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 sixteen years since publication of the previous ATS/ERS statement on respiratory muscle testing in 2002. Key advances were made in the field of mechanics of breathing, respiratory muscle neurophysiology (electromyography, electroencephalography, transcranial magnetic stimulation) and on respiratory muscle imaging (ultrasound, optoelectronic plethysmography, 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 sums up 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.