• Paulo Eugênio Silva, Karina Livino de Carvalho, Murillo Frazão, Vinicius Maldaner, Carlos Raphael Daniel, and Mansueto Gomes-Neto.
• Physical Therapy Division, University Hospital of Brasília, Brasília, Brazil, and Health Sciences and Technologies PhD Program, University of Brasília, Brazil. pauloeugenio.bsb@gmail.com.
• Respir Care. 2018 Oct 1; 63 (10): 1231-1238.

BackgroundInspiratory muscle strength has been considered an important marker of ventilatory capacity and a predictor of global performance. A new tool has become available for dynamically evaluating the maximum inspiratory pressure (the S-Index). However, the proper assessment of this parameter needs to be determined. Thus, the aim of the present study was to investigate the number of inspiratory maneuvers necessary to reach a maximum and reliable S-Index and the influence of inspiratory muscle warm-up on this assessment.MethodWe performed a retrospective study from the database of 432 healthy subjects who underwent S-Index tests and inspiratory muscle warm-up or sham. The effect of repeated maneuvers on the S-Index and the impact of inspiratory muscle warm-up were analyzed by using the intraclass correlation coefficient and unpaired t test.ResultsWe analyzed 81 subjects, (55% men), mean ± SD age 38.1 ± 9.6 y, 43 subjects in the inspiratory muscle warm-up group. Maximum and reliable S-Indexes were reached at the eighth maneuver in both groups preceding inspiratory muscle warm-up or sham, 102 cm H2O (95% CI 95-109 cm H2O); intraclass correlation coefficient 0.96; P < .001. Only the inspiratory muscle warm-up group presented a significant increase in the S-Index after warm-up, 13.5 cm H2O (95% CI 10-17), P < .001.ConclusionsEight maneuvers were necessary to reach maximum and reliable values of the S-Index preceding inspiratory muscle warm-up or sham. Moreover, inspiratory muscle warm-up preceding S-Index assessment improved inspiratory muscle performance.Copyright © 2018 by Daedalus Enterprises.

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