Reference equations for maximal respiratory pressures in healthy children and adolescents

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dc.contributor.authorBarral Fernández, Margarita
dc.contributor.authorJácome Pumar, María Amalia
dc.contributor.authorSouto-Camba, Sonia
dc.contributor.authorGonzález Doniz, Luz
dc.contributor.authorRamón Belmonte, María Antonia
dc.contributor.authorAmor Barbosa, Marta
dc.contributor.authorArbillaga Etxarri, Ane
dc.contributor.authorMazzucco, Guillermo
dc.contributor.authorBravo Cortés, Pilar
dc.contributor.authorCorral Núñez-Flores, Tamara del
dc.contributor.authorMartín Valero, Rocío
dc.contributor.authorLlorca Cerdà, Carlos
dc.contributor.authorMurcia Lillo, Fabiola
dc.contributor.authorSanchez Santos, José Antonio
dc.contributor.authorFrancín Gallego, Marina
dc.contributor.authorMartín Cortijo, Concepción
dc.contributor.authorGarcía Delgado, Esther
dc.contributor.authorSerrano Veguillas, Cristina
dc.contributor.authorVaras de la Fuente, Ana B.
dc.contributor.authorSan José Herranz, Paula
dc.contributor.authorGonzález Montañez, Carolina
dc.contributor.authorGimeno Santos, Elena
dc.contributor.authorTorres Castro, Rodrigo
dc.contributor.authorFregonezi, Guilherme A.F.
dc.contributor.authorPardàs Peraferrer, Mireia
dc.contributor.authorVilaró, Jordi
dc.contributor.authorFernández Cadenas, Ángeles
dc.contributor.authorRíos Cortés, Antonio Tomás
dc.contributor.authorMoreno Valera, María José
dc.contributor.authorLanger, Daniel
dc.contributor.authorLista Paz, Ana
dc.date.accessioned2026-01-26T08:17:24Z
dc.date.available2026-01-26T08:17:24Z
dc.date.issued2025-09-22
dc.date.updated2026-01-26T08:17:24Z
dc.description.abstractObjectives: Maximal respiratory pressures are key indicators of respiratory muscle strength; however, reference equations and cut-offs to define respiratory muscle weakness are scarce in the European paediatric population. The aim was to create sex-specific reference equations for maximal inspiratory and expiratory pressures (PImax/PEmax) in a large sample of healthy children and to objectively establish cut-offs to define respiratory muscle weakness. Methods: A multicentre cross-sectional study was conducted across 14 Spanish centres. Healthy children aged 6–18 years, stratified by sex and age, were recruited. Maximal respiratory pressures were measured following standardized methodology in accordance with international guidelines. Reference equations were developed through multiple linear regression analyses. Age- and sex specific cut-offs for respiratory muscle weakness were determined using Z-scores ≥ 1.645 standard deviation (SD) below group means. Results: The final sample included 513 subjects (257 boys; 11.5 [SD3.5] years). Reference equations are: (1) PImax: boys = −41.41 + 10.21 * age + 6.26 * body mass index (BMI) − 0.37 * age * BMI; girls = 125.96–0.34 * age − 0.41 * age2 − 5.75 * BMI + 0.63 * age * BMI; (2) PEmax: boys = 20.93 + 5.23 * age + 2.93 * BMI; girls = −12.67 + 11.98 * age − 0.39 * age2 + 2.57 * BMI. Cut-offs for respiratory muscle weakness are higher in boys and increase with age (p < .001). Depending on age, PImax cut-offs range from 46 to 85 cmH2O in boys and from 45 to 68 cmH2O in girls, while PEmax cut-offs span 54–98 cmH2O in boys and 57–85 cmH2O in girls. Conclusions: This study provides new reference equations for PImax and PEmax derived from the largest dataset of normative values in European children and adolescents. It also establishes age-specific cut-offs to define respiratory muscle weakness. These findings will facilitate the identification of respiratory muscle weakness and the selection of candidates for targeted training programmes.en
dc.description.sponsorshipThis work was funded by a research grant from the Spanish Society of Pulmonology and Thoracic Surgery (Sociedad Española de Neumología y Cirugía Torácica, SEPAR, Spain), project 1373/2023,from The Official College of Physiotherapists from Galicia (Colexio Oficial de Fisioterapeutas de Galicia, CoFiGa, Spain) and from The“San Juan de Dios” University School of Nursing and Physical Therapy (Universidad Pontificia de Comillas, Spain)en
dc.identifier.citationBarral-Fernández, M., Jácome Pumar, M. A., Souto-Camba, S., González-Doniz, L., Ramón Belmonte, M. A., Amor-Barbosa, M., Arbillaga-Etxarri, A., Mazzucco, G., Bravo Cortés, P., del Corral, T., Martín-Valero, R., Llorca Cerdà, C., Murcia Lillo, F., Sanchez-Santos, J. A., Francín-Gallego, M., Martín Cortijo, C., García Delgado, E., Serrano Veguillas, C., Varas de la Fuente, A. B., et al. (2025). Reference equations for maximal respiratory pressures in healthy children and adolescents. Archivos de Bronconeumologia. https://doi.org/10.1016/J.ARBRES.2025.09.009
dc.identifier.doi10.1016/J.ARBRES.2025.09.009
dc.identifier.eissn1579-2129
dc.identifier.issn0300-2896
dc.identifier.urihttps://hdl.handle.net/20.500.14454/4857
dc.language.isoeng
dc.publisherSociedad Espanola de Neumologia y Cirugia Toracica (SEPAR)
dc.rights© 2025 The Author(s)
dc.subject.otherMaximal respiratory pressures
dc.subject.otherMuscle strength
dc.subject.otherPaediatrics
dc.subject.otherReference values
dc.subject.otherRespiratory function tests
dc.subject.otherRespiratory muscles
dc.titleReference equations for maximal respiratory pressures in healthy children and adolescentsen
dc.typejournal article
dcterms.accessRightsopen access
oaire.citation.titleArchivos de Bronconeumologia
oaire.licenseConditionhttps://creativecommons.org/licenses/by-nc-nd/4.0/
oaire.versionVoR
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