84. Upper and lower CE showed a significant and positive correlation with all lung function parameters, with strong correlation with FEV1/FVC (r = 0.68). Upper and lower CE measurements with inch tape showed good intra- and interrater reliability and reproducibility in healthy nonsmokers, healthy smokers, and COPD subjects. Compared to upper, lower CE correlated well with the lung function parameters. Upper and lower CE may be more useful in clinical practice to evaluate chest mobility and to give indirect information on lung function but interpretation with caution is required when considering implementation into clinical setting.
Highlights
Noninvasive methods of monitoring respiratory function have gained increasing interest recently, measures of chest wall movement [1]. e chest wall distortion measurement allows objective assessment of the synchronous and asynchronous behavior of the rib cage during breathing
Associations between chest wall mobility, lung function, have been reported in patients with ankylosing spondylitis and fibromyalgia, there is a paucity of studies on chest wall mobility in healthy smokers and chronic obstructive pulmonary disease (COPD) subjects [19, 25]. erefore, this study investigates the correlation between chest expansion (CE) measurements and lung function measures i.e., forced expiratory volume in first second (FEV1), forced vital capacity (FVC), and FEV1/FVC and vital capacity (VC) obtained from spirometry in healthy nonsmokers, healthy smokers, and patients with COPD
Examiner A had higher intraclass correlation (ICC) values for lower CE (0.86) with a 95% limits of agreements (LOA) of 2.65–2.67 cm. e smallest detectable change (SDC) ranged from 2.24 cm to 3.6 cm, and standard error of measurement (SEM) ranged between 3.90 cm and 4.40 cm (Table 3)
Summary
Noninvasive methods of monitoring respiratory function have gained increasing interest recently, measures of chest wall movement [1]. e chest wall distortion measurement allows objective assessment of the synchronous and asynchronous behavior of the rib cage during breathing. Noninvasive methods of monitoring respiratory function have gained increasing interest recently, measures of chest wall movement [1]. Subjects with respiratory dysfunction may exhibit alterations in chest wall mobility resulting in chest wall stiffness and abnormal chest biomechanics [2]. In diseases such as asthma and chronic obstructive pulmonary disease (COPD), rib cage mobility may be decreased as a result of hyperinflation, airway obstruction, and mechanical disadvantage of the respiratory muscles [3]. Inhaling cigarette smoke causes alterations in airflow resistance and irritation in the airways resulting in alterations in respiratory function [5]. Respiratory function evaluation tests like chest expansion (CE) may indicate deterioration in respiratory function prior to the commencement of clinical symptoms
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