{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T03:40:27Z","timestamp":1791344427321,"version":"4.3.1"},"reference-count":18,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2015,4,1]],"date-time":"2015-04-01T00:00:00Z","timestamp":1427846400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2015,4]]},"abstract":"\n BACKGROUND:<\/jats:title>\n \n Neuromuscular diseases (NMDs) lead to different weakness patterns, and most patients with NMDs develop respiratory failure. Inspiratory and expiratory muscle strength can be measured by maximum static inspiratory pressure (P\n Imax<\/jats:sub>\n ) and maximum static expiratory pressure (P\n Emax<\/jats:sub>\n ), and the relationship between them has not been well described in healthy subjects and subjects with NMDs. Our aim was to assess expiratory\/inspiratory muscle strength in NMDs and healthy subjects and calculate P\n Emax<\/jats:sub>\n \/P\n Imax<\/jats:sub>\n ratio for these groups.\n <\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n \n Seventy (35 males) subjects with NMDs (amyotrophic lateral sclerosis, myasthenia gravis, and myotonic dystrophy), and 93 (47 males) healthy individuals 20\u201380 y of age were evaluated for anthropometry, pulmonary function, P\n Imax<\/jats:sub>\n , and P\n Emax<\/jats:sub>\n , respectively.\n <\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n \n Healthy individuals showed greater values for P\n Imax<\/jats:sub>\n and P\n Emax<\/jats:sub>\n when compared with subjects with NMDs. P\n Emax<\/jats:sub>\n \/P\n Imax<\/jats:sub>\n ratio for healthy subjects was 1.31 \u00b1 0.26, and P\n Emax<\/jats:sub>\n %\/P\n Imax<\/jats:sub>\n % was 1.04 \u00b1 0.05; for subjects with NMDs, P\n Emax<\/jats:sub>\n \/P\n Imax<\/jats:sub>\n ratio was 1.45 \u00b1 0.65, and P\n Emax<\/jats:sub>\n %\/P\n Imax<\/jats:sub>\n % ratio was 1.42 \u00b1 0.67. We found that P\n Emax<\/jats:sub>\n %\/P\n Imax<\/jats:sub>\n % for myotonic dystrophy was 0.93 \u00b1 0.24, for myasthenia gravis 1.94 \u00b1 0.6, and for amyotrophic lateral sclerosis 1.33 \u00b1 0.62 when we analyzed them separately. All healthy individuals showed higher P\n Emax<\/jats:sub>\n compared with P\n Imax<\/jats:sub>\n . For subjects with NMDs, the impairment of P\n Emax<\/jats:sub>\n and P\n Imax<\/jats:sub>\n is different among the 3 pathologies studied (\n P<\/jats:italic>\n < .001).\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n \n Healthy individuals and subjects with NMDs showed higher P\n Emax<\/jats:sub>\n in comparison to P\n Imax<\/jats:sub>\n regarding the P\n Emax<\/jats:sub>\n \/P\n Imax<\/jats:sub>\n ratio. Based on the ratio, it is possible to state that NMDs show different patterns of respiratory muscle strength loss. P\n Emax<\/jats:sub>\n \/P\n Imax<\/jats:sub>\n ratio is a useful parameter to assess the impairment of respiratory muscles in a patient and to customize rehabilitation and treatment.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.4187\/respcare.03367","type":"journal-article","created":{"date-parts":[[2015,1,14]],"date-time":"2015-01-14T02:26:19Z","timestamp":1421202379000},"page":"533-539","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":22,"title":["Muscle Impairment in Neuromuscular Disease Using an Expiratory\/Inspiratory Pressure Ratio"],"prefix":"10.1177","volume":"60","author":[{"given":"Guilherme","family":"Fregonezi","sequence":"first","affiliation":[{"name":"Physical Therapy Department of Universidade Federal do Rio Grande do Norte, Natal, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid G","family":"Azevedo","sequence":"additional","affiliation":[{"name":"Physical Therapy Department of Universidade Federal do Rio Grande do Norte, Natal, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa R","family":"Resqueti","sequence":"additional","affiliation":[{"name":"Physical Therapy Department of Universidade Federal do Rio Grande do Norte, Natal, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arm\u00e8le D","family":"De Andrade","sequence":"additional","affiliation":[{"name":"Physical Therapy Department of Universidade Federal de Pernambuco, Recife, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucien P","family":"Gualdi","sequence":"additional","affiliation":[{"name":"Physical Therapy Department of Universidade Federal do Rio Grande do Norte, Natal, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Aliverti","sequence":"additional","affiliation":[{"name":"Dipartimento di Elettronica, Informazione e Bioingegneria-Politecnico di Milano, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00e1rio Et","family":"Dourado-Junior","sequence":"additional","affiliation":[{"name":"Hospital Universit\u00e1rio Onofre Lopes\u2013Universidade Federal do Rio Grande do Norte, Natal, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ver\u00f4nica F","family":"Parreira","sequence":"additional","affiliation":[{"name":"Physical Therapy Department of Universidade Federal de Minas Gerais, Belo Horizonte, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2015,4,1]]},"reference":[{"issue":"1","key":"e_1_3_2_2_2","first-page":"51","article-title":"Respiratory management of acute respiratory failure in neuromuscular diseases","volume":"76","author":"Racca F","year":"2010","unstructured":"Racca F, , Del Sorbo L, , Mongini T, , Vianello A, , Ranieri VM. 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