{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T12:02:06Z","timestamp":1780315326340,"version":"3.54.1"},"reference-count":25,"publisher":"European Respiratory Society (ERS)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2000,11,13]]},"published-print":{"date-parts":[[2001,4]]},"abstract":"<jats:p>Expiratory muscle strength is a determinant of cough function. Mouth pressures during a maximal static expiratory effort (<jats:italic>P<\/jats:italic><jats:sub>E,max<\/jats:sub>) are dependent on patient motivation and technique and low values are therefore difficult to interpret. This study hypothesized that a short, sharp and maximal expiration through a narrow aperture, a \u201cwhistle\u201d, might provide a complementary test of expiratory muscle strength.<\/jats:p><jats:p>To obtain a maximal whistle, subjects (27 healthy volunteers and 10 patients with amyotrophic lateral sclerosis) were asked to perform a short, sharp blow as hard as possible, from total lung capacity, through a reversed paediatric inhaler whistle, connected to a flange-type mouthpiece.<\/jats:p><jats:p>In both healthy subjects and patients, whistle mouth pressure (<jats:italic>P<\/jats:italic><jats:sub>mo,W<\/jats:sub>) was closely related to the pressure measured in the oesophagus and stomach during the same manoeuvre. In healthy subjects,<jats:italic>P<\/jats:italic><jats:sub>mo,W<\/jats:sub>and<jats:italic>P<\/jats:italic><jats:sub>E,max<\/jats:sub>correlated with wide limits of agreement, although<jats:italic>P<\/jats:italic><jats:sub>mo,W<\/jats:sub>values were significantly higher than<jats:italic>P<\/jats:italic><jats:sub>E,max<\/jats:sub>(131\u00b131\u2005cmH<jats:sub>2<\/jats:sub>O<jats:italic>versus<\/jats:italic>101\u00b127\u2005cmH<jats:sub>2<\/jats:sub>O, p&lt;0.0001). In patients, it was also found that<jats:italic>P<\/jats:italic><jats:sub>mo,W<\/jats:sub>and<jats:italic>P<\/jats:italic><jats:sub>E,max<\/jats:sub>values were strongly related (r=0.937, p&lt;0.0001). In healthy subjects, the intraclass correlation coefficient and the variation coefficient for<jats:italic>P<\/jats:italic><jats:sub>mo,W<\/jats:sub>repeated measurements were respectively 0.88 and 7.0%. However<jats:italic>P<\/jats:italic><jats:sub>mo,W<\/jats:sub>and<jats:italic>P<\/jats:italic><jats:sub>E,max<\/jats:sub>were always smaller than the gastric pressure generated by a maximal cough.<\/jats:p><jats:p>It is concluded that mouth whistle pressure, a noninvasive, reproducible and simple test, provides a reliable measure of expiratory muscle strength in healthy subjects that is acceptable to patients and can be used in a complementary fashion to maximal static expiratory effort.<\/jats:p>","DOI":"10.1183\/09031936.01.17406880","type":"journal-article","created":{"date-parts":[[2002,10,11]],"date-time":"2002-10-11T18:37:23Z","timestamp":1034361443000},"page":"688-695","source":"Crossref","is-referenced-by-count":17,"title":["Whistle mouth pressure as test of expiratory muscle strength"],"prefix":"10.1183","volume":"17","author":[{"given":"A.","family":"Chetta","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.L.","family":"Harris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.A.","family":"Lyall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.F.","family":"Rafferty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.I.","family":"Polkey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Olivieri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Moxham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2001,4,1]]},"reference":[{"key":"2024101808412086000_17.4.688.1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.158.3.9710072"},{"key":"2024101808412086000_17.4.688.2","doi-asserted-by":"publisher","DOI":"10.1136\/thx.39.7.535"},{"key":"2024101808412086000_17.4.688.3","doi-asserted-by":"publisher","DOI":"10.1136\/thx.50.11.1131"},{"key":"2024101808412086000_17.4.688.4","first-page":"696","volume":"99","year":"1969","journal-title":"Am Rev Respir Dis"},{"key":"2024101808412086000_17.4.688.5","doi-asserted-by":"publisher","DOI":"10.1042\/cs0690091"},{"key":"2024101808412086000_17.4.688.6","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1164\/ajrccm\/138.3.598","volume":"138","year":"1988","journal-title":"Am Rev Respir Dis"},{"key":"2024101808412086000_17.4.688.7","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.150.6.7952632"},{"key":"2024101808412086000_17.4.688.8","doi-asserted-by":"publisher","DOI":"10.1002\/1531-8249(199912)46:6<887::AID-ANA11>3.0.CO;2-L"},{"key":"2024101808412086000_17.4.688.9","doi-asserted-by":"crossref","first-page":"1477","DOI":"10.1152\/jappl.1996.81.4.1477","volume":"81","year":"1996","journal-title":"J Appl Physiol"},{"key":"2024101808412086000_17.4.688.10","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1212\/WNL.24.8.721","volume":"24","year":"1974","journal-title":"Neurology"},{"key":"2024101808412086000_17.4.688.11","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1996.00550020045014"},{"key":"2024101808412086000_17.4.688.12","doi-asserted-by":"publisher","DOI":"10.1183\/09041950.005s1693"},{"key":"2024101808412086000_17.4.688.13","first-page":"8","volume":"18","year":"1966","journal-title":"Scand J Clin Invest"},{"key":"2024101808412086000_17.4.688.14","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1152\/jappl.1964.19.2.207","volume":"19","year":"1964","journal-title":"J Appl Physiol"},{"key":"2024101808412086000_17.4.688.15","doi-asserted-by":"crossref","first-page":"1469","DOI":"10.1152\/jappl.1985.58.5.1469","volume":"58","year":"1985","journal-title":"J Appl Physiol"},{"key":"2024101808412086000_17.4.688.16","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(86)90837-8"},{"key":"2024101808412086000_17.4.688.17","unstructured":"Armitage P, Berry G. 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