ERS statement on respiratory muscle testing at rest and during exercise.

Assessing respiratory mechanics and muscle function is critical for both clinical practice and research purposes. Several methodological developments over the past two decades have enhanced our understanding of respiratory muscle function and responses to interventions across the spectrum of health and disease. They are especially useful in diagnosing, phenotyping and assessing treatment efficacy in patients with respiratory symptoms and neuromuscular diseases. Considerable research has been undertaken over the past 17 years, since the publication of the previous American Thoracic Society (ATS)/European Respiratory Society (ERS) statement on respiratory muscle testing in 2002. Key advances have been made in the field of mechanics of breathing, respiratory muscle neurophysiology (electromyography, electroencephalography and transcranial magnetic stimulation) and on respiratory muscle imaging (ultrasound, optoelectronic plethysmography and structured light plethysmography). Accordingly, this ERS task force reviewed the field of respiratory muscle testing in health and disease, with particular reference to data obtained since the previous ATS/ERS statement. It summarises the most recent scientific and methodological developments regarding respiratory mechanics and respiratory muscle assessment by addressing the validity, precision, reproducibility, prognostic value and responsiveness to interventions of various methods. A particular emphasis is placed on assessment during exercise, which is a useful condition to stress the respiratory system.
Competing Interests: Conflict of interest: P. Laveneziana reports personal fees from Novartis France and Boehringer France, outside the submitted work. Conflict of interest: A. Albuquerque has nothing to disclose. Conflict of interest: A. Aliverti has a patent optoelectronic plethysmography licensed to BTS Bioengineering. Conflict of interest: T. Babb has nothing to disclose. Conflict of interest: E. Barreiro has nothing to disclose. Conflict of interest: M. Dres reports personal fees for research from Lungpacer, fees for conference accommodation from Pulsion Medical System and Maquet, outside the submitted work. Conflict of interest: B-P. Dubé reports grants and personal fees from Novartis and Roche, personal fees from Boehringer Ingelheim and GSK, outside the submitted work. Conflict of interest: B. Fauroux has nothing to disclose. Conflict of interest: J. Gea has nothing to disclose. Conflict of interest: J.A. Guenette has nothing to disclose. Conflict of interest: A.L. Hudson reports grants from Lung Foundation Australia and Boehringer Ingelheim, during the conduct of the study; grants from Rebecca L. Cooper Foundation, Lung Foundation Australia, Boehringer Ingelheim, National Health and Medical Research Council (Australia) and University of New South Wales, outside the submitted work. Conflict of interest: H-J. Kabitz reports personal fees and non-financial support from Inomed Medizintechnik GmbH, non-financial support from nSpire Health GmbH, during the conduct of the study. Conflict of interest: F. Laghi reports grants from National Institutes of Health, VA Research Service, Liberate Medical LLC and National Science Foundation, outside the submitted work. Conflict of interest: D. Langer has nothing to disclose. Conflict of interest: Y-M. Luo has nothing to disclose. Conflict of interest: J.A. Neder has nothing to disclose. Conflict of interest: D. O'Donnell reports grants and personal fees from AstraZeneca, Boehringer Ingelheim and GlaxoSmithKline, personal fees from Almirall, Novartis and Pfizer, outside the submitted work. Conflict of interest: M.I. Polkey reports personal and institutional payments for consultancy and speaking from Amicus, Genzyme Sanofi and Biomarin, institutional payments for consultancy from Orion, during the conduct of the study. Conflict of interest: R.A. Rabinovich has nothing to disclose. Conflict of interest: A. Rossi has nothing to disclose. Conflict of interest: F. Series has nothing to disclose. Conflict of interest: T. Similowski reports personal fees for advisory board work from Pierre Fabre Médicament, during the conduct of the study; personal fees from AstraZeneca, Boehringer Ingelheim France, GSK, Lungpacer Inc., TEVA, Chiesi and Invacare, personal fees and non-financial support from Novartis, outside the submitted work. Conflict of interest: C.M. Spengler has nothing to disclose. Conflict of interest: I. Vogiatzis has nothing to disclose. Conflict of interest: S. Verges has nothing to disclose.
(Copyright ©ERS 2019.)