title: Reference values for maximal inspiratory pressure: a systematic review.
abstract: BACKGROUND
  Maximal inspiratory pressure (MIP) is the most commonly used measure to evaluate inspiratory muscle strength. Normative values for MIP vary significantly among studies, which may reflect differences in participant demographics and technique of MIP measurement.
  
  
  OBJECTIVE
  To perform a systematic review with meta-analyses to synthesize MIP values that represent healthy adults.
  
  
  METHODS
  A systematic literature search was conducted using Medline, EMBASE, Cochrane, Cumulative Index to Nursing and Allied Health (CINAHL) and Sport Discus databases. Two reviewers identified and selected articles, and abstracted data. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. A random-effects model was used to calculate overall means and 95% CIs.
  
  
  RESULTS
  Of 22 included articles, MIP data were synthesized according to age group and sex from six reports (n=840) in the meta-analyses. The mean QUADAS score was 3.5 of 7. The age range was between 18 and 83 years (426 men, 414 women). MIP began to decrease with age in the 40 to 60 years age range and continued to fall progressively with age. For the same age group, men tended to have higher MIPs than women. Sensitivity analysis of withdrawing studies from the meta-analysis identified one study that contributed more to heterogeneity in some age groups.
  
  
  CONCLUSIONS
  MIP was higher in men and decreased with age, which was initially apparent in middle age. Several characteristics of participants and MIP technique influence values in healthy individuals.
  
  
  CONCLUSIONS
  The present meta-analysis provides normative MIP values that are reflective of a large sample (n=840) and likely represents the broadest representation of participant characteristics compared with previous reports of normative data.
authors.forename: Isabela M B
authors.initials: IM
authors.lastname: Sclauser Pessoa
authors.forename: Verônica
authors.initials: V
authors.lastname: Franco Parreira
authors.forename: Guilherme A F
authors.initials: GA
authors.lastname: Fregonezi
authors.forename: A William
authors.initials: AW
authors.lastname: Sheel
authors.forename: Frank
authors.initials: F
authors.lastname: Chung
authors.forename: W Darlene
authors.initials: WD
authors.lastname: Reid
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D001239:Inhalation / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology*; D011312:Pressure; D012016:Reference Values; D012132:Respiratory Muscles / Q000502:physiology*; D055815:Young Adult